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Retail Health Clinics

By November 15, 2016Commentary

Retail health clinics are small footprint departments in larger retail locations.  CVS and Walgreen’s alone account for over three-fourths of all retail clinic locations and various chain pharmacy, grocery and other retailers account for almost 100%.  These clinics typically treat a relatively small number of discrete health needs, although some are attempting to provide more chronic illness care.  A report from the Rand Corporation summarizes where the industry is today.    (Rand Report)    There were about 1200 retail clinics in 2010; estimates are that there will be around 2800 in 2017.  Most are located in the south and western parts of the country.  They tend to be located in higher-income areas, which limits their ability to supplant inappropriate emergency room use or to substitute for more expensive primary care office visits.  Most of these clinics accept multiple payer sources.  They tend to charge significantly less for their services than do primary care offices or urgent care centers and their pricing tends to be very transparent.

Users of retail clinics are often younger, uninsured and have no regular physician.  They are motivated by convenience and lower prices.  Contrary to fears expressed by physicians, research to date finds that the care provided at retail clinics is equivalent to that provided for the same conditions in other settings.  In fact, in regard to antibiotic prescribing, retail clinics were more guideline compliant.  While retail clinics have been promoted as reducing ER use and overall spending, the existing research suggests this has not happened.  While unit costs are lower, retail clinics appear to add to overall utilization because they allow access to care for patients who otherwise might go untreated.  This supports my perception that “inappropriate” utilization cuts both ways–some people may get services they don’t need, but there are also patients who aren’t receiving care when they need it.  The convenience and lower cost of retail clinics improves access to care, which is a good thing.  But it would be nice if more were located in underserved communities, where greater access is really needed.

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