Since the arrival of the Affordable Care Act in 2010, Wal-Mart has faced roughly $330 million in additional employee health care costs. To cut company expenditures and provide more affordable care for both workers and customers, Wal-Mart has opened three pilot health clinics in Texas that offer full primary care at a nominal fee.

Employers usually cover 75 percent or more of the total health care costs for employees. Per-employee costs averaged $12,000 nationally last year, but that figure will likely drop significantly through the growing establishment of in-house health clinics.

This isn’t a new concept. In 2006, Toyota expanded its use of in-house clinics and saw an investment return within two years. This venture has since saved the company $3 million per year in health care costs.

Wal-Mart U.S. CEO Bill Simon described the cost benefits of in-house clinics at the retailer’s shareholder week, saying:

When an employee goes to see a doctor they pay a co-payment. As a self-insured employer, we end up writing a check for the cost of that visit, through a third party administrator like Blue Cross Blue Shield. By controlling the clinics ourselves we can offer a nominal fee for our insured employees because we don’t have to pay for the outside doctor’s visits.

Because of this employer control, Wal-Mart clinics have the ability to charge rock bottom prices for health services. An office visit at a clinic costs an insured employee a mere $4, significantly less than what an employee would have to pay under traditional group insurance.

To further cut employer costs, Wal-Mart has staffed the in-house clinics with nurse practitioners (NPs), who have proven to be a more cost-effective solution for health care consumers in the long term. Expanding scope of practice in Texas for NPs would not only address the provider shortages throughout the state, it would also make it easier and more cost-effective for large companies to set up in-house clinics.

Wal-Mart’s recent expansion of in-house health clinics provides a prime example how employer self-insurance and the use of nurse practitioners can mitigate the effects of the ACA and deliver truly affordable care.