Key healthcare players across the U.S. are shifting to value-based reimbursement, placing the rapid proliferation of fee-for-service retail clinics at a particularly interesting, albeit controversial, intersection of cost and quality.
Retail clinics may be considered threats to the primary care model, one that prioritizes a long-term patient-provider relationship in managing patient outcomes, but they also present unique opportunities in improving population health.
Retail clinics are a consumer-driven model that capitalizes on patients’ desire for in-and-out services, something the traditional primary care provider struggles with due to generally high patient volumes and comparatively low accessibility. Retail clinics’ accessibility is much higher, leading to patient volumes offset by their easily replicable pop-up models. In the largest 87 U.S. markets, there are 0.8 retail clinics per 100,000 people, with markets like Nashville and Knoxville boasting more than 2.5.
The infrastructure for patient involvement is there, resulting in ample access points for patients to diagnose and treat colds and low-acuity ailments before they progress to something more costly and complex. While there is arguable evidence that retail clinics increase utilization for patients who otherwise would have stayed home, as explored in a previous blog post, they could also help diagnose more serious, underlying conditions that may have otherwise gone unchecked.
Early detection of chronic diseases like obesity and diabetes, for example, could empower patients to become active participants in their health. In turn, this could make it easier for providers to establish a collaborative and ongoing relationship with the patient.
Furthermore, by serving low-acuity patients who otherwise would have taken up a seat at the primary care physician’s office, retail clinics allow primary care physicians to focus quality efforts on treating patients with chronic diseases or more complex ailments—the patients that ultimately determine physicians’ payments in the value-based reimbursement environment.
Nationally, retail clinics are looking to expand their offerings to patients to better align them with the universal goal of healthier, happier patients. Even behavioral health is being incorporated in some clinics like Zoom+, an insurance company/clinic hybrid in Oregon and Washington that offers mental health therapy to patients, as well as Walgreens, which announced in May 2016 that its stores now offer behavioral health screenings and targeted therapies.
Retail clinics’ continued expansion of services into the full-body arena targeting mental, physical and emotional health indicates they can be increasingly looked at as competitors with whom to partner. Herein lies the most palpable value of retail clinics: their fee-for-service model hinges on patient utilization and volume, creating a ready, referable patient population for physician groups and hospitals.
Nearly 150 retail clinic affiliations exist in the largest 87 U.S. markets, and that number is likely to grow as providers face mounting pressure to improve population health. In essence, long-term financial viability of a provider group may very well depend on the group’s ability to treat a patient holistically, as they will be forced to more intensely compete against their peers to deliver positive outcomes and gain favorable reimbursements from payers.
If preventive screenings, prescription refills, and weight-loss services can be quickly and easily accessed during a patients’ Thursday afternoon trip to the grocery store, providers may increasingly choose to incorporate retail clinics into their patient care continuum. Providers’ role in improving patients’ health is what matters to the bottom line, not necessarily where the patient received the service.
Ultimately, patient engagement is the linchpin in healthcare transformation, and patients are more likely to engage in healthcare if it is cheap and convenient. How providers adapt will ultimately define the retail clinics role: either they will collaborate, or they will compete.
Follow Michelle La Vone on Twitter @mlavoneDRG