Convenient Care / Retail Clinics


News Overview 4.0


Medical team imageThe number of U.S. retail / convenient clinics has grown substantially in the past six years. In addition to providing walk-in medical services for common ailments, menu pricing is a model for cost-comparison shopping / transparency. Developments and news from the past several years is highlighted below.

Convenient Care Clinics (November 2008)

Convenient care clinics continue to open throughout the United States at a slow but steady rate. Abstracts describing some of the new locations appear below.

Largest U.S. Convenient Care Clinic Opens In Houston

At 926 square feet, RediClinic’s 15th clinic in the Greater Houston area is the largest retail / convenient care clinic operating within the United States. The extra size provides the capacity to serve more patients and/or expand services. Nurse practitioners staff the clinic, working with local physicians to diagnose and treat common medical ailments. Preventive services include immunizations, physical exams, screenings, and tests.

In other news, RediClinic was chosen by Health Net Federal Services to provide convenient care coverage to TRICARE North beneficiaries in nine locations within the Greater Richmond area (Virginia). Health Net Federal Services’ members include active and retired military personnel and their families. Two RediClinic facilities are near the Fort Lee military base (a 15-minute drive). TRICARE / RediClinic Richmond-based coverage became effective November 1st. [The original articles were issued by Bizjournals and Business Wire.].

MinuteClinic Facility Opens In Westford MA

At the new MinuteClinic in the Westford Marketplace CVS/pharmacy (Massachusetts), patients can walk in for a check-up or receive care for common medical conditions such as influenza, skin problems, and strep throat. Board-certified nurse practitioners diagnose and treat patients, provide immunizations, and perform health screenings, physical exams, and tests. A physician is available on call for consultation. Educational material is included, along with the option to use the Google National Health Database for electronic medical record storage. Prescriptions are written as needed. Patients with more serious medical problems are referred to their physicians or emergency service providers. [Read more about MinuteClinic at: http://www.minuteclinic.com.]

Take Care Health Systems Opens Office In Tennessee

Augmenting the May 2008 formation of its Health and Wellness division, Walgreens has opened an office in Franklin, Tennessee. One of its large worksite health management companies, CHD Meridian Healthcare, originally operated in Nashville, before being acquired by Walgreens. The Health and Wellness division also includes Take Care Health Systems, which operates convenient care clinics.

The Tennessee office currently houses 150 employees with the capacity to include 100 more in anticipation of further expansion within the Nashville area and beyond. There are 13 Take Care clinics in Nashville and another six in other parts of Tennessee. The new office is the largest of Take Care’s support centers.

Valley-Wide Health Systems New Convenient Care Clinic

In early November, Valley-Wide Health Systems opened its Convenient Care Community Clinic in Alamosa, Colorado. The clinic was developed as an alternative to the emergency room to provide patients with accessible, affordable health care services. The facility operates seven days a week (including holidays) until 10:00 p.m. Valley-Wide Health Systems has used a combination of resources (arrangements with insurers, grant funding, etc.) to offer free or reduced-fee health care even if reimbursement is not available. Adjusting fees for uninsured patients allows them to pay a fair share while also benefitting Valley-Wide with a high collection rate for services rendered (92%).

Valley-Wide operates clinics in several Colorado locations (e.g., Alamosa, Antonio, Center, Mancos, Monte Vista, Moffat, and San Luis). For information about the Alamosa facilities, call (719) 589-3658 or (719) 587-5932. [The original article was published by Alamosanews.com.]

Retail Clinics (August 2008)

In July, expansion of the retail clinic market appeared to be back on track at a slower rate than for the first half of the year. Several retail clinic locations closed in prior months. Early August brought some interesting developments that are described in the following news abstracts.

Blue Cross Blue Shield Co-Pay Coverage

As a cost-saving measure, Blue Cross & Blue Shield of Minnesota (BCBSM) is encouraging health plan members to use retail clinics instead of physician’s offices or other venues for treatment of minor ailments and routine vaccinations. As incentive, BCBSM co-payments are being waived for retail health clinic services.

In a separate development, CVS Caremark has contracted with Harvard Pilgrim Health Care and Tufts Health Plan to cover member visits to CVS retail clinics in Massachusetts. Co-payments of $10 – $25 will be charged instead of typical costs ($59 – $69).  The Tufts Health Plan may expand coverage to include visits to Walgreen’s Take Care clinics. In January 2008, the Massachusetts Public Health Council approved CVS’s plan with the expectation that retail clinics would expand access to care. An ongoing issue is whether patients will substitute retail clinic services for visits to their regular physicians.  A spokesperson for Harvard Pilgrim suggests that health plans and patients will save costs by using retail clinics. [The original article was published by the Chicago Tribune and the Kaiser Family Foundation.]

Technologies Supplement Retail Clinic Operations & Services

In a new business model, My Healthy Access (Houston TX) is partnering with NuPhysicia to combine retail clinic services with telemedicine technology.  Telemedicine consults will be available in select Wal-Mart retail clinics in the Houston area, enabling nurse practitioners to conduct patient examinations under supervision by a physician at a different location.

In a separate development, RediClinic has chosen athenahealth’s internet-based business services for electronic medical record and revenue cycle management.  The technology solutions will help optimize workflow for patients and staff through a centralized network that supports RediClinic’s expanding infrastructure. [The original article was published by the CBS New sand RediClinic.]

Slower Growth Of Retail Clinics…

The latest numbers available from Merchant Medicine indicate that the total number of retail clinics fell for the first time during June 2008, from 981 to 969. Growth seemed to improve in July, although the overall pace of development is likely to remain slower than during the prior twelve months. A retail clinic can take two or more years to make a profit, so large operators benefit from having established locations to offset expansion costs. The economic slow-down may have been a factor for clinic closures.

Retail Health (February 2008)

In a new book entitled Healthcare Tsunami, two market researchers/authors cite some dire forecasts and highlight the potential for consumers to mitigate rising U.S. health care expenditures. The following abstracts describe the book and other retail health news.

Changing The Health Care Model

As covered by the Manitowoc Herald Times Reporter, the authors of Healthcare Tsunami forecast the emergence of a health care revolution. Costs continue to be shifted to consumers by employers and insurers. The authors contend that high-deductable plans or lack of health insurance changes consumers’ behavior. Conceptually, paying out-of-pocket may be more like an “investment” than a hand-out, motivating consumers to adopt healthier lifestyles and wellness over the next twenty years. Knowledgeable consumers could apply pressure on hospitals and physicians by demanding quality services at competitive prices.

Mayo Express Care Clinics

According to the Heartland Institute’s Health Care News, the Mayo Clinic has announced plans to enter the retail clinic market by opening two Mayo Express Care clinics in early 2008. Following the example of other clinics, the facilities will be staffed by nurse practitioners with the support of family medicine physicians to treat common illnesses. As noted by a spokesperson for the National Center for Policy Analysis, the respect associated with the Mayo name legitimizes the business model while also extending the Mayo brand.

Combining Cosmetics With Nutrition

Nutraceutical companies are expanding into the cosmetic market with skin care products.  The latest entrant, eFoodSafety.com Inc., is marketing NumaDerm, which will be available commercially in April.  One product in the new line is a “repair cream” for dry skin.  Others deliver anti-oxidants, essential lipids, peptides, and phytonutrients using a nano-encapsulation technology for controlled release and absorption. [The original article was published at: www.nutraingredients-usa.com.]

Retail Clinics (November 2007)

The retail clinic market is rapidly advancing as new locations continue to be opened throughout the United States.  Consumers benefit from a wider range of companies to choose from in “established” regions such as the Mid-west, while other clinic operators expand services into “newer” markets, such as California.

A CEO’s Perspectives On Retail Clinics

At the Mayo Clinic’s (Rochester MN) first Transformation Symposium, one of the presenters was the current Chief Executive Officer of MinuteClinic, Michael Howe. In an interview published by the Minneapolis-St. Paul Star Tribune, Mr. Howe observed that systems management, a key component in the fast food industry, is also useful in the retail health clinic market. Other industry participants note the importance of having a flexible business model. When asked about what might happen next in retail clinics, Mr. Howe suggested that screening services may be expanded to improve preventive care. In general, the relatively slow pace of adopting new solutions within the medical community could be a significant barrier for health care innovators to overcome.

California Clinics – MinuteClinic’s Newest Locations

A total of 16 retail clinics should be operational in San Diego County by year-end 2007, according to an article published by the San Diego Union-Tribune. The first openings of MinuteClinic (Minneapolis MN) occurred in early November in Chula Vista, El Cajon, Oceanside, Poway, and San Diego. Additional facilities will be located in Carlsbad, Encinitas, Ramona, San Diego, and Solana Beach. In October 2007, MinuteClinic opened 17 clinics in Los Angeles, Orange, and San Bernadino counties. MinuteClinic operates 360 retail clinics within the United States (November 2007).

One industry source estimated that more than 700 retail clinics were already operating within the United States as of late October. [1] A report published by the California HealthCare Foundation forecasts that there may be as many as 6,000 retail clinics established by 2012. [To learn more, visit: MinuteClinic.]

Take Care Health Systems Reaches 100-Clinic Benchmark

In late November 2007, Take Care Health Systems (Conshohocken PA) announced operation of 102 retail health clinics in eleven states. New clinics were opened in Walgreens drug stores in Arizona (Tucson) and Florida (Miami, Orlando, and Tampa). Since November 2005, Take Care has served approximately 280,000 patients. Ideally, retail clinics provide immediate access to care for minor ailments as a convenient and cost-effective alternative to services provided by doctors’ offices, emergency rooms, and urgent care centers. Services are intended to supplement rather than replace conventional resources such as primary care physicians. One of Take Care Health Systems’ next goals is to establish a total of 400 facilities by year-end 2008. [For more information, visit: Take Care Health Systems.]

[1] Merchant Medicine, October 28th, 2007

Retail Clinics: Concerns & Conflicts (August 2007)

New retail clinic locations are being opened every month. Journalists and media outlets continue to cover what’s going on from a broader perspective. Competition and controversy are two common denominators in this month’s news.

The American Medical Association’s Latest Issues With Retail Clinics

As reported by numerous online and print sources over the years, the American Medical Association (AMA; Chicago IL) has raised issues about how retail clinics are operated. There’s been a flurry of news articles this month that are revisiting the topic.

The latest concern is whether retail clinics are operated independently without influence from retail stores.  As reported in June by Medical News Today, AMA members and spokespeople are asking the following kinds of questions:

  • Are incentives affecting the quality of care for patients?
  • Is there a conflict of interest in the relationships established between clinics and retail stores?
  • Can federal and state agencies investigate to determine if there are problems?
  • Will legislation be implemented to regulate the industry?
  • Why do some health insurance companies waive or lower patients’ co-payments for services provided at retail clinics but still require physicians’ offices to collect them?

On the surface, these issues are about fairness and patient safety. The explosion in retail clinics is also about competition —  which resources do consumers use to obtain health and medical services.  For minor ailments and standard testing, patients are taking advantage of the benefits offered by retail clinics –affordable, convenient, quick services that are provided immediately. Losing those patients may be another reason for the ongoing debate between the medical community and retail clinics. [The original article was published by: Medical News Today.]

Industry Perspectives On The Retail Clinic Market

A journalist from The Associated Press continued coverage of the topic in August and conducted interviews with various organizations and industry participants.  According to the Convenient Care Association (Philadelphia PA), approximately 7% of Americans have visited retail clinics one or more times.  CCA market forecasts estimate the total number of U.S. retail clinics will increase to 700 by the end of 2007 — a huge jump from the 400 sites that were in operation as of April 2007 according to a press release issued by Feedback Research Services in July 2007.

Some health insurance companies are covering patients’ costs. According to the CCA, 40% to 50% of retail clinics accept insurance from companies such as Aetna (Hartford CT), Humana (Louisville KY) and UnitedHealth (Minneapolis MN).

The American College of Nurse Practitioners (Arlington VA) notes that nurse practitioners can treat patients on their own in 23 states, while other states require physician collaboration or supervision. Retail clinics operate under the same standards as physicians’ offices, and oversight is the responsibility of state boards of nursing and/or boards of medicine, according to a CCA spokesperson.

The AMA has called for more oversight, based on concerns about conflicts of interest and the lack of consistent regulation (June 2007). Some state legislatures have delineated the role of nurse practitioners at retail clinics. Not surprisingly, officials at some retail companies consider the state rules to be too restrictive. [The original article was published by CentreDaily.]

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