Take Care worksite gamble a lock for Harrah’s

ATLANTIC CITY, N.J. —The House always wins.

Five years ago, Harrah’s gambled on worksite-based health care. And while the real jackpot lies in the long-term savings of helping its employees manage their conditions before they become catastrophic, it is a bet that continues to pay off for the casino-gaming giant a little bit at a time.

The company celebrated the fifth anniversary of the on-site Health and Wellness Center, located here at the Showboat casino, at an exclusive May 20 open house event, in which Drug Store News and Retail Clinician were the only trade media outlets invited to attend. Operated by Walgreens’ Take Care Health Systems employer solutions group, the center originally was opened by Whole Health Management, which Walgreens acquired in 2008.

Since the opening of the facility in 2005, which serves Harrah’s employees at its Harrah’s, Showboat, Caesars and Atlantic City Country Club properties, the offering has expanded dramatically—and with it, so has utilization among the 10,000-plus employees and their dependents enrolled in Harrah’s health plan.

“In year one, we were seeing about 26 patients a day,” said Emily Gaines, VP compensation, benefits and HRSS for Harrah’s Entertainment. “Today, we average about 65 patients a day. We are up to about 17,000 visits a year out of this facility.”

And along the way, Harrah’s Atlantic City facility has grown from a couple of exam rooms and a largely acute-care focus to seven exam rooms, X-rays, diagnostic testing, a pharmacy, physical therapy and a fitness center. Utilization tops 50% of the eligible employee population in Atlantic City, Gaines explained.

Take Care also operates employer-based facilities at four other Harrah’s properties in Las Vegas; New Orleans; Tunica, Miss.; and Lake Tahoe, Nev., where, because of issues of access and the utter convenience of the facility, utilization runs as high as 95%, Gaines said. Together, between those five locations, Harrah’s is able to reach more than 70% of its eligible employees.

While the exact numbers are difficult to parse out, particularly given the company’s 2006 acquisition of Caesars—which essentially doubled its beneficiary population—Gaines told Drug Store News she is certain that the Take Care facility is helping Harrah’s lower its healthcare costs on a per-employee basis. “What’s nice about it is that it actually improves costs for the employee. This is a really low-cost option. Just this year, we actually waived the co-pay—any preventive service here is free, and anything else (lab work, diagnostics, etc.) is a $10 co-pay,” she said.

What is easier to pinpoint is the role the facility has played in helping Harrah’s employees manage such chronic conditions as diabetes and hypertension.

“Looking back to 2007, and looking at hypertension, which is a huge cost for us,” Gaines said, “we had a 46.6% prevalence among our employees. Today, that population is down to 31.6%. Same with obesity: In 2007, it was 48.3%. Among that same population, that number is now down to 39.9%.”

To further increase utilization at the facility, Take Care clinicians get out of the Health and Wellness Center and take the message directly to Harrah’s employees in a program the company calls “Wellness Wednesdays.” Through the program, Take Care providers visit Harrah’s associates on-site in the employee dining rooms, conducting free screenings and in general, educating employees on Harrah’s plan design and ways that they can maximize the value of their health plan.

Like each of the employer-based centers that Take Care operates—it currently operates nearly 400 facilities across the country—its Harrah’s offering is customized to meet the needs of the company’s employees. That means being creative with staffing and hours, something Take Care and Harrah’s Gaines are constantly tinkering with. “In this industry, we have three major shifts a day—day, swing and graveyard—so we have employees working around the clock, and we need to have somewhat untraditional hours to meet our employee demand,” she said.

In addition to its hours of operation, which makes Take Care’s Atlantic City facility somewhat unique, the job profiles at Harrah’s also place a high demand on the Health and Wellness Center’s resident physical therapist J.R. Thomas. Dealers, cashiers, bartenders, waitresses and most other casino employees have one thing in common: too many hours on their feet. Thomas said he focuses most of his time dealing with lower-back, shoulder and neck pain issues. In addition, the center also has developed a very active customized orthotic service, which Thomas also oversees.