Written by Amanda Gaines for Inside Healthcare

In 1986, seven US states had an adult obesity rate between 10% and 14%. No states averaged beyond 15%. In 2006, only one state remained in the 10% to 14% range; three ranged between 15% and 19%. As for the other 46 states? Their adult obesity rates averaged more than 20%.

Recent studies have shown that, given the rise of disease conditions inherent to obesity, the next generation may have a shorter life expectancy than the generations that came before. The facts are scary enough for the general population, but consider the impact it’s having on the cost of health insurance.

As health insurance costs rise, employers have tried to cost shift to their employees with higher premiums, higher co-pays, higher costs for prescriptions, etc. But in the last five years, the annual price of health insurance has doubled from roughly $1,600 to $3,500. For the average worker, health insurance is almost unaffordable. That’s where Texas-based Concentra comes into play.

“As a nation, we’re producing disease at alarming rates in our country,” said Jim Greenwood, CEO. “We’ve got to do something to stem the tide of disease.”

Strategic divestiture

Concentra began in 1979 when it opened its first medical center in Amarillo, Texas. Within the first year, the company’s employer customer base noticed the impact the center was having on reducing their workers’ compensation (WC) costs. The employers asked the founding physicians, one of whom remains with Concentra as its chief medical officer, to expand the model to other cities where they had additional concentrations of employees.

Today, Concentra has 324 medical centers across 40 states and in 90 major metropolitan areas. According to Greenwood, the company now treats more than 10% of the work-related injuries in the US.

“Our medical centers include physicians and physical therapists, and we have relationships with more than 100,000 employers,” he said. “We started as a clinic-based company delivering healthcare services, but, in the late ’90s, we merged with another public company in WC managed care and expanded into performing services on behalf of group health carriers.”

In 2007, the company divested its WC managed care business to Coventry Health and renewed its focus on its medical center business. “It’s all about helping people get healthier and improving the productivity of America’s workforce by getting workers back to work promptly,” said Greenwood.

After the divestiture, Concentra again responded to its employer clients by adding urgent care services to its medical centers. Historically, the centers handled only occupational medical issues such as physical exams, drug tests, or on-the-job injuries. But problems with overcrowded EDs and limited access to primary care physicians have grown in recent years. By giving those centers urgent care capabilities, both employees and their families have access to convenient, affordable treatment of a wider range of health issues.

“We saw a real opportunity to better serve the areas where our clinics are located,” said Greenwood, “both for the employees and the employers. We have roughly 700 physicians working in our medical centers, and now we’re fully using their expertise.”

The medical centers are also attractive for physicians as Concentra handles the staffing, the space, the equipment, and the billing. Physicians are able to come to work and do what they went to medical school to do—treat patients. And because Concentra has clusters of centers in any given market, physicians’ weekend or after-hours on-call schedules are minimal.

TotalCare

After the 2007 divestiture of its WC managed care business, the company also developed its Health Solutions business segment in which medical and physical therapy providers are placed in the workplace episodically or in the form of a full-scale clinic. In addition to its 324 medical centers, the company now has 280 employer “onsites” that directly help employers lower medical benefit costs while promoting good health practices for their workforce.

“More and more employers are realizing the fact that they have to take action to improve the health of their employees,” said Greenwood. “Of our 280 employer onsites, we’re delivering some form of wellness and/or health improvement programs to more than 50%.”

The nurses and physicians who staff these onsites work with employees injured both on and off the job who might otherwise need short-term disability, but that’s not the extent of their services. From group health benefits to providing health risk assessments and biometric screenings or delivering urgent care and pharmacy services, these medical professionals are actively helping improve the wellness of the workforces they serve.

“We call it TotalCare because it combines primary, preventive, occupational, and environmental health,” said Greenwood. “By working with employers to deliver a tailored solution that’s based on their particular needs, we help them understand where to invest dollars to make a real impact on the health of their workers.”

In recent years, this concept of “total care” has grown in popularity, which Greenwood attributes to employers realizing that cost shifting is no longer an applicable solution to rising healthcare costs. Although the company’s growth is exciting from a business perspective, that’s not exactly the point. Greenwood thinks that if America doesn’t realize the full-scale impact of its worsening health, we’re going to lose more jobs abroad because this situation doesn’t exist in other parts of the world.

“At Concentra, we’re improving the health of America, one patient at a time,” he said. “We’ve been doing it since 1979, but now we’ve expanded the types of patients we can treat and the types of situations we can help solve.”