Are company clinics becoming fashionable again?

More than 250 of the nation's 1000 largest employers are expected to offer some form of onsite primary care or preventative health services by year's end. According to healthcare specialist David Beech of the Watson Wyatt benefits consulting firm, large-scale employers such as Toyota, Pepsi, Sprint and Florida Power and Light, all of whom have recently opened or expanded onsite clinics, expect to recover millions of dollars in premiums and lost productivity. In many instances, the new centers offer the same primary care or urgent services employees can receive at their doctor's offices, often for little or no out-of-pocket expense. Toyota recently opened a 20,000-square-foot medical center at its truck assembly plant in San Antonio, the largest onsite primary care clinic to date. The $9 million facility is available to more than 4,000 Toyota employees and suppliers and features two full-time doctors, a part-time physician, a blood-test lab and an X-ray center.

Large health insurers, such as Cigna and Aetna, are closely watching these developments, and studying ways to "partner" with the employers and clinic providers to ensure patients' medical needs are met, and to integrate their own programs, such as disease management, with employers' onsite wellness programs.