If someone took an aerial picture of the Dallas/Fort Worth area, it would show 14 OccuSystems clinics-soon to be 16-clustered near industrial parks.
That's no coincidence. Convenient locations make it easier for employers to send workers to OccuSystems for drug screenings, physical exams and treatment for on-the-job injuries.
"Most of the customers who use the centers are driving 10 to 15 minutes-no more than that," said James Greenwood, OccuSystems' chief financial officer.
Convenience has helped OccuSystems capture half the initial reported on-the-job injuries in the Dallas/Fort Worth market. It also has helped the company grow from its Texas roots into by far the No. 1 provider of integrated occupational healthcare services in the country.
Founded in 1990, the Dallas-based company now manages the practices of more than 140 physicians and runs 82 occupational healthcare centers in 22 markets in 13 states. Serving more than 40,000 employers, the company expects 1996 revenues of $33.5 million.
Its main selling point, however, is its aggressive efforts to get injured workers back on the job sooner.
By coordinating care, OccuSystems claims to be able to cut 30% to 60% of a company's workers' compensation costs.
That's significant. Work-related injuries cost American employers an estimated $60 billion to $70 billion a year. In 1994, those costs represented 2.09% of an average payroll, according to a survey by Tillinghast-Towers Perrin, an international consulting firm.
Only about half those costs are medical. The rest come from lost productivity, retraining and other costs that accrue while an employee is out of work.
After steep increases, workers' compensation costs leveled off in the past three years as employers implemented cost controls such as return-to-work programs and preferred provider arrangements.
"Employers are not just going to let (injured workers) wander off and fall off the dark side anymore," said Kenneth F. Martino Jr., a consultant with Tillinghast-Towers Perrin.
OccuSystems is playing right into that strategy. It coordinates specialty and ancillary services and operates proprietary software to help physicians identify the best courses of treatment. It even helps identify alternative duties for employees who aren't ready to return to their old jobs.
Those are things traditional, fragmented occupational healthcare providers haven't done well, if at all.
OccuSystems officials like to say their physicians are accountable. The word accountable is part of the company's mission statement, which is printed on the back of its business cards.
With its specialized focus, OccuSystems is putting pressure on hospital-based occupational health programs to reduce costs and improve service.
In some markets, OccuSystems formally links with hospitals that already offer occupational health services.
It formed its first affiliation in August 1995 with Detroit-based Henry Ford Health System. Primary-care physicians at OccuSystems' 13 Detroit-area clinics refer to Henry Ford for inpatient and hospital-based ancillary care. In return, Henry Ford provides prompt treatment and works with OccuSystems to develop best practices based on outcomes.
Since then, OccuSystems has created joint ventures with Columbia/HCA Healthcare Corp.'s El Dorado Hospital and Medical Center in Tucson, Ariz., and Integris Health, a 15-hospital system based in Oklahoma City.
In each case, the hospital contributed its existing occupational health centers to the venture in exchange for a 49% interest. OccuSystems owns 51% and takes a management fee.
In 14 states, including Texas, employees have the right to choose where to go for care. But OccuSystems has found a way around that.
Employees usually accept their employer's suggestion of where to seek care, Greenwood said. Also, many workers sent to OccuSystems for routine exams are inclined to return for a work-related injury, he said.
In many states, workers' compensation cases by law command higher fees than regular healthcare. That makes it an attractive market for hospitals.
Phoenix-based Samaritan Health System recently established its own occupational health program. It aims to deliver comprehensive services with an emphasis on cost containment.
Samaritan only has about 5% of the Phoenix market, compared with OccuSystems' 60%. It hopes to attract cases by providing 24-hour care at five locations, including its four hospital emergency rooms. OccuSystems has one 24-hour clinic in the market.
"We've got the opportunity to make sure people don't get lost in the system. To a large extent, that's what we're trying to do," said Patricia Treharne, M.D., medical director of Samaritan's occupational health services.
Risk sharing is still unusual in workers' compensation, but OccuSystems wants to change that. Its goal is to capture a portion of the millions of dollars in nonmedical savings that employers enjoy when workers return to work sooner.
John Carlyle, OccuSystems president and chief executive officer, said at a recent investors' conference that the company expects to enter a risk-sharing arrangement with a managed-care plan sometime this year.
He summed up the occupational health market this way: "The best outcome is not lower medical dollars; it's lower overall dollars."