The Role of Retail Health Clinics

Retail health clinics burst on the health care scene over a decade ago, driven by consumer desires for greater convenience and lower cost for relatively minor health needs.  Today they are often found in drug stores, grocery stores, discount retail chains like Walmart and Target.  They increasingly overlap with another rapidly growing health service location–urgent care centers.  While the retail clinics started out with a limited menu of health issues-sore throats, etc., now they are exploring treatment of chronic diseases and other revenue sources.  A Robert Wood Johnson Foundation report attempts to describe the current state of the industry.   (RWJF Report)   In 2014 there were 10.5 million visits to 1800 retail clinics.  CVS alone owns 900 of these sites, with Walgreens having another 437.   Major reasons for patients choosing a retail clinic setting for care include 59% who say the hours were more convenient, 56% who said they didn’t have to make an appointment, 48% saying the location was more convenient and 39% who said the cost was lower.  Uninsured respondents were more than twice as like as insured ones to say that cost was a factor.  Although the clinics are lower cost than alternative care settings, they are more heavily used by middle-income patients than poor ones, which likely reflects their locations, typically in suburban or more affluent urban neighborhoods.  Because treatment costs are substantially lower at the retail clinics, and prices are often posted and easily understandable by patients, commercial insurers have often not only included them in their networks, but offer incentives for their use, such as reduced or waived copays.  There have been concerns about disjointed care, but many of the clinics are integrated into larger primary care and health system settings.  The clinics have generally scored well on quality measures and patients report high levels of satisfaction with the care and service they get in the clinics.  Some suggestions made in the report for expanding and optimizing the role of these clinics include better integration of data and services with other care settings, expanding the ability to conduct telemedicine visits from clinics, reducing scope of practice and other regulatory barriers, and improving access in poorer neighborhoods.  For owners there is an issue about whether retail clinics can generate a return on capital, but it seems clear that patients appreciate having them available and get lower cost care with equivalent quality.