Large employers, especially manufacturing operations, have hadonsite nurses and doctors available to their workers for years. Butnow health clinics and coaches are becoming an increasingly commonsight at employers of all kinds and sizes.

The trend has proven to be a win-win for all involved, boosting,among other things, “patient engagement,” the term for how activelypeople address their health issues and how well they followdoctors' orders.

As a consequence, health care costs are dropping andproductivity is increasing at workplaces where these efforts areunderway.

These clinics are staffed by nurses, dieticians and exercisespecialists, among others. Ill employees can make appointments andjust swing in for a consultation. Onsite health centers can offerprimary care, occupational services, a pharmacy, diseasemanagement, X-rays and wellness services. Copays are oftenespecially low, screenings are free and employees can get more timewith a physician.

According to a 2013 survey by the National Business Group onHealth, 44 percent of large employers have onsite clinics, and 9percent were thinking about adding them.

Where clinics aren't popping up, coaching is. Estimates are thatwell over 30 percent of U.S. companies now offer a consumer-drivenhealth plan that includes health coaching in some fashion.

Marriott International has had clinics and has hired coaches fora few years now. The results in some areas are dramatic. Forexample, it saw a 12 percent reduction in ER visits between 2011and 2012 in its Chicago market.

“Anytime you can make access to health care easier, as easy aspossible, make it convenient, you want to take advantage of thatopportunity,” says Rick Morrow, Marriott's director of benefitstrategies.

The hotel chain began to roll out its program in 2010. Now mostof its larger properties have a coaching system in place. “Thebiggest challenge was getting the employees connected and engagedwith the coaches,” says Morrow.

Marriott first used telephonic health coaches. Employees weremore reluctant to participate with a distant, faceless expert. Asthe company added in-house medical professionals, employees beganto warm up to the concept.

Marriott tracked employee engagement with coaches at a mere 10to 12 percent when it relied on phone consultations. With on-sitecoaches, engagement reached 60-70 percent.

“At the end of the day,” said Morrow, “we learned that justhaving a warm face-to-face encounter to talk about a very personalmatter was the solution to increasing the effectiveness of thehealth coaches.”Marriott's largest properties include a smallhealth clinic either onsite, or nearby, where doctors ornurse-practitioners see patients and prescribe medicine.

Marriott has clinics at its premier, high-volume locations ofOrlando, Florida, Nashville's Opryland and New York's TimesSquare. In these cases, the hotel chain partners withestablished local health entities, for example Vanderbilt Health inNashville and Mount Sanai Hospital in New York.

In smaller markets and in suburban settings, Marriott connectsits associates with mini-clinics with extended hours at area CVSpharmacies.

Where two or three smaller hotels are in close proximity, theyshare a coach.

Every full-time Marriott employee is covered under its plan andcoaches' advice is free. Dependents are generally covered and takeadvantage of the program as well.

Coaching, of course, can lead to prevention of health problemsas well as early detection of serious illness. But the benefits aremore immediate, employers have found.

A basic doctor's office visit can consume a half-day of work. Anin-house consultation can be a 20-minute encounter before lunch. Byone account, health coaching typically leads to 20 percent fewersurgeries, 20 to 30 percent fewer doctor visits, and 20 to 30percent fewer hospital admissions.

In comparing results at properties with health coaches and thosewithout, Marriott has found a 1 to 2 percent difference in overallhealth care costs.

Morrow acknowledges these are small numbers, but he has everyreason to believe that that differential will increase.

“It's something we want to continue,” he said. “Becauseemployees value it and talk about how much they value it.”

BenefitsPro