Since the passage of the 2010 health care reform law, worksite health and medical clinics have seen modest but steady increases in popularity among large U.S. employers, according to a new study published Tuesday by Mercer L.L.C.

New York-based Mercer's most recent National Survey of Employer-Sponsored Health Plans, released in November 2012 indicated 37% of firms with 5,000 or more employees reported they offer occupational and/or primary care services through an on-site clinic, compared with 32% in 2010. Another 15% indicated they are considering installing a clinic within the next two years.

On-site clinics were slightly less popular with midsize employers. Approximately 30% of employers with more than 500 employees said they currently offer on-site clinical services, while 9% said they may begin offering on-site occupational health services, and 15% said they are considering offering primary health care services by 2014.

In a follow-up survey of 131 employers offering on-site clinical services released Tuesday, 82% of firms listed reducing lost employee productivity as a primary motivator for installing a worksite clinic. Seventy-five percent said controlling overall health care costs was a top motivating factor in their clinical offerings, while 73% indicated managing employees' health risks and chronic conditions as a primary program driver. Additionally, nearly half of employers polled said they see the clinics as a way to attract and retain talent.

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Under the Patient Protection and Affordable Care Act, increased health insurance enrollment and other new requirements could create shortages in the availability of primary health care providers in some parts of the country. Worksite clinics allow employers to ensure health care provider access for their employees, the study noted.

“Where worksite clinics once focused on occupational health, employers are increasingly using them to provide a wide array of primary care services,” said Dr. Bruce Hochstadt, Mercer's consulting leader on worksite clinics. “These more robust clinical offerings can help employers reduce overall medical spending since they can be controlled more directly than community-based services.”

Although 87% of employers polled rated their programs as generally successful, more than two-thirds of them have not been able to measure their clinics' financial return-on-investment. However, a majority of employers that have measured the net value of their clinical services said they have experienced an investment return rate of 1.5 or better.

A separate study, also released by Mercer on Tuesday, found that less than one-third of employers worldwide have actively incorporated health and wellness into their business values or strategic priorities.

Among 1,268 global employers polled in Mercer's “Talent Barometer Survey,” only 20% said they were active in measuring the financial return on investment of their health management programs, and just 21% said they were actively measuring improvements in individual health statuses. Only 17% of employers said they actively share data across their varying health care programs in order to understand their employee population's health profile.

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The study also indicated a correlation between the perceived effectiveness of an employer's health and wellness management program and the level to which they have invested in the program. Employers that reported making the most significant investments in health and wellness management were twice as likely to rate their program as “effective” as those reporting only modest or minimal investments.

“The research suggests a strong link between employers' focus on health and wellness and employee engagement and productivity,” said Dave Rahill, president of Mercer's health and benefits practice. “This means that employers are missing out on one of the greatest tools available to enhance their strategic workforce plans.”