Retail Health Clinics to Continue to Boom as Profits Soar

Ken Terry

November 12, 2015

The number of retail health clinics will exceed 2800 by 2017, which is an increase of 47% from about 1900 in 2014, according to a new report from Accenture.

Located in pharmacies, retail chains, and supermarkets, these walk-in clinics will be able to handle 25 million patient visits in 2017, up from 16 million in 2014, Accenture predicts.

The main reason for the surge in retail clinics, which have been around since 2001, is that they are starting to generate substantial profits for their companies. Originally, these clinics, staffed by nurse practitioners, dealt mainly with minor acute or seasonal medical issues. Now many retail clinics also manage chronic conditions and have added electronic health records (EHRs) and access to telehealth services. Some of the companies that operate retail clinics are partnering with regional healthcare providers to build patient volume, Accenture noted.

"These changes are having a profound impact on the overall profitability of these clinics and will serve as a key driver of future growth," the researchers write.

Although the clinics are convenient for consumers, providing services when most medical offices are closed, physicians continue to view them warily. An Accenture survey of 1000 physicians found that 41% of them are comfortable with patients using retail clinics for preventive care, such as vaccinations, but many physicians do not want patients to receive chronic care or other primary care in these settings.

Branching Out

One reason for physicians' discomfort with retail clinics is that they charge less than medical offices for the same services, and their charges are often covered by insurance. Although retail clinic visits are still a small fraction of visits to physicians, this poses a potentially sharp challenge to primary care practices. Also, although studies show that retail clinics provide high-quality care for simple acute problems, medical societies question whether they should be delivering other kinds of services.

The American College of Physicians recently warned in a position paper against retail clinics taking on too many care functions. Published in the Annals of Internal Medicine, the paper advised against the clinics managing chronic conditions until more is known about how well they can perform those services. The American College of Physicians also stated it is inappropriate for retail clinics to refer patients directly to subspecialists without consulting a primary care physician. The paper added that clinics should have a structured way of referring patients to primary care settings and that they should encourage patients who do not have a primary care physician to find one.

The Accenture report noted that some retail clinic parents are collaborating with healthcare organizations. Target, for example, is partnering with Kaiser Permanente to launch retail clinics in California that "provide greater levels of service and information sharing between clinics and the integrated delivery network." Among the services to be provided are pediatric and adolescent care, family planning, wellness services for women, and the management of hypertension and diabetes.

Similarly, Walgreens is collaborating with Trinity Health, one of the largest health systems in the United States, "to coordinate patient care in an effort to improve outcomes and increase access to care while reducing overall costs," Accenture said.

CVS Health, meanwhile, is joining with four major regional health systems to provide better access to healthcare through its clinics. CVS' MinuteClinic is now affiliated with 60 health systems, Accenture reported. Medication counseling, chronic disease monitoring, and wellness programs are among the services offered.

CVS is installing an Epic EHR nationwide in its MinuteClinics, and Walgreens recently announced it will also implement Epic in its retail clinics. Although this will make it easier for these drug chains' clinics to exchange records with the many practices and hospitals that use Epic, it is unclear how they will transfer information about patient visits to providers who use other EHRs. Accenture suggested that MinuteClinics could transmit data to regional health information exchanges, but these are still few and far between.

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