By Caroline Ticse, AcademyHealth
Spring may have sprung in Washington, but with the late arrival of the flu this season, I’m glad that a few months ago I decided to couple an errand run with my annual flu shot. At the time I thought: why not save time, money, and myself from the hassle of scheduling a doctor’s appointment? At my convenience, I waltzed into the nearest drug store and headed for the pharmacy in the back, prepared to wait in a modest line of like-minded individuals. To my surprise, I was next in line and vaccinated within the half hour.
Until recently, many patients received their flu shots in the traditional office setting, often laden with long wait times and inconvenient hours. In recent years, however, a more convenient and accessible option emerged, offering preventive services like immunizations as well as treatment for low-acuity conditions. Enter: retail clinics. Located in pharmacies, grocery stores, and other retail settings, retail clinics have grown as an industry of their own, reaching six million visits per year. Given how simple, quick, and inexpensive my experience was, I’m not surprised that retail clinics are an attractive option for many Americans. But is there a catch?
For more than 25 years, AcademyHealth has managed the Robert Wood Johnson Foundation’s Changes in Health Care Financing and Organization (HCFO) grantmaking program. In this final year of the program, AcademyHealth is working with our grantees to disseminate their research findings.
One such grantee is AcademyHealth member Ateev Mehrotra, M.D., M.P.H., of Harvard Medical School. In a HCFO-funded study, Mehrotra and his colleagues examined the impact of retail health clinics on health care utilization and costs. In a paper recently published in Health Affairs, they found that roughly two-thirds of retail clinic visits for low-acuity conditions represented new utilization of health care services by patients who otherwise would not seek care, rather than substitution for more costly visits, resulting in a modest increase of 21 percent higher spending for these conditions. These findings suggest that rather than reducing health care spending, retail clinics increase utilization and spending for low-acuity conditions. Highlights of the study are also available here.
So is an increase in utilization, and subsequently in spending, a bad thing for the health care system? On one hand, retail clinic visits may contribute to early diagnosis and prevent costly treatments down the road. On the other, they may disrupt a patient’s relationship with his/her primary care provider and impede care coordination. It is also important to consider the ailments for which patients are seeking treatments – would they get better on their own, or do they require medical attention? Whichever perspective you take, the study shows that if the goal of retail clinics is to reduce spending, we may need to pursue an alternative mechanism.
Caroline Ticse is a Research Assistant at AcademyHealth, where she supports the work of a number of Robert Wood Johnson Foundation-sponsored initiatives, including the Changes in Health Care Financing and Organization (HCFO) program.