Fighting Jays: a 256% Return on Onsite Care
Oct 2, 2026 · By Wesley Yielding
Mortenson, general contractor on TotalEnergies’ Fighting Jays project, spent approximately $100,000 on 1st Response onsite care from Apr 15 to Dec 10, 2024 and avoided an estimated $355,500 in offsite medical visits. That is an estimated 256% return on investment, a net savings of $255,500.
1st Response handled 245 first-aid encounters on the project and resolved 237 of them (96.7%) on site. Of the 148 work-related encounters, 143 (96.6%) were resolved on site.
The encounter counts are exact tallies from patient charts. The dollar figures are estimates, and the last section shows every input behind them.
The project
On a site this size, every injury or illness forces a choice: treat the worker where they stand, or send them off the job to a clinic. Mortenson brought 1st Response on site so the first option was always available.
| Owner | TotalEnergies |
|---|---|
| General contractor | Mortenson |
| Site | Fighting Jays, Guy, Texas |
| 1st Response on site | Apr 15, 2024 to Dec 10, 2024 |
| Peak workforce | 340 (average 260) |
| Staffing | One nationally registered paramedic (NREMT-P), 6 to 7 days a week |
| Services | Onsite medical care and first aid, drug testing, case management |
Results: 97% of encounters resolved on site
Six in ten encounters were work-related, and 1st Response resolved 143 of those 148 on site.
| Encounter type | Encounters | Resolved on site | Percent resolved |
|---|---|---|---|
| Work-related | 148 | 143 | 96.6% |
| Personal | 97 | 94 | 96.9% |
| Total | 245 | 237 | 96.7% |
Those 245 encounters covered 176 individual workers across 343 visits. The 98 follow-up visits were handled on site as well, so a worker did not have to leave the job for a recheck.
The 97 personal encounters matter to the contractor too. A worker with a non-work health problem who gets seen on site stays on shift instead of leaving to find care.
Return on investment: 256%
Without 1st Response on site, each of the 237 encounters resolved there, 143 of them work-related, has one route to care: off the site.
On site, care cost about $408 per encounter ($100,000 across 245 encounters). That figure is conservative, because the same program cost also paid for drug testing and case management.
| Line | Amount |
|---|---|
| Encounters resolved on site | 237 |
| Assumed cost of one offsite clinic or ER visit | $1,500 |
| Estimated offsite cost avoided | $355,500 |
| Program cost (approximate) | $100,000 |
| Estimated net savings to the general contractor | $255,500 |
| Estimated return on investment | 256% |
How it worked
Nothing here is exotic. The return comes from putting care where the work is and paying only for what the site needs.
- Care in minutes. Workers were seen within minutes of an injury, on site, instead of after a drive and a waiting room.
- Coverage sized to the job. One provider on the site’s own schedule, 6 to 7 days a week, with no clinic facility to carry.
- Workers stay on the job. No trip, no escort pulled off the crew, no half-day lost to a clinic visit.
- Follow-up on site. Rechecks happened where the worker already was: 98 follow-up visits across the project.
- One provider, several jobs. The same program covered first aid, drug testing and case management.
- Personal health included. Non-work problems were seen on site too, which kept those workers on shift.
Where the numbers come from
The counts are measured and the dollars are modeled. Each figure below is labeled as one or the other.
| Figure | Source | Precision |
|---|---|---|
| Encounters: 245 total, 148 work-related, 97 personal | 1st Response electronic patient charts for this site. Charted encounters run Apr 15 to Nov 26, 2024. | Exact count |
| Resolved on site: 237 total, 143 work-related, 94 personal | The same charts. An encounter is resolved when it closes with a completed 1st Response visit. | Exact count |
| Work-related or personal | The final determination recorded on each chart | Exact count |
| Workforce and site dates | Site data approved for publication by the general contractor’s safety department | As reported |
| Program cost: $100,000 | 1st Response | Approximate, rounded |
| Offsite visit: $1,500 | Planning assumption covering the visit, transport and paid time away from work | Assumption, not a billed figure |
How encounters were counted
The count was built to run low, not high.
- Only first-aid encounters count. Drug tests, alcohol tests and physicals are excluded.
- Test and training charts are removed.
- Visits by the same worker within 4 days count as one encounter, so 343 visits became 245 encounters.
- An encounter charted as both work-related and personal is counted once, under its final determination.
How far the estimate can bend
The return stays positive under every conservative case below.
The program breaks even at 67 avoided offsite visits, which is 28% of the 237 resolved on site, or at an offsite visit cost of $422.
| Scenario | Cost avoided | Return on investment |
|---|---|---|
| Base case: 237 visits at $1,500 | $355,500 | 256% |
| Program cost 50% higher ($150,000) | $355,500 | 137% |
| Work-related encounters only (143) | $214,500 | 115% |
| Offsite visit cost cut in half ($750) | $177,750 | 78% |