ER visits fall after Dayton opened clinic for employees

Emergency room visits by city of Dayton workers and their family members have plunged since the city opened an off-site health and wellness center that is the only one of its kind in the state.

City Hall estimates that the clinic have helped their medical plan avoid almost $1 million in ER costs in the last three years because patients instead are choosing to go to the clinic. The clinic is a less expensive way to access health care services than the ER or urgent care, said Kenneth Couch, Dayton's director of human resources.

“Our stats are that every time a city employee or someone covered by our health plan walks through the emergency room doors, it’s about $1,500 — minimum,” Couch said.

The city has recently approved new contracts with the clinic’s manager and operator that will expand services so that the clinic staff will now treat occupational injuries.

MORE: High-dollar medical claims hurt Dayton’s budget

This month, Dayton City Commissioners approved a contract worth more than $6 million with Healthstat Inc. to continue operating its off-site health and wellness center through the end of 2024.

Commissioners also approved a three-year contract with the company, with a couple of one-year renewal options, that will add new services, at a total cost of nearly $2.4 million.

The off-site clinic, which was dedicated in late 2016, has been a success because it has helped control health care costs by reducing unnecessary and excessive ER and urgent care visits, city staff said.

The clinic provides health and wellness service for “medically homeless” workers and their family members. Those are people who do not have primary physicians and were going to the ER and urgent care for non-emergency medical needs, city officials said.

“A lot of times when we have situations where individuals feel like they have to go to the emergency (room) — this provides an opportunity for them not to do that,” said Dayton City Commissioner Jeffrey Mims Jr. “That’s a big savings for us.”

The city’s seen an increase in ER visit costs, even though visits have declined, which city officials suggest shows that the people going to the ER actually need its services, Couch said.

The city’s health care plan recorded 950 ER patients in 2018, down more than 28 percent from 2016. Urgent care patients decreased by 32 percent during that time.

Couch said he believes Dayton’s center at 1222 S. Patterson Blvd., in the Wright Health Building, remains the only off-site government medical clinic in the state of Ohio.

MORE: Dayton plans health, wellness center for employees

About 72 percent of employees have visited the health and wellness clinic, and more than a quarter of their spouses have done the same, Couch said.

“Employees seem to love it,” Couch said.

The city recently hired a chronic condition manager who is a registered dietitian to work with employees and patients to try to get them to adopt healthier lifestyle habits, he said.

High-cost chronic conditions are the main driver of the city’s increased health care costs, he said. Last year, this newspaper reported that about 20 city employees submitted claims that together cost about $4.4 million.

Between April 2016 and April 2019, the clinic has helped the city avoid about $960,000 in ER claims, $233,000 in office visits and $28,000 in urgent care claims, Couch said.

“For every dollar we spend on the DOC (the clinic), there is a $1.13 we don’t spend on Anthem,” Couch said.

The city has taken other measures to try to control health care costs as well. This summer, the city changed its policies and no longer will hire smokers and job applicants who test positive for tobacco or nicotine.

The city said employees who smoke on average cost an additional $6,000 annually in direct medical costs and lost productivity.

MORE: Dayton stops hiring smokers, vapers; union worries about ‘slippery slope’

Healthstat also will expand services at the center to include x-ray and occupational health services for workers who sustain on-the-job injuries.

The clinic plans to have a full-time doctor and two part-time nurse practitioners. Currently, the center only has one clinician who works 40 hours per week.

“This is very exciting — the DOC is awesome — and I’m glad that so many people are using it,” said Dayton Mayor Nan Whaley. “We hope that more spouses use it in coming years.”

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