Though negotiations between the two companies are in their infancy, one option is to rent a floor of St. Vincent's Manhattan, a 150-bed hospital that is part of St. Vincent Medical Centers. The deal could also help alleviate the financial pressure facing the Queens-based hospital chain, which filed for Chapter 11 bankruptcy protection last year. While the clinic would be used primarily for urgently needed care that is faster and, ideally, more cost-effective than emergency room visits, the clinic could also promote health screenings and assessments.

Both Marriott and Pitney Bowes, which has health clinics at its headquarters in Stamford, Connecticut, have been aggressive in managing the health of their employees as a way to drive down costs associated with chronic diseases. On-site medical care, common at suburban office parks, is impractical in large cities because employees are dispersed across multiple office buildings.

"We're looking at figuring out how to extend clinics to areas where we have large populations of employees," says David Hom, a vice president at Pitney Bowes who has been a driving force behind the company's health care benefits strategy. "We're looking at the possibility of building a business case for (clinics in) New York City." The company has about 1,000 employees in Manhattan, but in different buildings and ZIP codes, he says.

Creating a jointly owned clinic poses logistical and liability issues that have yet to be worked out, Hom says. If a deal materialized, it could be a model for establishing clinics in other metropolitan areas. The clinic would not be available to union employees and, unlike clinics sponsored by unions, the clinic would not limit its focus to workers' compensation claims.

The idea would be to make care as convenient as possible, says Jill Berger, vice president of health and welfare plan management and design for Marriott. "Our ultimate goal is to make sure our associates get the essential care they need."

The need for employees to have access to urgent medical care has been acute for many large employers in New York and other metropolitan areas where emergency room wait times are long, says Laurel Pickering, president of the New York Business Group on Health. She encourages employers to work together to establish clinics that might improve the health of their workers and reduce lost productivity.

"Access to care is a concern for employers, especially those that have hourly employees," whose shifts would need to be covered if they were to get sick, Pickering says.

Jointly operated medical clinics are not unheard of, but most exist in industries like mining and logging, where employees operate in remote areas, says David Beech, a consultant with Watson Wyatt. Jointly operated clinics thrive best when both organizations' employee populations are similar and have similar health needs.

According to a recent survey by Watson Wyatt, 22 percent of companies with 2,000 or more workers have on-site health clinics and 5 percent more plan to open one next year.

—Jeremy Smerd