Nashville's in-school clinics for teachers and their families are successfully reducing health care costs. According to a new study led by the nonprofit RAND Corporation, primary care delivered within Metro Schools saves more than $700 a year for every teacher who uses it.
In 2009, the district established five clinics staffed by Vanderbilt nurse practitioners. For those who used the clinics for their family's primary care, the study found the biggest savings was from avoiding costly hospital stays. And they didn't overuse the clinics either. There was also some savings in pharmaceuticals, according to the study published in the Journal of Occupational and Environmental Medicine.
Senior author Harry Liu says one advantage of the worksite care is that nurse practitioners are on salary and not under pressure to see more patients. They're paid directly by the teacher's insurance plan.
"The providers there, they spend much more time with teachers than a community-based primary care provider," he says.
Liu's team did look at whether having a worksite clinic drove down teacher absenteeism, but they found no significant change. There also wasn't much correlation with student test scores. And their self-reported health was no different than those who used an outside doctor.
According to RAND, nearly a quarter of all workplaces with 1,000 employees or more now have a dedicated clinic, but the study of Metro Schools is one of few to find a decrease in health care costs. The district has embraced the concept to the point of building a free-standing fitness center, walk-in clinic and full-service pharmacy in 2017.