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BioPharma: Retail Medical Clinics

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HIT Perspectives Biopharma Insights – June 2016

Retail Medical Clinics: Untapped Resources for Patient Education

By Trey Riley, Life Science Account Executive and Co-Lead

Retail medical clinics are on the rise, offering millions of Americans ambulatory and preventive care at their convenience and traditionally at a lower cost than regular doctor visits.  Patients – primarily young adults and the elderly – are going to retail clinics more than 10 million times a year at 1,900-plus locations, including big box stores, pharmacy chains and grocery stores, according to a 2015 report.  Moreover, more than half of these patients lack a primary care provider.

Retail medical clinics burst on the scene about a decade ago – and are still growing. By 2015 there were 1,900 retail clinics in the United States, which should reach 3,000 in 2016.  They are attractive for several reasons:

Convenience.  The clinics are open nights and weekends, when physician offices are closed, and they have shorter wait times.  The accessibility of retail clinics also plays into the rising impact of consumer demand on health care, including the so-called ‘convenience revolution’  for treating simple, acute medical problems and some non-acute preventative treatments such as vaccinations.

Location. Retail clinics are located where patients regularly shop and get their prescriptions filled.  For the retailer, this tends to keep the prescription business in house for an episode of care.

Legitimacy.  The trend toward branding these clinics with a well-known health plan—such as collaborations with Michigan-based Henry Ford health system and Kaiser-Permanente–adds to their legitimacy as a treatment facility.  One expert noted that such relationships are having a dramatic impact on the role of retail clinics, which are shifting away from episodic care and promoting chronic disease management and the sharing of electronic health records.

Insurance coverage.  Retail clinics typically take many kinds of insurance, including Medicare and Medicaid.  Commercial payers also enjoy the lower cost these clinics provide for patient services.

Lower costs to patients.  Although there has not been much research on the topic, anecdotal evidence suggests that a routine retail medical clinic visit costs about $110 for commercially insured patients, compared with $166 at the physician’s office.  Many retail clinics additionally have competitive and transparent pricing.  The cost factor is very important to the ‘young invincibles,’ who still lack insurance coverage despite the requirements of the Affordable Care Act and those senior citizens on a fixed budget and facing the Medicare ‘doughnut hole.’  Costs of visits also are critical to the millions of Americans with high deductible health plans, which are becoming the norm for workers with employer-based coverage and those who buy insurance through the federal and state exchanges.

Lower costs to retailers.  Retail clinics can leverage information technology and care guidelines, which makes it easier and more cost effective to provide ambulatory and preventive care with a nurse practitioner or physician assistant.  In addition, their space in the store already is a sunk cost.

Filling a void.  Retail clinics are attempting to exploit a niche in affordable care delivery, since traditional health systems focus on the more lucrative conditions and forms of care delivery. In fact, RAND researchers found that the consumers who use retail walk-in clinics are less likely to go back to their family doctor.   And the clinics are making it easy, offering tools – such as personal dashboards – to help patients manage their conditions, screenings and prescription refills.

That is why retail medical clinics are here to stay and why they are an untapped resource for brands to consider a platform for engaging this growing segment of potential patients.   For example, RAND researchers point out that retail clinics could play an even bigger role in vaccination delivery if they reviewed patients’ vaccination histories and counseled them about the benefits.   A natural extension of this process is to provide related educational materials.  The same goes for treating various ambulatory issues typically seen at retail clinics, such as rashes, bronchitis, ear infections and urinary tract infections.  This path will be paved for chronic conditions as well, as patients migrate to retail clinics for their primary care needs.

Taking it a step further, the store’s information technology system can be leveraged to find out about a patient’s other conditions and co-morbidities.  If an elderly patient comes in for a flu shot, a quick check of the store’s medical record could reveal the presence of diabetes or chronic obstructive pulmonary disease or potentially the failure to refill a prescription. This opens the door for the patient to receive related educational materials and perhaps provide the impetus to fill another prescription.

Not only do the retail clinics reach millions of patients, manufacturers’ materials already have been prepared.  Providing them should be reasonably uncomplicated.  It should be as simple as working with the stores’ headquarters to get the materials entered into the computer system.

Manufacturers also could provide retail clinics with information and resources to promote disease screening or targeted distribution of brochures to stores with a high volume of senior citizens, who prefer paper with big print.

All in all, the rising number of retail medical clinics will subsequently capture patient visits in EHRs and offer new outlets for pharmaceutical manufacturers to support prospective patients.  Let Point-of-Care Partners help you tap into this opportunity.