For years, officials in Lakeland, Fla., had no effective remedy for the pain caused to city workers by rising health-care costs. They tried raising premiums, increasing deductibles and many other cost-shifting methods to ease the financial pressure. Nothing worked.

"It became apparent that this wasn't the way to address the root cause," said Karen Lukhaub, the city's director of risk management and purchasing.

Four years ago, after much debate, Lakeland set out to open an in-house health clinic for city workers and found Healthstat Inc. For space, they didn't need to look farther than the centrally located risk management-civil service building, where facility maintenance crews gutted a civil service conference room to install medical examining tables and electrocardiogram machines.

In 2007, Lakeland opened the employee on-site wellness clinic, where city workers can get basic medical services for free. In its first year, Lukhaub said, the program saved the city $1 million.

"We save in overall reduction of medical costs and insurance claims," she said. "In order to participate, you have to be covered under the city health plan, but it costs zero dollars out of pocket and no vacation time."

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Russell Nichols  |  Staff Writer