SARATOGA SPRINGS -- Davida Scripter might not have bothered to see her doctor about a splitting headache earlier this week if the office wasn't so conveniently located.
In fact, the Quad/Graphics employee might not keep close tabs on her blood pressure or her weight either, which are improving thanks to visits with her primary care physician.
For Scripter and about 800 other Quad/Graphics employees at the Saratoga Springs plant, medical care is as close as the workplace.
The international printing company runs a health care subsidiary called QuadMed, which operates full-service clinics at five of its manufacturing facilities. The clinics serve workers and family members who opt to receive their primary care and coverage in-house.
Locally, the clinic has a full-time family practice doctor, a physician's assistant, two nurses, and a receptionist. At larger Quad/Graphics plants in Wisconsin, the clinics offer a cardiologist, nutritionist, pediatrician, dentist, mental health professionals, physical therapist and a pharmacy.
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The experiment started with a doctor and a nurse at one of the Wisconsin plants 20 years ago as a way to control rising health care expenses. For the highly integrated company - Quad/Graphics makes its own ink and develops its own printing technology - adding a clinic was not such a stretch, even if it was risky.
"We did it out of necessity," CEO Joel Quadracci said last month while speaking at Skidmore College, his alma mater.
So far, the risk has paid off - the company claims its health care costs are a third below the industry average. What's more, QuadMed has worked so well that the firm now operates clinics for other major employers with 1,000 or more employees on-site, including Northwestern Mutual, Briggs & Stratton Corp. and MillerCoors.
"We have the data to show preventative health care works," Quadracci said. "We are practicing medicine the way it should be practiced."
According to Dr. Raymond Zastrow, QuadMed's chief medical officer, the system's success boils down to preventative care and chronic disease management, which stands in contrast to the fee-for-service model driving much of health care today.
QuadMed's physicians are salaried, and patients at the Saratoga Springs clinic are automatically booked for 30 full minutes with the doctor. Incentives are offered to workers who watch their blood pressure, sugar levels, weight, cholesterol and who quit smoking.
"We've figured out by delivering a more vastly integrated, more proactive model of care that we can trim our overall expense by about a third," he said. "This is not how cheap can we deliver primary care - we spend more than most companies do - but we way more than make up for it by preventing avoidable hospitalizations, avoidable visits, expensive brand-name drugs and unnecessary diagnostic imaging."
For an company with a goal little employee turnover, the system amounts to an investment in the long-term health and productivity of its workforce.
Dr. Suzanne Palmieri, who runs the local clinic, said she is given the time necessary to really evaluate patients.
After working for a private practice in Greenwich and at a Saratoga Hospital clinic before coming to QuadMed, she said the pace of patient appointments is the biggest difference.
She and her staff see an average of 12 to 15 people per day, and the extra face time allows her to emphasize preventative screenings and care.
"When you are in private practice, you are seeing sick patients every 10 minutes," she said. "You are not looking at their cholesterol level or blood pressure (for incremental progress)."
While workers can go elsewhere for their care, it's cheaper to stay in-house. Still, some employees don't want their employer telling them what to do, or having a hand in their health care.
Palmieri stressed that patiently confidentiality is taken very seriously, and the clinic is run separately from the plant, with no sharing of information.
She does have the advantage of reaching out to workers, though, during bi-monthly staff meetings or by offering free screenings or flu clinics in the cafeteria.
On a recent weekday, employees filtered in and out of the quiet, spacious clinic, located on the second floor inside the Quad/Graphics compound in the W.J. Grande industrial Park.
For the majority of employees who work long shifts, it can be difficult to find time during the day to get to a doctor's office or pick up prescriptions. In addition to making sure appointments are easily available, there's no long wait and medications can be filled at the office.
Corey Utter, a finishing technician at Quad/Graphics, stopped in for a last-minute visit Tuesday morning because he wasn't feeling well. He didn't have to make a co-pay, and recently enrolled his 3-month-old daughter so she could also benefit from check-ups and vaccinations.
"It's very convenient, a great idea," he said. "I think most jobs should have it. The next step is a day care."
