Employers save an average of 25% on their employees’ total cost of care through Premise Health onsite and nearsite wellness centers, claims-based analysis shows

Unsustainable healthcare costs: It’s the biggest challenge facing every benefits leader.

One strategy many organizations deploy to address costs is onsite and nearsite clinics. More than 50 percent of large employers offer at least one onsite or nearsite clinic, according to a Business Group on Health survey.1 But does it work? In a recent claims-based analysis of over 148,000 lives across 19 organizations from nine different industries, the resounding answer was yes.

The Findings

A representative, claims-based analysis showed that employers save an average of 25%, or $2,014, on total cost of care for employees and dependents attributed to a Premise Health onsite or nearsite wellness center, compared to those employees and dependents who access care in their communities. The study, which was based on approximately 148,000 eligible lives, represents one of the largest sample sizes ever assessed in the direct healthcare industry. It was conducted by Premise Health using a methodology validated by Milliman, an internationally recognized actuarial and consulting firm.

Together, employers and Premise achieved these savings by connecting employees and dependents with high-quality healthcare in a primary care setting.

The study showed that onsite and nearsite health led to:

39%   increase in routine and preventive office visits
27%   reduction in emergency room visits
36%   reduction in inpatient hospital admissions


By helping their people get high-quality primary care when they needed it, employers helped them address health issues earlier. With this approach, employees and dependents stay healthier and experience fewer costly emergency room visits and hospital admissions.

A claims-based analysis of 19 organizations from nine industries demonstrated 25% savings on employees’ total cost of care across varied markets.

A Range of Cost Savings

While all employers in the study benefited from offering onsite and nearsite primary care, there was a range of outcomes in total cost of care savings from 34%, or $2,930 per member per year, to 15%, or $1,246 per member per year.

In a comparison of employers at the high and low ends of the range, two strategies stood out. Employers with the greatest savings:

  1. Designed their benefits to encourage employees and dependents to use the onsite and nearsite wellness centers, increasing overall utilization of preventive care. They also allowed Premise to proactively reach out to members with the greatest health needs.
  2. Offered both primary care and additional services such as pharmacy, behavioral health, or care management, driving both higher member utilization and stronger clinical coordination.

Together, these steps incentivized employees and dependents to leverage the onsite and nearsite wellness centers as their “medical home.” Studies have long shown that when a person has a dedicated primary care provider, they benefit from greater continuity of care across their lifetime and overall better health.

The Study

The study compared a cohort of employees and dependents who were attributed to a Premise Health wellness center to those attributed to a community provider. Attribution is determined by where someone receives most of their primary care and pharmacy services. It is based on visit frequency, not cost.

The analysis looked at data from medical claims, prescription drug claims, and community claims to evaluate risk-adjusted health outcomes and cost of care over a 12-month period. Members were assigned a risk score using Milliman’s Advanced Risk Adjuster (MARA) methodology. Total cost of care per community-attributed member was then risk-adjusted to compare Premise-attributed members to a similar cohort of community-attributed members.

Over 148,000 eligible lives

19 self-insured employers

Average eligible population of 7,800

Average Premise attribution rate of 44%

Average Premise-attributed member savings of $2,014

Average Premise client tenure of 6 years

Industries represented:

>  Manufacturing
>  Finance and Insurance
>  Healthcare
>  Retail
>  Utilities
>  Wholesale
>  Public Administration
>  Agriculture
>  Rental and Leasing

The Methodology

Premise leveraged its Milliman-validated methodology for measuring total cost of care savings and calculating return on investment (ROI). In addition, Premise partnered with health data analytics company Cedar Gate Technologies to complete this study.

The use of independent third parties to validate an appropriate savings methodology (Milliman) and perform complex analysis on large datasets (Cedar Gate) was critical to accurately measuring the value that employers and risk-bearing organizations can receive from onsite and nearsite wellness centers.

To access a full report from Milliman on this methodology, click here.

1Business Group on Health. 2024 Large Employer Health Care Strategy Survey. August 2023. Available at: https://www.businessgrouphealth.org/resources/2024- large-employer-health-care-strategy-survey-intro.

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