• Reviews the benefits and challenges of on-site healthcare
• Assists employers in determining whether on-site healthcare, direct healthcare contracting, and related benefit re-design is appropriate for their organization
• Defines the terms and phases of employer healthcare purchasing and implementation of on-site solutions
• Provides an ongoing resource for both employers and providers as they continue to develop on-site healthcare services

"If there is one key idea to take from this book it is that the ‘on-site clinic’ is a catalyst that allows all other programming to ‘work better’ and to be more coordinated and internally complementary. … We are buying health care without any clear understanding of how to value health care. We need to take a step back and ask ourselves, as we have with many other production inputs, whether we can simply make it better than we can buy it. …

"Mr. La Penna’s book outlines the many aspects of how to think about an on-site program and how to implement one, once the decision is made. These features alone recommend the book as a valuable reference but there are other parts of the book which address important tangents and support programs which complement the employer sponsored on-site clinic. The underlying premise is that the employer must first start, as Toyota did, with planning and design. Hopefully, this book will give those who are embarking on this process a much needed road map."

—From the Foreword by Ford Brewer, M.D., Medical Director, Toyota Motor Manufacturing of North America

The advent of organizations considering an on-site approach to the delivery of health care services increases in direct proportion to the rising of health care costs. This volume is a how-to manual on the design and implementation of an on-site program and presents the challenges and benefits of such a system. Topics discussed include hospital and specialty contracting; employee choice concerns; cost control; ancillary services such as pharmacy, lab work, physical therapy; workers compensation; quality vs. value analysis; and other considerations. An extended case study follows the implementation of a program from inception to introduction.

1 Introduction: Workplace On-Site Healthcare as a Catalyst for Cost Savings and Improved Productivity
2 Company Planning for Healthcare and Employees’ Participation in the Planning and in the "Plan"
3 The Myth of the Company Doctor
4 Components and Complements to On-Site Healthcare:Planning to Plan
5 The On-Site Program: What and Who Are In and Out? Why?
6 Cost Savings, Cost Avoidance, and Confidence Levels
7 The Quest for a Dependable Return on Investment: Claims Analysis
8 The Quest for a Dependable Return on Investment: Key Assumptions and Drivers
9 The Quest for a Dependable Return on Investment: Benef t and Program Design
10 The Healthcare "Buy": Determine What to Purchase by First Figuring Out What Not to Purchase
11 Electronic Medical Records, Personal Electronic Health
Records, the Medical Home, and the Medical Homeless
12 Legal Issues: Contracting and Regulatory Challenges
13 Working with Hospitals Rather than against Them
14 Utilizing Local Physicians as the Primary Care Anchors
15 Pharmacy, Pharmacy Benefit Managers, and Other Mysteries
16 Employees, Consumerism, and the Illusion of Choice
17 Ambulatory Care Nuts and Bolts: Site Design and Function
18 Workforce and Population Analysis: Prevention, Intervention, Wellness, Disease Management,and the Care Management Team
19 Special Situations and Some Solutions (Middlemen, Brokers, Third-Party Administrators, and Consultants)
20 Working with Vendors: The Request for Proposal and Its Application to the Development Process
21 Political and Functional Barriers to Establishing an On-Site Medical Service
22 Involving Other Businesses as Customers of the On-Site Program
23 The Future of On-Site Services and the On-Site Industry
Appendix A Book References and Interviews
Appendix B Claims Request (Complete Listing)
Appendix C Pro Forma Example
Appendix D On-Site Provider Listing
Appendix E Workplace On-Site Program Consultants and Resources

"If there is one key idea to take from this book it is that the ‘on-site clinic’ is a catalyst that allows all other programming to ‘work better’ and to be more coordinated and internally complementary. … We are buying health care without any clear understanding of how to value health care. We need to take a step back and ask ourselves, as we have with many other production inputs, whether we can simply make it better than we can buy it. …

"Mr. La Penna’s book outlines the many aspects of how to think about an on-site program and how to implement one, once the decision is made. These features alone recommend the book as a valuable reference but there are other parts of the book which address important tangents and support programs which complement the employer sponsored on-site clinic. The underlying premise is that the employer must first start, as Toyota did, with planning and design. Hopefully, this book will give those who are embarking on this process a much needed road map."

—From the Foreword by Ford Brewer, M.D., Medical Director, Toyota Motor Manufacturing of North America