On-site clinic improves health odds at casino
ER visits avoided, preventive health provided
For more than two years, an on-site medical facility at the Mohegan Sun Casino in Uncasville, CT, has helped employees avoid costly trips to the emergency room while providing vital treatment for work-related injuries and illnesses.
The 750-square foot facility, operated by Industrial Health Care Company (IHC), of Windsor, CT, is a "24-7" operation within the grounds of the casino. It is staffed by either a physician or a PA and a clerical employee at all times, providing basic first aid, suturing, and the removal of foreign bodies from workers’ eyes, as well as screening for tuberculosis and Hepatitis A and B, and immunizations to protect workers from exposures on the job.
Backing up this facility is a 10,000-square foot IHC occupational health clinic about five miles from the casino in Norwich, staffed by physicians and PA’s and physical and occupational therapists. "It is a full-service occupational health facility licensed by state of Connecticut," notes Jeffrey A. Berkman, MD, CEO and medical director of IHC.
The casino is owned by the Mohegan tribe, which in turn contracted with Sun International to manage and operate the casino. The IHC facility is available not only to casino employees, but to tribal members as well.
Recognizing a good thing
The Perini Building Company, which has been retained to construct a $900 million expansion of the casino, knows a good thing when it sees it, and has chosen IHC as the first-aid provider for the 4,000 workers who will be building a 37-story hotel, conference center, and an expansion of the current gaming area.
"We’ve done this kind of thing before," says Stephen Almony, safety manager for Perini. "It enables our employees to get professional treatment the minute they get hurt; they just report to the first-aid station and then they’re ready to go back to work. If they had to go to the ER, someone would need to accompany them and you’d have more than one person off the work site." The on-site facility, located in a trailer, will provide construction workers, plumbers, and electricians with first-aid, immunization, and drug-screening services.
Almony has tracked first-aid costs on other jobs. "At our last work site, we had a technician who could treat wounds but couldn’t do eye washes, and we had to pay $350 to send a worker to the ER. So, when we contracted with IHC, we asked them to make sure their nurse can do eye washes."
Drug testing is another costly issue. "Elsewhere, I’ve paid $37 per person," Almony notes. "Here, the same nurse who does first aid does sampling, which cuts my cost by $10 a person. With maybe 4,000 workers on site, that really adds up."
Finally, says Almony, IHC’s network of providers is a real plus. "It helps to have the backup of somebody who can put together a PPO system," he says. "Here, we have an IHC clinic down the street, and they provide the transportation — which is fantastic. On other sites where we don’t have a nearby clinic, we have to go out and find medical providers. As an employer, we need someone who knows the business and can go out and get a panel of doctors for you at reasonable price."
"Thus far, the majority of work-related injuries have been first-aid only — cuts, scrapes, something in the eye," notes Berkman. "Workers are evaluated at the first-aid station, and we have a van that comes and transports them to the Norwich facility if they need X-rays, sutures, or physical therapy. "
Who needs on-site services?
On-site first-aid facilities are most cost-effective for larger companies, says Berkman.
"For companies with 500 employees or less, it’s very unusual to see an on-site facility, because the cost-benefit analysis would not work out," he explains. "Your typical injury rate is less than 8%; so if you have under 500 employees, that’s three injuries a month — which just doesn’t pay. Once you get to 2,500 and above, we’ve found that having the ability to provide services for both prevention and treatment not only makes sense economically, but it keeps people in the workplace. We have found that when employees see their employers have gone out of their way to provide these services, they’re looked at as a benefit."
There are a number of different ways in which IHC bills for its services. "In some cases, it can be fee for service, and the insurance company is billed for everything. Or, there can be a facility charge, where the employer pays for our staff, equipment facility, regardless of how many people we see," Berkman explains. "Most companies would pursue the facility charge, because they want to know what their costs are up front."
How much can on-site facilities save employers? "At the Mohegan Sun Casino, they have probably realized a 75% to 85% savings in health care expenses," Berkman estimates. "No. 1, medical treatment is included in the facility charge, and a large number of employees who would have gone to doctors have gotten their medical treatment on site. Then, you have to factor in lost wages, replacement costs, and absenteeism costs you would have incurred by having an employee go off site for treatment, instead of walking down the hall, getting the help they need, and going right back to work."
The Mohegun Sun site has reaped an added benefit, Berkman reports. "Now, they’re getting into the prevention and wellness side of health care," he says. "The health station represents a place people can go to learn about stress, weight loss, and healthy behavior by picking up printed materials."
[For more information about IHC and on-site first-aid facilities, contact: Carol Attas, IHC, 1060 Day Hill Road, Windsor, CT 06095. Telephone: (860) 688 4800, ext. 7111.]
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