The geographic distribution, ownership, prices, and scope of practice at retail clinics

RAND Health, Pittsburgh, Pennsylvania 15213, USA.
Annals of internal medicine (Impact Factor: 17.81). 10/2009; 151(5):315-20.
Source: PubMed


Retail clinics are clinics within a retail store that provide simple acute and preventive care services for a fixed price without an appointment.
To describe characteristics of retail clinics, including their location, scope of practice, prices, acceptance of insurance, and ownership, and to estimate the proportion of the U.S. population that lives within a short driving distance of such a clinic.
Cross-sectional descriptive study.
United States.
All 982 retail clinics operating as of August 2008.
Population living within a 5- and 10-minute driving distance of a retail clinic.
In August 2008, 42 operators ran 982 clinics in 33 states; 88.4% were located in urban areas. Nearly half (44%) of all clinics were located in 5 states (Florida, California, Texas, Minnesota, and Illinois). All offered sore throat treatment (average price, $78) and more than 95% offered treatment of skin conditions, immunizations, pregnancy testing, and lipid or diabetes screening. Almost all (97%) accepted private insurance and Medicare fee-for-service (93%). Among 42 clinic operators, 25 are existing health care companies that operate 11% of the clinics, and 3 are for-profit retail chains that operate 73% of the clinics. An estimated 10.6% of the total U.S. and 13.4% of the urban U.S. population lives within a 5-minute driving distance of a retail clinic, whereas 28.7% (total) and 35.8% (urban) live within a 10-minute driving distance.
Our inventory of clinics stopped in August 2008 and estimates of proximity are based on 2000 census data.
Retail clinics are positioned to provide immunizations and care for simple acute conditions for a substantial segment of the urban U.S. population.
California Healthcare Foundation.

Download full-text


Available from: Rena Rudavsky, Dec 29, 2014
  • Source
    • "The first of such clinics began in the year 2000 [28]. This form of urgent care has proliferated in the last decade, with the number increasing ten-fold from 2006 to 2008 [29]. In 2009, almost 1,000 of these clinics existed in the United States [30]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Intermittent treatment of acute lower acuity situations has come to be defined as urgent rather than emergent care. The location of urgent care delivery has been shifting from exclusively hospital or office settings to other community locales. To review the concept of urgent care and the new models of health care delivery in the niche between hospitals and primary care. To highlight the roles of urgent care in Israel and compare these roles with those in other countries. Narrative review of the literature.Main findings: The new models of community based urgent care include 1) the urgent care center; 2) the retail or convenience clinic, 3) the free standing emergency center, and 4) the walk-in clinic. These models fall on a continuum of comprehensiveness. They offer care at a lower cost than hospital-based emergency departments and greater temporal convenience than primary care physicians. However, their impact on emergency department utilization and overcrowding or primary care physician overload is unclear.Israel has integrated its urgent care centers into its national health system by encouraging the use of urgent care centers and by requiring all health insurance funds to reimburse patients who use these centers. This integration is similar to the approach in England; however, the type of service is different in that the service in England is provided by nurses. It is different from most other countries where urgent care facilities are primarily private ventures. Community-based acute care facilities are becoming a part of the medical landscape in a number of countries. Still, they remain primarily on the fringe of organized medicine. Despite the important role of community-based acute care facilities in Israel, no nationwide study has been done in two decades. Health policy planning in Israel necessitates further study of urgent care use and its clinical outcomes.
    Israel Journal of Health Policy Research 10/2013; 2(1):38. DOI:10.1186/2045-4015-2-38
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Retail clinics are an increasingly popular source for medical care. Concerns have been raised about the effect of these clinics on the cost, quality, and delivery of preventive care. To compare the care received at retail clinics for 3 acute conditions with that received at other care settings. Claims data from 2005 and 2006 from the health plan were aggregated into care episodes (units that included initial and follow-up visits, pharmaceuticals, and ancillary tests). After 2100 episodes (700 each) were identified in which otitis media, pharyngitis, and urinary tract infection (UTI) were treated first in retail clinics, these episodes were matched with other episodes in which these illnesses were treated first in physician offices, urgent care centers, or emergency departments. Enrollees of a large Minnesota health plan. Enrollees who received care for otitis media, pharyngitis, or UTI. Costs per episode, performance on 14 quality indicators, and receipt of 7 preventive care services at the initial appointment or subsequent 3 months. Overall costs of care for episodes initiated at retail clinics were substantially lower than those of matched episodes initiated at physician offices, urgent care centers, and emergency departments ($110 vs. $166, $156, and $570, respectively; P < 0.001 for each comparison). Prescription costs were similar in retail clinics, physician offices, and urgent care centers ($21, $21, and $22), as were aggregate quality scores (63.6%, 61.0%, and 62.6%) and patient's receipt of preventive care (14.5%, 14.2%, and 13.7%) (P > 0.05 vs. retail clinics). In emergency departments, average prescription costs were higher and aggregate quality scores were significantly lower than in other settings. A limited number of quality measures and preventive care services were studied. Despite matching, patients at different care sites might differ in their severity of illness. Retail clinics provide less costly treatment than physician offices or urgent care centers for 3 common illnesses, with no apparent adverse effect on quality of care or delivery of preventive care. California HealthCare Foundation.
    Annals of internal medicine 09/2009; 151(5):321-8. · 17.81 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The landscape of primary care medicine is rapidly changing. The decline in interest, both in primary care fields and students choosing these career paths, has left a vacuum in the health care system that must be filled. One of the recent developments has been the birth of "convenient care centers," also known as "retail clinics." This form of health care delivery has mostly been entrepreneurial and based in retail organizations, such as drug stores. These walk-in clinics provide basic medical care for minor common medical conditions, such as sore throat, urinary tract infection, the common cold, and ear infections. Much of this care is provided not by physicians, but by nurse practitioners or physician assistants. After seeing the success of the earliest of these clinics, MinuteClinic by CVS, many other businesses joined the venture, and retail clinics popped up in Wal-Mart, Target, and many local grocery stores. Gradually, hospital systems, physician groups, and managed care companies have also entered the market, sometimes partnering with retail outlets, such as the local grocery store or Wal-Mart, and less often, starting a stand-alone facility. Only 12% of retail clinics are owned by hospital systems or physician groups, while 73% are owned by CVS, Walgreens, or Target. There is even a national nonprofit organization called the Convenient Care Association, started in 2006, and based in Philadelphia, PA. This new trend in delivering health care has been mostly, if not totally, ignored by the medical school practice plans, with the exception of the Mayo Clinic in Minnesota, which has developed several "express care" clinics as stand-alone facilities. As a medical school practice plan and a division of general internal medicine, we could continue to keep a blind eye toward this new trend in primary care medicine or embrace the concept. We aim to develop a new convenient care model integrating our College of Medicine practice plan in partnership with our College of Nursing graduate nursing program to form a stand-alone clinic within a bustling business district in downtown Philadelphia.
    Postgraduate Medicine 01/2010; 122(1):7-9. DOI:10.3810/pgm.2010.01.2093 · 1.70 Impact Factor
Show more