Free medicine

By Anna B. Mitchell  

FEBRUARY 18, 2010 9:58 a.m. (0)

Tony Bell was visiting the clinic he helped set up for Spartanburg County employees recently, and the clinic’s advising physician happened to be there.

“My shoulder has been bothering me forever and a day,” said Bell, sporting a blue canvas arm sling late last week. “He said, ‘Why don’t you get an MRI?’ I hadn’t gotten back to my office before they were calling me to set it up.”

Bell did get an MRI and shortly after received surgery on a right shoulder whose ligaments had been torn severely. Regular, meaningful access to medical personnel is a benefit Bell has wanted to bring to Spartanburg County employees for years as their director of human resources.

That he would benefit personally within the first year of setting up a clinic for them, he said, is another example of how important establishing health and wellness relationships can be – both for the happiness and productivity of workers and the bottom line of an employer facing annual increases in insurance rates.

The county employee health clinic opened in January 2009. The three nurses on staff work on a salary – not for service fees – and care is free to employees, their spouses and dependents 18 and older, and retirees.

Bell estimates the facility on North Church Street has saved the county’s insurer $220,000 in claims – a figure, he said, he plans to bring to the negotiating table when insurance renewals come up later this year.

This also doesn’t include the long-term savings in medical costs he expects due to preventative checkups and early detection – like the man about to have a heart attack who came in for back pain or the one who came to have a spider bite checked only to find out it was a serious bacterial infection.

“You can’t put a price tag on that, but it’s worth every dime we spent on that clinic,” Bell said.

Diabetics come in to get their blood sugar checked regularly; women can get pap smears and pregnancy tests; older men can get a PSA test (for prostate cancer); and people with high blood pressure can get daily checks and a recommendation for medication.

The clinic’s three nurses, on contract for the county from Spartanburg Regional Healthcare System, draw and send blood out for tests – routine but usually an extra cost to insured patients – for free.

“I encountered women who had not gotten pap smears done in years,” said Connie Battleson, the clinic’s nurse practitioner.

With her credentials, Battleson has prescription-writing authority, conducts head-to-toe exams, diagnoses problems, refers patients to specialists and, when able, treats.

The clinic is easy to miss across the street from the Marriott in downtown Spartanburg.

Located in the old public defender’s office, it is a small, square office building dating to the 1960s.

Employees in the county administrative offices and the county courthouse are less than five minutes away, and those who use the clinic are not docked for sick leave.

The program saved the county’s employees about $130,000 in lost wages – that is, hours they would have otherwise had to take away from the job to see a doctor.

“So far we’ve been pretty successful getting people out in 20 or 30 minutes,” Bell said.

The clinic’s budget its first year: $208,000.

Elizabeth Hammond, spokeswoman for Blue Cross Blue Shield of South Carolina, said her company has encouraged large employers to pursue on-site clinics, especially those integrated with their health plan.

Spartanburg County, which uses Blue Choice, has gotten an agreement with the insurer and Spartanburg Regional to share patient files so the clinic nurses will know more about patients as they walk in the door.

Bell said he’s aware of a handful of Spartanburg organizations with their own employee clinics, all staffed by nurses – the city of Spartanburg, Spartanburg Regional Healthcare System and JM Smith Corp.

“I think more and more employers are going to have to take the lead to do something like this,” Bell said. “One of the primary reasons so much is spent on healthcare is because people don’t know how to access the system.”

This past year, medical coverage for county workers cost $10.5 million – not including the premiums and copays coming out of workers’ pockets.

Spartanburg County Administrator Glenn Breed said he doesn’t know if insurance rates will go up 1 percent or 10 percent this coming year – but it’s going to be substantial regardless. As planning for the 2010-2011 fiscal year approaches, the county has considered many options for reducing costs.

“We have a number of employees with health insurance coverage options with a spouse that is working,” Breed told County Council members during a meeting last month. “We want to see what savings we might achieve if that employee were to be incentivized to join the other insurance plan.”

Bell said he’s considering limiting employees to visiting their primary care physicians to twice a year – a way to push them toward the cheaper clinic down the street.

Nurses at the Spartanburg County clinic said many of the patients who come through – an average of nine a day – also don’t have primary care doctors.

Employees are now seeing medical professionals for seemingly minor ailments they might otherwise suffer through or sit on until too serious to ignore.

One county employee had a lesion she was worried about. She tried to get an appointment with a dermatologist but was told she would have to wait six months. She went to the clinic that week where Battleson judged the lesion too serious to wait on.

It was cancer.

“So far I haven’t gotten any complaints,” Bell said.

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