PHARMACY

Consumers visit retail clinics for convenience

BY DSN STAFF

Long before payers, large insurers and health systems got on board, consumers were already voting for retail clinics “with their feet,” as patient visits steadily climbed over the years. According to research conducted by Rand Corp., retail clinic traffic doubled each year between 2007 and 2009, to 6 million patient visits a year. Since then, the number has risen to more than 10.5 million in 2014 and rising, according to various estimates.

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And there is a good reason for that. Patients by and large genuinely liked the experience. As early as 2008, customer satisfaction rates were extremely high right out of the gates, with consumers reporting a high rate of satisfaction with both the convenience (93%) and quality of care (90%) they received in retail clinics, according to a Wall Street Journal online/Harris Interactive poll conducted that year. Industry leader MinuteClinic, which counts more than 25 million patient visits since its first retail clinic location opened in 2000, reports customer satisfaction ratings of 95%.

Initially, “sick visits” (cold, flu, etc.) and vaccinations drove the bulk of these visits, but according to new research, as clinics have been able to expand their scope of services, the reasons patients use clinics also has expanded. According to recent data from Kalorama, while vaccinations (74%) and cold-flu (55%) were still the dominant drivers of patient visits, nearly one-third of consumers (32%) said they actually visited a retail clinic for a prescription renewal.

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PHARMACY

Cost, quality and transparency drive insurer, health system interest

BY DSN STAFF

There are very logical reasons that a growing number of health systems, large payers and insurers continue to embrace the retail clinic model: cost and quality.

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According to a recent Robert Wood Johnson Foundation study, there are currently more than 100 partnerships between retail clinics and health systems. “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. One study estimated that up to 27% of ED visits could be handled appropriately at retail clinics and urgent care centers, offering cost savings of $4.4 billion per year,” noted the April 2015 RWJF study, “Building a culture of health: The value proposition of retail clinics.”

“The cost of providing care for commercially insured patients has been found to be significantly lower when care was initiated at retail clinics ($110) than when it was initiated in physician offices ($166), urgent care centers ($156) and EDs ($570),” according to the RWJF report. “Studies have also found that for five common conditions treated at retail clinics — pharyngitis, otitis media, acute sinusitis, conjunctivitis and urinary tract infections — cost savings of $50 to $55 per episode could be realized and that cost of care for consumers who visited a retail clinic on aggregate was $262 less than those who did not.”

Retail clinics also are starting to emerge in new patient care models like the Accountable Care Organization and Patient-Centered Medical Home models. “BlueCross BlueShield of Minnesota has created an ‘aligned incentive’ ACO program that now accounts for 40% of its network spend. They have developed an ACO-like product with Allina Health Network and have ‘wrapped’ AHN’s network with other providers, including retail clinics,” according to the RWJF study.

It’s not just all about dollars and cents. The other critical reason that payers and providers are aligning with retail clinics is simply that the quality of care delivered at retail clinics is as good or better than most other practice settings. Retail clinics had almost 93% compliance with quality measures for appropriate testing of children with pharyngitis versus the Healthcare Effectiveness Data and Information Set (HEDIS) average of less than 75%, according to the Convenient Care Association.

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The value of retail clinics

BY DSN STAFF

With the expansion of coverage to millions of more Americans in the years since the Affordable Care Act was fully implemented, access to care is becoming more strained than ever before, seemingly creating more interest among payers, insurers, health systems and patients in the use of retail clinics.

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“Retail clinics are increasingly expanding their service offerings to include behavioral health screenings, more comprehensive primary care and chronic care management,” noted the Robert Wood Johnson Foundation’s April 2015 report, “Building a culture of health: The value proposition of retail clinics.” The RWJF study sought to “examine the potential value proposition in building a ‘Culture of Health’ in the United States.” This ‘Culture of Health’ is the RWJF’s own version of the Triple Aim goals first introduced by the Institute of Health in 2008: to provide better access to care for individual patients; to improve health outcomes for large patient populations and lower costs.

There are currently about 2,000 retail clinics in operation, a number that is expected to grow to some 3,000 locations by 2016, according to research from the Convenient Care Association. Annual clinic visits totaled more than 10.5 million last year.

According to Kalorama Information, retail clinics generated sales of more than $1 billion in 2014 — this, of course, only measures the sale of retail clinic services and procedures, and excludes any impact to the host pharmacy in terms of pharmacy and OTC sales. One-third of those visits were driven by a prescription refill, according to Kalorama.

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