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The Dallas Morning News Section D Sunday, July 19, 2020 DallasNews.com

Business

Amazon is getting into the healthcare delivery business, at leastfor its employees.

Last month, the e-commerce giantopened a primary care clinic in Irvingand soon plans to open similar healthcenters in Coppell, Garland, Duncan-ville, North Fort Worth and nearHaslet. The local launch is the firststage of a pilot project that will in-clude four other U.S. metros by earlynext year, Amazon said.

Depending on results in Dallas-Fort Worth, Phoenix, Louisville, De-troit and San Bernardino, Calif., Ama-zon could eventually expand the clin-

ics to additional employee hubs.The project was conceived over a

year ago, before COVID-19 emerged.Officials said the coronavirus has hadlittle effect on their plans, except toput even more emphasis on virtual

health visits.Amazon’s centers will be staffed by

Crossover Health, a California compa-ny that operates onsite and near-sitefacilities for some large self-insuredemployers, including Microsoft, Face-book and LinkedIn. The clinics willinclude doctors, nurses, chiropractors,physical therapists and behavioralhealth experts.

Amazon has about 20,000 em-ployees in North Texas and has beengrowing rapidly here. About 11,000work in operations and fulfillment

Amazon’s prime offer: 6 healthclinics for 20,000 D-FW staffers

BUSINESS INSIGHT

MITCHELLSCHNURMAN

mschnurman@dallasnews.com

Ben Torres/Special Contributor

The Amazon Neighborhood Health Center in Las Colinas has a physicaltherapy section with exercise machines for patients who work for Ama-zon. Care will be provided by doctors and nurses from Crossover Health.See CLINICS Page 8D

8D Sunday, July 19, 2020 dallasnews.com The Dallas Morning News

071920D08w:66PP h:66PP

BUSINESS

centers, and the rest are corpo-rate staff, management andtech workers.

Amazon is hardly a pioneerin this space. Walmart unveiledits own health clinics in 2014,charging $4 for a doctor’s visitfor employees and $40 forstore customers.

Amazon clinics will belimited to employees and theirdependents. To accommodateso-called Amazonians on lateshifts, the centers will haveextended hours, includingweekends.

“Hopefully, we’re within 10miles of almost everybody whoworks for Amazon in the D-FW area,” said Derek Rubino,senior program manager forworkplace health and safety.

He said Amazon was proudto offer health insurance to allfull-time employees on theirfirst day, including hourlyworkers. But many in D-FWdon’t use the benefit.

“A lot of it really comesdown to convenience,” Rubinosaid. “Having benefits only getsyou part-way there.”

Amazon wants to removebarriers that keep workersaway and persuade them toembrace primary care. Thatincludes a range of services,from check-ups and immuni-zations to managing chronicconditions. Studies show pri-mary care helps avoid morecomplicated, costly problemslater.

“I honestly believe this isgoing to be life-changing forsome folks,” Rubino said.

Onsite clinics are usuallyembraced by large employersand often were started to ad-dress workplace injuries. Morerecently, companies haveadopted them for general

medical care, putting clinicsnear the workplace, not insideit.

In 2017, one-third of compa-nies with at least 5,000 em-ployees had a general medicalclinic at or near their worksite,according to a survey by Mer-cer, a human resources consul-tant. That share was twice ashigh as a decade earlier.

“The vast majority of theseclinics have done very well,both in meeting their financialobjectives as well as improvinghealth and wellness,” saidLarry Boress, executive direc-

tor of the National Associationof Worksite Health Centers.

Companies cite many rea-sons for investing in clinics,from lowering health spendingto boosting worker productivi-ty. Over 40% of employees whouse the clinics don’t have apersonal doctor, Boress said,and in the Mercer survey, morethan 1 in 3 said the clinicsserved as their medical home.

“These clinics often becometheir only source of medicalcare,” he said.

Health advocates, employ-ers and insurers are emphasiz-

ing primary care as a way tobend the curve in healthspending. In Plano, to encour-age city employees to go tocertain doctors, the health plancharges a copay of just $5 for avisit. In Fort Worth, it’s free forcity employees to use certainclinics or virtual health provid-ers — but there’s a stiff penaltyfor going to the ER if it’s not anemergency.

The Amazon health centersare in-network providers soemployees will pay the stan-dard rate, which depends onthe health plan they’ve chosen.Amazon officials would notprovide a number or range. OnAmazon’s benefits website, theprice of an in-network officevisit is $30.

“We wouldn’t drive anyoneaway because of price,” Rubinosaid.

Crossover Health, whichstarted in 2010, said employers

save 30% on health spendingthrough its program. Onereason is that it claims to cuturgent care visits and imagingservices by half.

During the pandemic,Crossover said it has shifted90% of interactions to virtualcare, and secure messaging —emails and texts between pa-tients and providers — is up40%.

“We can identify things thatmay be important to a specificpopulation and really tailor theprogram,” said Dr. StephenEzeji-Okoye, Crossover’s chiefmedical officer.

The extended hours, therange of services, the coverageof young dependents — all thatwas designed for Amazonemployees, he said. Crossoveralso emphasizes short waits,usually fewer than five min-utes, to see a doctor.

Visits last 30 minutes or

more, in part because doctorsaren’t reimbursed on a fee-for-service basis. Crossover gets amonthly payment, based on aper-member fee or a cost-plusarrangement, Ezeji-Okoyesaid, and that keeps the focuson keeping patients healthy.

The long encounters lead tofewer tests and imaging andfewer referrals, he said, “be-cause we have the time to es-tablish a relationship.”

While many companies andproviders are rethinking theirapproaches to health care,Amazon’s move could have anoutsize influence, said Boressof the worksite trade group.

“Employers like to bench-mark themselves against theleading edge companies,” hesaid. “They look to the leaders,and in many cases, they follow’em.”

Twitter: @mitchschnurman

Clinics could become medical home for local AmazoniansContinued from Page 1D Big companies with onsite clinics

Among employers with at least 5,000 workers, the share

offering a general medical clinic onsite or nearby:

Why they invest in the clinics

Share of large companies citing these factors as "important" or

"very important" in establishing an onsite clinic:

Here’s the deal

How companies with onsite clinics encourage employees to use

the facilities:

Staff graphic

SOURCE: Mercer's National Survey of Employer-Sponsored Health Plans

Better manage health spending

Reduce employees' health risk

Increase employee productivity

Manage chronic conditions

Improve quality of care

Enhance health leadership image

Attract, retain employees

SOURCE: Mercer's Worksite Medical Clinics 2018 Survey

SOURCE: Mercer's Worksite Medical Clinics 2018 Survey

No copayment

Reduced copay

Cut employee premium

Cash, gift cards

Contribute to HSAs

24%

24%

29%

31%

32%

33%

89%

84%

75%

71%

69%

66%

59%

41%

24%

9%

7%

2%

2012

2013

2014

2015

2016

2017

MITCHELL SCHNURMAN

Ben Torres/Special Contributor

The Amazon Neighborhood Health Center in Las Colinas, which opened last month, is thefirst of six that the e-commerce giant plans in North Texas. The pilot project is scheduledto add four other U.S. metros by early next year, Amazon says.