Retail Clinic Growth

Health Affairs carries a study on the number and nature of retail clinic visits.   (HA Article)   As their name suggests, retail clinics are small medical facilities located in drug-stores, chain discount stores or other retail shopping settings.  They are usually staffed by nurse practitioners or physician assistants and offer a limited menu of services, although they increasingly are looking at expanding services into areas like chronic disease management.  According to the data, these service sites are popular with consumers.  From 2007 to 2010 the number of retail clinics increased from 300 to almost 1200.  Using data from the three largest operators of retail clinics, which have about 80% of the sites and probably more of the visits, the authors examine utilization characteristics from 2007 through 2009.  Visits rose from 1.48 million in 2007 to 5.97 million in 2009.  There is a seasonal peak in October and November, probably related to flu shots in large part.  Monday had the highest utilization and the weekends the lowest.  About 44% of visits occurred when doctors’ offices are likely to be closed.

Use by Medicare eligible patients increased, and females account for around 60% of utilization.  About 30-40% of patients paid out-of-pocket and the same percent said they had a regular physician, while 70% had insurance, which now normally will pay for retail clinic visits.  Almost half of visits were for preventive care, almost 40% for vaccines.  Chronic disease care represented only 1% of visits.  Of the acute care visits, respiratory infections, sore throats and earaches were the most common presenting symptoms.  While physician groups often voice opposition to the clinics, there is no research to suggest that quality is worse.  The clinics obviously are filling a consumer demand and they cost the system significantly less than a comparable doctor, urgent care or ER visit.  This is a classic case of market innovation which is resulting in a true lowering of spending.  Coupled with the increased availability of workplace clinics, they offer consumers a better alternative for meeting medical care needs.