Not that long ago, employers who put low-fat snacks in the vending machines and banished smokers to the loading docks might have considered themselves health-conscious.
Then came company workout rooms, smoking cessation programs and pedometers for office walking competitions — all efforts to keep employees healthy and insurance claims down.
Now, large Tampa Bay employers — from municipalities to Raymond James Financial to BayCare Health System — have taken the biggest step yet to control their health care costs:
Bringing doctors to work.
Over the last two years, several local employers have opened worksite health centers that offer a wide range of services.
Workers can see a doctor or nurse practitioner at these centers for everything from an annual checkup to blood draws to immunizations to prescription drugs. They can get an ache checked out or learn to manage their diabetes.
Depending on their employers' plans, patients owe either nothing or very small co-pays on their visits and medications. Some employers allow dependents and retirees to use the clinics.
Employers say they hope the clinics, which are open during working hours, can help save money on claims and reduce absenteeism.
Workers can continue to see their own doctors if they don't want to use the clinics, alleviating possible fears of employers controlling employees' health care choices or concerns over privacy.
"It's been so well received here," said Elizabeth Trofi, benefits administrator at Raymond James, which opened a center at its Carillon location in February 2012. "I think convenience is a big key."
Employers typically pay a flat fee to a vendor that specializes in running the clinics. Clearwater paid Oklahoma-based Care ATC about $1.4 million to run its clinic last year. Tampa pays Care ATC $2.9 million to operate its two clinics.
It's too early to tell if the centers will save money. Employer-based wellness programs, in general, have had mixed results. But some Tampa Bay employers say they are seeing some promising impact.
By comparing the cost of visits to the clinic with visits to a private doctor, the city of Clearwater estimates it saved $2 million in the first year. The city of Tampa says its health care costs have risen around 5 percent over the last two years. That's about half the average growth rate, employee relations director Kimberly Crum said. Health care spending in general has been down during the recession.
But employee health centers can also cause tension with local providers. Tarpon Springs commissioners this month approved a plan to open an employee medical clinic over the opposition of Florida Hospital North Pinellas, whose chief executive officer said his facility could offer comparable benefits and spare taxpayers the expense of a clinic.
Larry Boress, executive director of the newly formed National Association of Worksite Health Centers, said his group has identified close to 1,000 large, self-insured employers who provide some level of on-site primary care.
About 60 percent of employers hire a contractor to do the work, deciding they lack the expertise to run the centers or want to keep a bright line between an employee's boss and health care.
Boress noted that most employers use the phrase "wellness center" rather than "clinic," which may carry negative connotations. (Disney World calls its facility the "Center for Living Well.")
BayCare, the Tampa Bay area's largest hospital group, opened two employee centers last month, one on the Morton Plant campus in Clearwater and the other at St. Joseph's in Tampa. The not-for-profit system, which has 30,000 people on its insurance plan, pays an outside administrator, though clinic staff are BayCare employees.
Chief executive officer Steve Mason said BayCare leaders decided it was time to provide employees the early interventions that can save in the long run. For instance, learning to manage diabetes early prevents it from becoming a huge — and life-threatening — expense later on.
"We know the cost of health care is too high," he said. "We think we've got a responsibility to lead the way on that."
At the same time, millions of Americans are poised to get health insurance in 2014 — and seek medical help — under the Affordable Care Act. Experts have warned this will likely mean a worsening shortage of primary care doctors, another reason employers may become more interested in worksite clinics to ensure their staff can see a physician, Boress said.
Effrem Green, a Tampa solid waste worker and union president, said he has been satisfied with the care he received at the city's health centers. He's gone in for a check-up and knee pain.
Had he gone to a private doctor, he would have owed a $40 co-pay for each visit. His trips to the workplace clinics were free.
"With the way health care is right now," Green said, "I think we're blessed."
Jodie Tillman can be reached at firstname.lastname@example.org or (813) 226-3374.