PHARMACY

Affiliations, partnerships driving patient health

BY Richard Monks

As it continues to evolve, CVS Health’s MinuteClinic is taking the concept of walk-in health care to a new level.

(To view the full Category Review, click here.)

With more than 1,100 clinics — including 79 in Target stores — MinuteClinic offers the country’s largest network of no-appointment-needed retail health services. The company estimates that since becoming part of CVS a decade ago, it has treated nearly 30 million patients.

Recognizing that the ongoing evolution of the U.S. healthcare system will lead to convenient care clinics playing a more significant role in patient care, MinuteClinic has continually expanded its reach, added new services and enhanced its offering through partnerships with other healthcare providers.

In April, for instance, the company teamed up with the Cleveland Clinic to provide patients at Ohio MinuteClinics with access to its experts for both online and mobile doctor visits. Under the program, patients deemed to need more extensive care than the walk-in clinic staff can provide can get a video follow-up consultation with a primary care practitioner from the Cleveland Clinic.

Anderew Sussmanm, president of Minute-Clinic and SVP and associate chief medical officer of CVS Caremark, has said CVS sees such telehealth services as this as playing an increasingly central role in patient care going forward. To that end, the company has been working with three established remote visits companies — American Well, Doctor On Demand and Teladoc — to expand its telehealth capabilities and services.

Meanwhile, MinuteClinic continues to add clinical affiliations. In recent months, the company has joined forces with John Muir Health in California; University of Chicago Medical Center in Illinois; Novant Health, serving the Winston-Salem area, in North Carolina; and University of Michigan Health System in Michigan.

Executives said the affiliations and the more than 60 other partnerships MinuteClinic and CVS Health have developed over the years help drive patient health.

“By allowing our electronic health records and information systems to communicate and share important information about the patients we collectively serve, we will have a more comprehensive view of our patients, which can aid in healthcare decision-making and help ensure patients adhere to important medications for chronic diseases, and collaborative programs that enhance access to patient care, improve health outcomes and lower healthcare costs in the communities they serve,” CVS Health chief medical officer Troyen Brennan said when the deals were announced.

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PHARMACY

Study argues against cost-savings benefits at clinics

BY Richard Monks

While much has been made about retail clinics’ ability to trim healthcare costs, a study published in the journal Health Affairs this spring suggested that these walk-in health centers may actually boost overall spending by encouraging people to get care for minor problems that mostly would have cleared up on their own.

(To view the full Category Review, click here.)

The study — conducted by a six-person team of researchers from RAND; Health Policy and Governing Board of the Health Care Cost Institute at Carnegie Mellon University; Brigham and Women’s Hospital; University of Texas School of Public Health; and Harvard Medical School — found that 58% of retail clinic visits for several minor conditions represented a new use of medical services. Just 42% replaced a costlier doctor visit or trip to the hospital.

The authors concluded that the additional visits caused healthcare spending to increase by $14 per person per year.

Industry officials were highly critical of the results, calling them flawed and too narrowly focused on old data.

“It is not an accurate assessment of retail clinic cost savings and value,” CVS MinuteClinic president Andrew Sussman told the online publication California Healthline. “It is a step backward to think of people who did not have a primary care physician as excess utilization. It’s not excessive costs to take care of people who don’t have a doctor. In fact, we are reaching an underserved population with retail clinics.”

The study, he said, failed to explore the overall savings clinics can provide.

“If you think about a patient with the flu who doesn’t have a physician, they can get care at an inexpensive retail clinic on the weekend before their condition gets worse and they might need a costly hospitalization,” Sussman said.

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Quality of care delivered at retail clinics

BY Richard Monks

More than a decade after they began to appear in community pharmacies across the country, retail clinics have become a key provider of health care to millions of Americans. Both the number of clinics and the types of services provided are expanding, and even regional and supermarket chains are joining the trend of becoming a one-stop healthcare destination.

(To view the full Category Review, click here.)

The market research firm Accenture estimates that by the end of 2016 there will be 2,150 clinics in the United States, and that number will exceed 2,800 in just two years.

Forecasters said the key to retail clinics’ growth and their increased role in the country’s healthcare system will be their continual forging of relationships with other providers and ensuring that they have the technology to work closely with these other healthcare groups. Such partnerships, they noted, will allow more pharmacy operators to add clinics — as evidenced by the recent proliferation of clinics in a wider range of supermarkets and regional chains — and will help walk-in healthcare facilities take their business in a new direction. CVS Minute-Clinic and Walgreens’ Healthcare Clinic, for instance, have said they are exploring moving beyond just offering urgent care to providing more coordinated care for chronic conditions. Meanwhile, others are growing their network of clinics through a combination of corporate-owned facilities and in-store clinics operated by outside companies.

“Some delivery systems seeking to improve primary care access and manage total cost of care are using retail clinics to reduce unnecessary emergency department visits,” according to a report released last year by the Robert Wood Johnson Foundation, noting the growing number of alliances being formed between clinics and health systems.

“The cost of providing care for commercially insured patients has been found to be significantly lower when care was initiated at retail clinics than when it was initiated in physician offices, urgent care centers and emergency departments,” the report stated.

In fact, according to the report, slightly more than a quarter of emergency room visits could be handled at retail clinics or urgent care centers, leading to a $4.4 billion reduction in healthcare spending.

In addition, the study found that the cost of treating five common conditions — pharyngitis, otitis media, acute sinusitis, conjunctivitis and urinary tract infections — were about a fifth of what they were if patients used other providers.

Healthcare researchers and clinic proponents stress that the benefits of retail clinics are more than just a matter of dollars and cents. Payers and providers, they said, are aligning with retail clinics because they see the quality of care delivered at these locations to be as good or better than most other practice settings.

For instance, the Convenient Care Association, the trade group representing retail clinics, said that a recent analysis of clinics found that they had almost 93% compliance with quality measures for appropriate testing of children with pharyngitis versus the National Committee for Quality Assurance’s Healthcare Effectiveness Data and Information Set average of less than 75%.

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