April 4, 2014

Walk-in health care is a fast-growing profit center for retail chains

Retail walk-in clinics, which saw several years of slow growth after the recession, are taking off again.

Retail walk-in clinics, which saw several years of slow growth after the recession, are taking off again.

CVS, for example, is fast expanding its MinuteClinics. It expects to add 150 nationwide this year and to have 1,500 clinics by 2017, or almost as many as the more than 1,600 retail clinics across the country now, according to the Convenient Care Association. CVS currently has 800 clinics nationwide, including about a dozen in Charlotte, according to its website.

Accenture, a global management consulting firm, predicted last year that the number of walk-in retail clinics industrywide would almost double by 2015, reaching nearly 3,000 next year.

Several trends are driving the expansion of health care into retail stores – including pharmacies, big-box stores and grocery stores – and some of those trends will be accelerated by the Affordable Care Act.

One is the growing deficit in primary care doctors. The shortfall is expected to reach 45,000 by 2020, according to the Association of American Medical Colleges. This dearth has been blamed on more doctors choosing higher-paying specialties, too little money for hospital residencies and the aging of the baby boom generation, which now needs more medical care.

The health care law will only add to the demand. It is designed to provide insurance for millions of additional customers through Medicaid and subsidized private plans and by allowing individuals up to age 26 to remain covered by their parents’ health insurance. That will make getting in to see a primary care doctor even harder.

“That’s a strong driver of retail clinics,” said Ateev Mehrotra, a doctor who is an associate professor at Harvard medical school and a policy analyst at the research organization Rand Corp. “If your primary care provider says you can have an appointment in three days, and you’re worried about a urinary tract infection or your daughter has an ear infection, the retail clinics are going to benefit from that.”

Most walk-in clinics are staffed by nurse practitioners or physicians’ assistants, and nearly all take private insurance, Medicare and Medicaid. Costs per visit are in the $79 to $89 range, with additional charges for lab tests. A quick strep throat test, for instance, is $30 at a CVS clinic.

Transparency in pricing is one way in which retail clinics reflect growing trends in health care, said Ceci Connolly, managing director of PricewaterhouseCoopers Health Research Institute. “The price is just out there on a giant board” for consumers who want to comparison shop for care the way they shop for other services, she said.

Not everyone is an unabashed fan. The American Academy of Family Physicians has warned that growing use of the clinics might result in a “missed opportunity to address more complex patient needs.” It noted that “the overwhelming majority of family physicians offer same-day scheduling” and that many have extended their hours.

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