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Efficient care

Kohl's does not expect the clinic to generate large savings from the start. In addition, some of the potential savings will be hard to measure. The convenience of the clinic, for instance, should increase productivity.

It also will help employees balance the demands of work and their personal lives, said Telvin Jeffries, Kohl's executive vice president of human resources. However, the clinic also could provide more efficient - and less costly - care.

A doctor who sees a patient with a bad back might schedule an X-ray, followed by a second appointment and then physical therapy. That can all be done at Kohl's Wellness Center.

The company also should save money on fewer referrals to specialists. Moreover, it is almost certain to save money on tests, X-rays and physical therapy by eliminating the mark-up.

The savings are not immediate. Nevertheless, Quad/Graphics and other companies have shown that they can be real.

They also have shown that putting more emphasis on primary care - and changing the incentives that exist in the current system - could make the health care system more efficient.

"This is what patients want, this is what they are looking for," Krause said. "But because of the economics of medicine, they are not getting it.



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