In the past five years, more and more businesses have been investing in their own in-house medical centers, hoping to save on employer-provided health insurance by keeping their workers out of emergency rooms.

One such company is Maryland Live Casino, which has made free medical services available to employees and their families since the Anne Arundel County gaming hall opened in 2012.

“From the very beginning, before they even knew it was going to be financially successful, they bought off on [the in-house clinic] before they even had a strong revenue stream. They said. ‘This is the right thing to do for our employees,’ ” said Randy Hart, a benefits consultant at Cleveland-based CBIZ who advised Maryland Live on its benefits package.

With a staff of just two people — an office administrator and a nurse-practitioner — the clinic serves several hundred patients each month, and the company says employees rarely spend more than five minutes in the waiting room.

The company recognizes that many of their employees don’t have access to primary-care networks and instead rely on costly emergency room visits for the smallest of check-ups. A nurse practitioner can’t take on the same duties as a doctor, so the clinic focuses on preventive care and basic treatment. Clinic staff can’t set broken bones, they don’t draw blood and they don’t conduct any diagnostic testing. But they can treat such issues as flu symptoms, upper-respiratory problems, migraines, high blood pressure, dizziness, back pain, and eye and ear infections — which if treated in the emergency room could cost 10 times as much.

When the patient’s needs stretch beyond the abilities of the company’s staff nurse, the patient is referred elsewhere. The company is also looking into adding biometric testing to its wellness regimen, joining a wave of companies that pay their employees to get healthy.

Casino executives say they set up the clinic because they wanted to differentiate themselves from other employers, hoping the clinic will be a positive perk for the employee while saving money for the company.

So far, the staff has seen between 150 and 400 patients a month.

“I think it has affected our bottom line very positively.” said Howard Weinstein, senior vice president and general counsel for the casino.

“Because utilization [of the clinic] has been so high, you have to assume that employees would otherwise be missing time to go to the doctor.”

Casino executives say they have hosted executives of other businesses seeking to emulate their model, but Polly Thomas, also a consultant at CBIZ, cautions that the service may not be a cost-effective option for all enterprises. Maryland Live can take advantage of the fact that its 3,000 employees, some of whom live as far away as West Virginia, all work at one location, providing a critical mass of workers.

Company executives “knew that their health-care costs were going to be growing. And with Obamacare happening at the same time, they knew they were going to have to cover people they previously didn’t have to,” Thomas said.

Nonetheless, a wider range of companies are considering this sort of service.

“Five or six years ago, it was just the Googles and Ciscos of the world that had on-site clinics, but now, with between 700 and 1,000 employees, it could justifiably work,” Thomas said. “This is the next shining object in employee benefits.”

Life at Work highlights novel workplace practices in the Washington area.

Maryland Live Casino

Location: Hanover, Md

Employees: 3,000