By Tom Peterson
1,800 retail clinics and growing
For minor health needs, a visit to the emergency room is usually not the right door; it’s expensive and can take hours. The rapid spread of clinics in retail stores is providing one alternative. These walk-in clinics are barely over ten years old (the first opened in 2001). Today, according to a recent Forbes article, there are more than 1,800 retail clinics in the United States, and they are visited more than 10 million times in a year. But this still accounts for only 2 percent of primary care visits. The article cites a Manatt Health study (funded by the Robert Wood Johnson Foundation) that found a visit to a retail clinic costs one-third that of other outpatient settings.
The Manatt study reports that “clinics are more prevalent in higher-income, urban and suburban areas, though they also can be found in rural and underserved communities. The majority of retail clinics accept commercial, Medicare and Medicaid coverage, and all accept cash payment regardless of insurance status.”
Target, Safeway and Kroger are now in the business. Walgreens has almost 450 “Healthcare Clinics” where no appointments are needed. They treat “illnesses, aches and pains, minor injuries and skin conditions to prevention and wellness services and monitoring and management of ongoing health conditions.”
Not to be outdone, of the 7,800 CVS pharmacies roughly 1,000 have a “MinuteClinic” that offers affordable no-appointment, walk-in services. Staffed by nurse practitioners and physician assistants and open seven days a week. According to CVS, they offer treatment “for common family illnesses and administer wellness and prevention services, including health-condition monitoring for patients with chronic diseases.”
Retail clinics and health systems
The Manatt study also looked at the relationship between retail clinics and health systems:
To date, more than 100 partnerships between retail clinics and health systems have been formed, linking care between retail sites and primary care medical homes, expanding after-hours care options and enabling health systems to provide patients with alternatives to emergency departments (EDs). In fact, one study estimated that up to 27 percent of ED visits could be handled appropriately at retail clinics and urgent care centers, offering cost savings of $4.4 billion per year.
The full benefit of these partnerships can only be realized when care is coordinated, protocols are adopted, and information systems are effectively linked. The reach and effectiveness of retail clinics can be constrained by varying and restrictive state scope-of practice rules that increase the administrative costs of retail clinic operators and limit their practitioners’ scope of services. Health system partners have helped resolve some of these issues by providing physician oversight, though that can add to overhead and cost.
CVS and Henry Ford
MinuteClinic collaborates with a growing number of health systems across the country. For example, Stakeholder Health partner Henry Ford Health System in Detroit works with CVS in more than a dozen locations in Southeast Michigan. The partnership was featured in an article in Modern Healthcare:
“Our physicians serve as medical directors to meet with nurse practitioners at MinuteClinics on a regular basis to review quality,” said Paul Szilagyi, Henry Ford’s vice president of primary care and medical centers. “They are a phone call away if the nurse practitioner has a question about a patient.”
The contract also allows patients of the Henry Ford Medical Group to use the MinuteClinics as if they were one of the 27 Henry Ford-owned medical centers and nine affiliated physician offices.
Through market trends and innovations retail clinics will continue to evolve and will, hopefully, play a positive role in providing affordable healthcare to Americans.
Photo: Otisfrog, CC.