• Christopher Conover, Rebecca Namenek Brouwer, Gale Adcock, David Olaleye, John Shipway, and Truls Østbye.
• Duke University, DUMC Box 2713, Durham, NC 27710. E-mail: rebecca.brouwer@duke.edu.
• Am J Manag Care. 2015 Jul 1; 21 (7): e422-9.

ObjectivesTo examine the relationship among use of an on-site employer-provided primary care medical home, and health services use and health plan costs for inpatient and outpatient services and pharmaceuticals.Study DesignThe study was a retrospective observational analysis of health plan claims, human resources data, and Health Care Center (HCC) encounters.MethodsThree years of data for employees and dependents designating the HCC as their primary care provider (HCC major users) were compared with data from 2 comparison groups: "casual" HCC users and HCC nonusers. The outcomes of interest were: 1) health services utilization, and 2) monetized use of the health plan. Secondary data from an employer-provided Health Care Center (HCC).ResultsAfter adjusting for several potential confounders, HCC major users had less use of external healthcare services than the comparison groups (employees had 2.7 fewer external encounters than HCC casual users [P < .001] and 1.2 fewer external encounters than nonusers [P < .001]; dependents had 3.5 fewer external encounters than HCC casual users [P < .001] and 1.9 fewer external encounters than non-users [P < .001]). Annual monetized use of the health plan for employees and dependents was highest for HCC casual users relative to HCC major users (employees: $482 greater, P < .01; dependents: $598 greater, P < .001).ConclusionsEmployees and their dependents who were "casual users" of the HCC had the highest claims costs and use of outside healthcare services. Additional research is needed to assess the extent to which employees' utilization of services at on-site primary care medical homes affects employee health outcomes, resulting in potential effects on company healthcare plan expenditures, worker productivity, and return on investment.

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