Rapid growth has occurred in convenience care clinics in retail settings, although that growth has leveled off. Physician groups and others have raised concerns about the quality of care provided and the potential for disruption of ongoing care relationships. Physicians are also likely concerned about the impact on their incomes. Researchers have begun to examine some of these issues and one such study is reported in the current issue of Health Affairs. (Health Affairs Article)
The study compared the characteristics of patients who used a retail clinic versus those who visited an emergency room or a primary care physician, and looked at the reasons for the visits at each site. Retail clinic users are generally younger than patients accessing PCPs or ERs. They were more likely to be paying out of pocket than those visiting a PCP and somewhat more likely than those patients using an ER. This may reflect a lack of insurance or may be attributed to insurers’ not reimbursing for retail clinic use. Interestingly, however, the study found that over the last few years insurers have dramatically increased coverage of these visits, likely because they are much cheaper than physician or ER visits.
Most patients go to retail clinics for relatively simple issues; ten diagnoses account for almost 90% of visits. Many of the patients did not report having a regular PCP. It appears that the clinics are providing a convenient, less expensive avenue of care for people who often do not have an ongoing physician relationship. The clinics also appear to be a source of preventive care, such as immunization. The authors did not specifically assess quality or impact on coordination of care when the patient did have a PCP. The study appears to suggest that these clinics can play a useful role in the health system. Many of these clinics, however, have yet to show that they make money or generate sufficient store traffic to pay for themselves and their growth has begun to slow.