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With his companys health costs soaring and his workers struggling with high blood pressure and other medical conditions, Winston Griffin, CEO of Laurel Grocery Co., knew his company had to do something.

So the London, Kentucky, wholesaler opened a health clinic.

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Our margins are tiny, so every expense is important, Griffin said. The clinic, he said, has helped lower the companys health costs and reduce employee sick leave.

Large employers have run clinics for decades. At Laurel Grocerys in-house clinic, workers can get checkups, blood tests, and other primary care needs fulfilled free, without leaving the workplace. But Griffins move is notable because of his companys size: only about 250 employees.

Nationwide, a modest number of small- and medium-size employers have set up their own health clinics at or near their workplaces, according to surveys and interviews with corporate vendors and consulting firms that help employers open such facilities.

Improving employee health and lowering health costs are among the main advantages employers cite for running clinics. But some companies also say theyre helping to blunt the nations shortage of primary care doctors and eliminate the hassle of finding and getting care.

Why did we do this? So my employees would not drop dead on the floor, Griffin said. We had such an unhealthy workforce, and drastic times called for drastic measures.

KFFs annual survey of workplace benefits this year found that about 20% of employers who offer health insurance and have 200 to 999 workers provide on-site or near-site clinics. That compares with 30% or better for employers with 1,000 or more workers.

Those figures have been relatively steady in recent years, surveys show. Email Sign-Up

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And U.S. employers reported the biggest increase this year in annual family premiums for their sponsored health plans in a decade an average jump of 7% to nearly $24,000, according to the KFF survey, released Oct. 18. That spike may intensify interest among business leaders in curbing underlying health costs, including by exploring delivering care at workplaces.

Employers dont require their workers to use their clinics but typically provide incentives such as free or reduced copayments. Griffin offered employees $150 to get a physical at the clinic; 90% took advantage of the deal, he said.

Employer clinics could alleviate the rising demand for primary care. A far lower proportion of U.S. doctors are generalists than in other advanced economies, according to data compiled by the Peterson Center on Healthcare and KFF.

For patients, frustrating wait times are one result. A recent survey by a physician staffing firm found it now takes an average of three weeks to get in to see a family doctor.

In 2022, Franklin International, a manufacturer of adhesives in Columbus, Ohio, began offering its 450 workers the option to use local primary care clinics managed by Marathon Health, one of about a dozen companies that set up on-site or near-site health centers for employers.

Franklin employees pay nothing at the clinics compared with a $50 copayment to see an outside doctor in their insurance network. So far about 30% of its workers use the Marathon clinics, said Doug Reys, Franklins manager of compensation benefits.

We heard about the difficulty employees had to get in to a doctor, he said. They would call providers who said they were accepting new patients but would still wait months for an appointment, he added.

At the Marathon clinics which are shared by other employers workers now can see a provider within a day, he said.

Thats good for employees and for the companys recruiting efforts. It is a good benefit to say you can get free primary care, Reys said.

Not all employers that have explored opening their own clinics have seen the value. In 2020, the agency that oversees health benefits for Wisconsin state employees opted against the on-site model after a review of experiences by similar agencies in Indiana and Kentucky found it didnt save money or constrain health insurance premiums.

Kara Speer, national practice leader for consulting firm WTW, said potential cost savings from employer-run clinics can take years to accrue as employees shift from pricier hospital emergency rooms and urgent care clinics. And it can be difficult to measure whether clinics control costs by improving workers health through preventive screenings and checkups, she said.

Katie Vicars, a senior vice president at Marathon Health, said about 25% of its 250 clients are firms with fewer than 500 people. She said Marathons clinics help drive down costs and help employees get easier access to doctors who spend more time with them during appointments. Her company helps employers manage workers with chronic diseases better and redirects care from urgent care centers and ERs, she said.

Hospitals have also sought to get into the business of running on-site clinics for employers, but some potential clients question whether those health systems have incentives to funnel workers to their own hospitals and specialists.

At Laurel Grocery, Griffin said he knows many of his employees dont regularly exercise and have poor diets a reflection of the overall population in the region. Health screenings performed by a local hospital over the years found many residents with high cholesterol and high blood pressure. Nothing tended to change, he said.

Laurel Grocery contracts with a local hospital for about $100,000 a year to manage its clinic, including having a physician assistant on-site three days a week. Laurel Grocery does not have access to any employee health records.

He said the clinic has saved money by reducing unnecessary ER use and reducing hospitalizations. Its been way more successful than I thought it would be, he said.

The clinic is about a three-minute walk from Kip Faulhabers office. Faulhaber, a senior vice president at Laurel Grocer who is 73, said he goes in every week for a vitamin B12 shot to treat a deficiency. He also turns to the clinic for an annual physical, vaccinations, and when he has a sinus infection but doesnt want to wait several days to see his regular physician.

This is more than convenient, he said.

[Correction: This article was updated at 4 p.m. ET on Oct. 27, 2023, to correct the name of Marathon Healths Katie Vicars.]

Phil Galewitz: pgalewitz@kff.org, @philgalewitz Related Topics Health Industry Insurance States Copayments Investigation Kentucky Ohio Primary Care Disrupted Wisconsin Contact Us Submit a Story Tip

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Regulators must catch up to the new privacy paradigm

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Regulators must catch up to the new privacy paradigm

Opinion by: Agata Ferreira, assistant professor at the Warsaw University of Technology

A new consensus is forming across the Web3 world. For years, privacy was treated as a compliance problem, liability for developers and at best, a niche concern. Now it is becoming clear that privacy is actually what digital freedom is built on. 

The Ethereum Foundation’s announcement of the Privacy Cluster — a cross-team effort focused on private reads and writes, confidential identities and zero-knowledge proofs — is a sign of a philosophical redefinition of what trust, consensus and truth mean in the digital age and a more profound realization that privacy must be built into infrastructure.

Regulators should pay attention. Privacy-preserving designs are no longer just experimental; they are now a standard approach. They are becoming the way forward for decentralized systems. The question is whether law and regulation will adopt this shift or remain stuck in an outdated logic that equates visibility with safety.

From shared observation to shared verification

For a long time, digital governance has been built on a logic of visibility. Systems were trustworthy because they could be observed by regulators, auditors or the public. This “shared observation” model is behind everything from financial reporting to blockchain explorers. Transparency was the means of ensuring integrity.

In cryptographic systems, however, a more powerful paradigm is emerging: shared verification. Instead of every actor seeing everything, zero-knowledge proofs and privacy-preserving designs enable verifying that a rule was followed without revealing the underlying data. Truth becomes something you can prove, not something you must expose.

This shift might seem technical, but it has profound consequences. It means we no longer need to pick between privacy and accountability. Both can coexist, embedded directly into the systems we rely on. Regulators, too, must adapt to this logic rather than battle against it.

Privacy as infrastructure

The industry is realizing the same thing: Privacy is not a niche. It’s infrastructure. Without it, the Web3 openness becomes its weakness, and transparency collapses into surveillance.

Emerging architectures across ecosystems demonstrate that privacy and modularity are finally converging. Ethereum’s Privacy Cluster focuses on confidential computation and selective disclosure at the smart-contract level. 

Others are going deeper, integrating privacy into the network consensus itself: sender-unlinkable messaging, validator anonymity, private proof-of-stake and self-healing data persistence. These designs are rebuilding the digital stack from the ground up, aligning privacy, verifiability and decentralization as mutually reinforcing properties.

This is not an incremental improvement. It is a new way of thinking about freedom in the digital network age.

Policy is lagging behind the technology

Current regulatory approaches still reflect the logic of shared observation. Privacy-preserving technologies are scrutinized or restricted, while visibility is mistaken for safety and compliance. Developers of privacy protocols face regulatory pressure, and policymakers continue to think that encryption is an obstacle to observability.

This perspective is outdated and dangerous. In a world where everyone is being watched, and where data is harvested on an unprecedented scale, bought, sold, leaked and exploited, the absence of privacy is the actual systemic risk. It undermines trust, puts people at risk and makes democracies weaker. By contrast, privacy-preserving designs make integrity provable and enable accountability without exposure. 

Lawmakers must begin to view privacy as an ally, not an adversary — a tool for enforcing fundamental rights and restoring confidence in digital environments.

Stewardship, not just scrutiny

The next phase of digital regulation must move from scrutiny to support. Legal and policy frameworks should protect privacy-preserving open source systems as critical public goods. Stewardship stance is a duty, not a policy choice.

Related: Compliance isn’t supposed to cost you your privacy

It means providing legal clarity for developers and distinguishing between acts and architecture. Laws should punish misconduct, not the existence of technologies that enable privacy. The right to maintain private digital communication, association and economic exchange must be treated as a fundamental right, enforced by both law and infrastructure.

Such an approach would demonstrate regulatory maturity, recognizing that resilient democracies and legitimate governance rely on privacy-preserving infrastructure.

The architecture of freedom

The Ethereum Foundation’s privacy initiative and other new privacy-first network designs share the idea that freedom in the digital age is an architectural principle. It cannot depend solely on promises of good governance or oversight; it must be built into protocols that shape our lives.

These new systems, private rollups, state-separated architectures and sovereign zones represent the practical synthesis of privacy and modularity. They enable communities to build independently while remaining verifiably connected, thereby combining autonomy with accountability.

Policymakers should view this as an opportunity to support the direct embedding of fundamental rights into the technical foundation of the internet. Privacy-by-design should be embraced as legality-by-design, a way to enforce fundamental rights through code, not just through constitutions, charters and conventions.

The blockchain industry is redefining what “consensus” and “truth” mean, replacing shared observation with shared verification, visibility with verifiability, and surveillance with sovereignty. As this new dawn for privacy takes shape, regulators face a choice: Limit it under the old frameworks of control, or support it as the foundation of digital freedom and a more resilient digital order.

The tech is getting ready. The laws need to catch up.

Opinion by: Agata Ferreira, assistant professor at the Warsaw University of Technology.

This article is for general information purposes and is not intended to be and should not be taken as legal or investment advice. The views, thoughts, and opinions expressed here are the author’s alone and do not necessarily reflect or represent the views and opinions of Cointelegraph.