Retail-based health clinics are here to stay. The walk-in centers got off to a quiet start about 15 years ago, and now the convenient-care industry is growing rapidly. The estimated $1 billion industry has more than 2000 retail health clinics nationwide — a number that’s expected to more than double in the future.
This trend is being driven by a shortage of primary care providers, demand for easier access to care and the new consumerism that’s entered the health care market. Cost and speed are also factors. Typically a visit to a retail health center is a fraction of the price of an emergency department visit and takes 15-20 minutes.
Formerly a cash-only option, retail clinics now have a strong foothold in the payer community: Forbes reports that four in five visits to CVS and Walgreen clinics are covered by insurance.
Clearly, benefit design plays a key role in driving patients to this high quality, lower-cost alternative.
Here’s what you should know about retail-based health clinics:
- They appeal to the budget-minded. For beneficiaries with a high deductible plan, the choice is a no-brainer. Several years ago, researchers compared the average cost of treating ear infections, sore throats and urinary tract infections in retail centers and traditional settings. Retail centers were the clear winner at $110, compared with $166 for physician’s offices and $570 for hospital emergency departments, according to Managed Care Magazine.
- They could save billions. Both retail clinics and urgent care centers are less expensive than a hospital’s emergency department for non-emergent care. Deloitte reports that an estimated 13.7%-27.1% of all emergency department visits could be handled elsewhere, saving the health care system about $4.4 billion annually.
- They could inch up spending. Clinics receive more than 6 million patient visits annually, and about 6 out of 10 visits were for medical care that patients otherwise would not have sought. This increased utilization is driving up costs, according to a recent RAND Corporation study. The bottom line: The use of retail clinics for minor issues was linked to an increase of about $14 per person per year.
- They provide cost-effective, quality care. Research shows that patients are receiving quality health care, often delivered by a nurse practitioner. This judicious use of nursing care leads to lower costs, especially in states where nurse practitioners are allowed to practice independently and prescribe medications, according to a Robert Wood Johnson Foundation report.
- Many business models succeed. Retailers including CVS, Walgreens, RiteAid, Target, Kroger and Walmart are all familiar players in the retail clinic game, often operating independent of other health providers. Other models are also thriving. For example, the Geisinger Health System uses an integrated model — it owns and operates more than 200 walk-in clinics that are part of its overall continuum of care. The Cleveland Clinic has collaborated with CVS Health to provide a hybrid system of more than 20 clinics in northeastern Ohio, according to Managed Care Magazine.
- The controversy continues. The medical community has raised red flags for a variety of reasons include a perceived lack of care coordination. For example, the American Academy of Pediatrics advises parents against using retail-based clinics “because they fragment children’s health care and do not support the medical home.”
- They could help control chronic conditions. Almost half of Americans have chronic conditions, like diabetes, asthma, hypertension and others. Retail health clinics may grow their business by helping their customers manage their conditions with convenient, affordable care. For example, patients may find it more convenient to go to a retail center for a blood pressure check and HbA1c monitoring instead scheduling checkups with their primary care physician.