It was five years ago, and I had just opened up my new office in Boca Raton, FL and a recent patient of mine walked in with a big set of floor plans. Keep in mind; I had tried for three years before cracking the code of getting “on-site” at some local corporations without much success. However, today was my lucky day. The floor plans she possessed were of the elaborate Main Street inside of the new ADT Security Headquarters a mile down the road from my office.
As she opened up the floor plans of Main Street, it was apparent they were going big with their corporate wellness. Picture this cobblestone street lined with different types of stores, services, amenities and palm trees inside of a very large office building. On Main Street was going to be a Starbucks, Fitness Center, Salon, Tech Shop, Primary Care Physician, Massage Therapy and a Chiropractic office. Sign me up I excitedly announced!
Fast forward to today, and we have learned a lot about corporate wellness and how the Chiropractor can integrate themselves into this ever expanding health and wellness field for the corporations and the desk worker. We have expanded our reach into multiple corporations in South Florida and have also developed a digital platform Office Ergonomics Initiative that has been implemented in two large corporations since its inception three months ago.
I want to challenge us as a profession to look outside the box when it pertains to Chiropractic’s role in the corporate wellness movement, or we will get left behind. Traditionally the Chiropractor has participated in health fairs, spinal screenings, and lunch and learned at corporations. Those are fabulous outreach options, but it always ended there. However, as the research starts to reveal our effectiveness and affordability (Optum Health Study “Conservative Spine Care: The State of the Marketplace and Opportunities for Improvement”), we need to integrate ourselves more into the corporate setting.
Too often as Chiropractors, we limit ourselves and fail to think outside the box or have a big vision of what we can do for our practice and the community. The harsh reality of this particular community, the corporate world, is that it is in dire need of health and wellness improvement for the desk workers who are suffering from chronic health issues.
There is a considerable trend towards on-site health services for large corporations, and Chiropractic sees an increasing role in this movement. We have developed on-site Chiropractic clinics at ADT, Tyco, Royal Caribbean, UPM, and The Fiur Organization in South Florida with plans for expansion shortly. On-site chiropractic can be implemented in many different scenarios, based on the companies needs and set-up.
The ideal situation is to have a contracted hourly rate that you charge the employer for the set amount of time you are at the corporation treating the employees. This has many benefits for the company and the chiropractor. First, employee utilization is increased which increases the results of the employee and the return on investment of the company. The December 2010 issue of The Harvard Business Review: “What’s the Hard Return on Employee Wellness Program” reveals a 6:1 ROI, which is a huge win for corporations that successfully implement wellness. Utilization is the key for a successful wellness program of any type.
Secondly, an hourly contracted rate helps your cash flow stream from a source other than the private health insurances. As we all know, insurance reimbursement is getting worse by the year, not better. Diversification of your revenue streams, with low overhead options like on-site care, is instrumental in protecting the long-term health of your business. And yes, your practice is a business, and it needs to be protected.
Lastly, if you can negotiate an hourly contracted rate from the company, it doesn’t matter how big or small the company is since you will be compensated for your time and efforts. Based on the company’s size and budget, you will coordinate the amount of days and hours per week you would be on-site. We have some locations where we are there one time per week for a 2-hour block of time, and others where we are there for three days a week for 4-hour blocks of time each day.
Another option for the on-site care for larger companies is to be in-network with the employee’s insurance plans and bill the insurance and charge the employee the copay. I only recommend this for companies with 300 employees or more and with good insurance benefits. Some in-network plans have large deductibles and high copays which essentially make them akin to cash patients. Utilization in these situations can be low and not worth your time and efforts. We always perform a company needs analysis and audit before presenting our optimal plan for them. This is key to making it a mutually beneficial situation for the chiropractor, employer, and employee. Without all three of those variable working harmoniously, it may be a fruitless effort.
Some of the variables that you need to consider when implementing on-site Chiropractic care at a corporation are the following:
You should always negotiate rent-free space. This may be a treatment room with a full-set up, or a space somewhere discrete with a portable table and laptop. There should be extremely minimal overhead.
How many employees are on-site?
What insurance plans do the employees have?
How many days and hours per week are ideal for on-site care
What other healthcare services are on-site?
Make sure to have proper liability insurance and city/county occupational licenses
Add the location to your malpractice insurance.
Have a detailed internal marketing strategy to education the employees of the benefits of Chiropractic care.
How far is the corporation from your main office?
Will it be you, an associate or independent contractor who will be on-site?
These are most, but not all of the variables, but will lead you down the right path when assessing the viability of an on-site chiropractic clinic at a corporation. As Chiropractors, we are positioned well to help with the health and wellness of the desk worker and decreased the healthcare costs for the employer. This is still a cutting-edge concept and many barriers to work through to achieve a large footprint in this arena. Does the company believe in the ROI of on-site care in general? And if so, do they think Chiropractic is the right option for them? These are the hurdles you need to be prepared to jump when sitting at the table with the wellness director, facilities manager or CEO/COO of a company. Make sure you are prepared for that patient of yours that walks in with a unique opportunity such as on-site care. Lastly, I recommend having discussions with your patients who work for these local corporations and maybe they can get your foot in the door. That has been a valuable tactic for our developing corporate business.