The Stemilt Clinic: Sustainability Case Study

Nurturing Wellness and Community

Healthcare costs are rising at a faster rate than other goods and services and, often, these costs are passed down to employees. For some, this can create a critical dilemma—opt into a costly health insurance program that creates a financial burden or opt out and risk their health and the health of their families. This is not a choice anyone—especially those with children—should have to consider, but this is an unfortunate and all-too-common reality.

While many companies search for ways to offset these spiraling costs—most through increased employee contribution via copays and deductibles or less comprehensive coverage or both—Stemilt created a people-centric program to help their employees overcome the challenges of obtaining affordable, quality healthcare.

Stemilt is a family owned and operated growing, packing and shipping company, established in 1964, whose farming roots date back to 1893. They are one of the leading growers of apples, pears and cherries in the world. Today, the fifth generation of the Mathison family leads the company business.

They have approximately 1,600 year-round, full-time employees. That number spikes to 4,000 between June and August during cherry season, more than doubling the number of employees. The health of their employees is paramount to the health of their business.

“We really do believe preventative care is how we can reduce our health care costs,” says Brianna Shales, Stemilt Senior Marketing Manager

The challenge: Affordable healthcare for all

Stemilt has always offered medical benefits to full-time employees on an opt-in basis. Though, as a large company, the employee cost was considerably lower than that of smaller company opt-in insurance programs, they still found that a fair number of employees were declining this coverage because of the out-of-pocket expense.

Instead, employees relied on emergent or charity care for medical issues to directly address immediate threats to life or limb. They would go to a walk-in clinic or emergency room to get treatment only when the problem was severe. Others would go undiagnosed altogether and, at times, waited until it was too late. In the event that employees opted to go to the doctor and medication was prescribed, many of the prescriptions were never filled due to their high cost.

As a company whose mission is to cultivate people and delight consumers, Stemilt wanted to provide a program that would benefit not only some of their employees but would improve the lives of each and every employee.

According to Apotheco Pharmacy Group

“…prescription abandonment rates have been rising; one study found that 3.27% of prescriptions filled during a three-month time period in 2017 were never picked up. When applied to all of 2018, these numbers equate to about 140 million prescriptions. This non-adherence contributes to about $300 billion in avoidable health care costs and around 125,000 avoidable deaths.”

A study published by Harvard Health Publishing (June, 2020) found that younger adults (those under age 65), 6% who had private insurance skipped medicines to save money, compared to 10% for those with Medicaid and 14% of those with no insurance. Among the poorest adults—those with incomes well below the federal poverty level—nearly 14% did not take medications as prescribed to save money. Some would stretch a one month’s supply of medication out for several months. When patients abandon prescriptions or don’t take them as prescribed, it is costly for themselves, physicians, and pharmacies—especially if hospital intervention becomes necessary.

The solution: The Stemilt Family Clinic

At a time when healthcare was becoming a hot topic, Stemilt took up the baton on behalf of their employees, championing their access to affordable quality healthcare. It was important to them that their employees knew the company cared about their health and well-being.

“Fruit isn’t the only thing Stemilt is focused on growing,” says Shales. “The company is committed to our team members, and making healthcare easily accessible to provide team members and their dependents with access to free, quality healthcare.”

For the pilot program, Stemilt contracted with AnovaWorks, an occupational health company, to treat employees who were sick or injured. The positive impact on employee health and the company’s bottom line was considerable. To build on the pilot’s success, Stemilt partnered with local healthcare provider, Confluence Health.

In 2015, they opened the Stemilt Family Clinic, a fully staffed primary care facility for employees, spouses and dependents that ran in tandem with a clinic pharmacy. The services and prescriptions are free and require no co-pay, no out-of-pocket expenses and no insurance plan. When employees do not feel well they are not going to work at their optimal potential, and the onsite clinic provides the opportunity for them to get treatment for minor illnesses or injuries before they worsen.X

The clinic and pharmacy are located at a Stemilt facility, adjacent to company headquarters and, because they own the facility, overhead costs are less than that of an off-site facility. An added, and equally significant, benefit of the onsite location is convenience. Employees can easily visit the clinic during the workday without leaving the premises.

Same day and walk-in appointments are available and, on average, the clinic sees 24-27 patients per day, which equates to over 5,000 visits a year. From their first day, employees can go to the clinic, get the primary care they require, get their prescription and be on their way—all at no cost to them.

The convenience has proven effectual in that employees are getting the ongoing care they need and 99% of all prescriptions are being filled. Over half of the patients who have insurance and could go elsewhere for care, choose to go to the onsite clinic.

The clinic is run by Confluence staff, who work to build long-term relationships by creating an environment of trust. The clinic doctor is well-known within the community and when patients—particularly so that don’t like going to the doctor—enter an environment that feels familiar and safe, they are more likely to confide in staff who can then effectively help them address their needs.

As a supplement to the free clinic care, Stemilt offers medical, dental and vision insurance that employees can opt into, much like traditional health insurance benefits. As an added incentive, employees who elect to have an annual preventative wellness exam receive a 15% discount on their monthly contribution to the plan. This helps to ensure that participating employees are seeing the doctor at least one time per year to establish a medical baseline. Some visit the clinic and pharmacy more frequently.

While the clinic provides routine or primary care at no cost, if an employee needs specialized care, they can use the more traditional coverage to help cover costs for treatment that falls outside of Stemilt Family Clinic services.

The clinic served as a valuable asset during Covid-19, facilitating the ability for the essential workforce to be tested and treated. Clinic staff also assisted employees’ return to work processes if they tested positive for the virus and had to isolate.

The Stemilt Family Clinic adopts the same approach as Confluence Health, adding additional services during the pandemic that included virtual visits, when applicable, and house calls for employees needing support.

The program has not only benefited Stemilt and their employees, but Confluence Health and the healthcare system as a whole.

That partnership has also taught Confluence Health how to provide efficient primary care at a remote site. The program has been beneficial in treating a sector of patients who might not seek care otherwise. Confluence Health’s mission aligns with Stemilt’s mission to provide safe, high-quality care in a cost-effective way and adds strength to the partnership. By meeting people where they are in a way that is more comfortable to receive care, they are fulfilling their goal.

“The Stemilt Family Clinic is a unique agriculture and healthcare collaboration that benefits our community,” said West Mathison, Stemilt President. “Focusing on primary care and wellness lightens the burden our local hospitals face on emergent care. Most importantly, we are able to help our team members and their families live healthier lives.”

The takeaway: Creating a win-win

Stemilt has proven that, with innovative partnerships, it is possible to save significant money in healthcare costs, ease the burden on the healthcare system and provide employees and their families with the affordable quality health care they need.

“The Stemilt Family Clinic has afforded us significant savings on healthcare with its focus on preventative care,” said Mathison. “This has helped us keep insurance premiums at bay during a time where healthcare costs are rising.”

In 2020, Stemilt celebrated the fifth anniversary of the Stemilt Family Clinic and their partnership with Confluence Health. The anniversary marks a significant milestone for the company and celebrates a great resource for Stemilt employees.

“Stemilt exists to cultivate people and delight consumers with our world famous fruit. Putting our health first via the Stemilt Family Clinic helps our teams work together to achieve our mission," Mathison stated. “It’s evolved quickly in five years and is a wonderful and convenient resource our team members and their family utilize. Confluence Health’s involvement is instrumental, and Stemilt is grateful for this partnership.”

Stemilt has shown that convenient locations and a zero-cost model for care and prescriptions are important benefits for employees. When employees are happy and healthy they tend to stay with a company longer, and an organic result of their healthcare program is low employee turnover and less employee absences, which adds another level to the cost savings. Their model proves that cost-effective healthcare for employees and their families is possible and offers a valuable roadmap for other employers to follow.

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