A recent survey reveals employee virtual care visits increased in 2021; employer health centers have been a vital resource during COVID-19; and employers are seeing a positive return.

While COVID-19 impeded traditional healthcare models, employer health centers transitioned seamlessly to virtual offerings, served as trusted partners for guiding pandemic task forces, and remained a top health and benefits strategy, according to a 2021 survey released by the National Association of Worksite Health Centers (NAWHC) and Mercer.

“Less than 1% of employers decreased their number of clinics or shut down due to COVID, and employee utilization remained mostly unchanged,” says Larry Boress, Executive Director of NAWHC. “The value of these centers was clearly not just recognized, but treasured by employees during these difficult times.”

For the 2021 report, NAWHC and Mercer worked with leading clinic management providers to survey organizations ranging from 30 to 30,000 employees about the current state and emerging trends of the healthcare industry.

1. Health centers lead COVID-19 task forces 

Rather than turning elsewhere for guidance on testing, virtual care infrastructure, and COVID-related safety measures, employers leveraged their in-house provider teams as valued advisors to guide their pandemic task forces.

“Clinic providers became cornerstones of COVID-19 task forces, monitoring and translating news, statistics, and medical information,” the report states. “In many cases, health center resources helped develop protocols, work-flows, and return-to-work playbooks.”

According to the 2021 survey of employer-sponsored health centers:

  • 89% offered employee virtual care
  • 66% provided COVID testing
  • 42% administered vaccines
  • 18% managed contact tracing

“People really want to know they’ve got a trusted advocate in their court,” says Jeff Shea, Executive Vice President and Managing Director, National Practice Leader at Marathon Health. “At the beginning of the pandemic, people had questions and no one knew anything about COVID. We made over a quarter of a million outreach calls as soon as the pandemic hit, just to check on people.”

2. Employee virtual care grows significantly, expands services

Employee virtual care grew significantly in 2021, with 78% of worksite health centers offering virtual visits — a 57% increase since 2018. Employers also expanded the scope of virtual services beyond acute visits, with 54% of employers offering chronic condition management virtually, and 30% providing behavioral health services.

The survey notes how the employer-sponsored virtual model fosters a “closer connection between patient and provider,” mentioning that “clinic staff typically have access to the full patient history and medical information, allowing for more holistic treatment, tracking of prescriptions, and follow-up.”

“In a typical telehealth or virtual care offering, the results are completely fragmented from the healthcare system. Nobody shares the records,” Boress says. “But in the case of the employer health center, the results of those calls are fed back into the patient’s medical records, so you have that continuity of care. The last thing you want is another fragmentation of the health system.”

3. 86% of employers see a positive ROI on their health center investment

Of the employers that monitor ROI, almost 90% saw a positive return on investment, according to the 2021 report. In fact, 43% of respondents reported an ROI of 1.5:1, meaning that for every $1 invested in their employee health centers, they saved $1.50 or more. Additionally, 31% of employers noted an ROI of 2:1 or higher, and 12% reported 3:1 or higher.

4. Worksite clinics account for less than 10% of total healthcare spending

The survey asked employers to report the operating costs of their full health center investment as a percentage of total annual healthcare spending. Sixty-five percent of employers said their clinics accounted for between 2% and 10% of spending, with 14% reporting less than 2% of total spending on healthcare.

“If an employer deploys a high-engagement, high-efficacy clinic model and they reduce specialty spend by 20%, ER spend by 20%, and they optimize how people utilize urgent and primary care, it often doesn’t cost them a dime,” Shea says. “Because that current spend is going to fund the onsite health center, and then some.”

5. Employers increasingly let employees select the health center as their PCP

Employers increasingly allow members to select the health center as their primary care provider, with the report showing 71% of respondents now give employees the option, up from 49% in NAWHC’s 2015 survey.

Shea says that increase comes from word-of-mouth referrals, phenomenal patient experiences, and health centers offering more comprehensive services like chronic condition management, physical therapy, and behavioral health support.

“It’s continual employee and spousal feedback saying, ‘That was the greatest healthcare experience I’ve ever had. They had the time, they had the talent, they had the tools, and they really understood where I was on my journey, and met me where I am,’” Shea says.


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