Clinical Care Access to Care Quality of Care Search Policies & Programs

hints
Display All Policies & Programs

Retail clinics

Health Factors: Access to Care
Decision Makers: Employers & Businesses Healthcare Professionals & Advocates Public Health Professionals & Advocates
Evidence Rating: Expert Opinion
Population Reach: 50-99% of WI's population
Impact on Disparities: No impact on disparities likely

Is this program or policy in use in your community? Tell us about it.

Description

Retail clinics offer rapid access (Ahmed 2010, Wang 2010) to basic health care services for simple conditions and basic procedures such as sore throats, skin conditions, immunizations, pregnancy testing, lipid screening and diabetes screening (Rudavsky 2009). Services are usually provided by nurse practitioners and prices for services are posted and available before seeing a provider. Clinics are located within retail stores such as CVS, Target, and Walgreens, and may be owned by the retailer or associated with physician practices. Retail clinics are usually open for longer hours than physician practices and are often located in more affluent metro areas.

Expected Beneficial Outcomes

Increased access to care
Reduced emergency room visits
Reduced health care costs

Evidence of Effectiveness

Retail clinics are a suggested strategy to increase access to health care (Salinsky 2009). However, additional evidence is needed to confirm effects.

Available evidence suggests that retail clinics may provide care to patients without a medical home (Mehrotra 2008). Retail clinics appear to increase access to care and provide care equal in quality to traditional clinics (Mehrotra 2015, Rohrer 2012, Jacoby 2011, Rohrer 2009, Mehrotra 2009) without decreasing receipt of preventive care (Reid 2012). Retail clinics hosted by a health system may bring new patients into that system and establish patient relationships with primary care providers (Feder 2011). Patients who visit retail clinics hosted by a pharmacy or grocery store, however, appear less likely to visit their primary care physician in the future, decreasing continuity of care (Reid 2012).

Some researchers suggest that retail clinics may reduce health care costs through reduced visits to emergency departments (Patwardhan 2012, Feder 2011, Wang 2010), primary care physicians (Patwardhan 2012, Feder 2011), and urgent care providers (Patwardhan 2012). Such clinics can, in some circumstances, reduce total cost per episode compared to other settings (Spetz 2013Mehrotra 2009, AHRQ HCIE-Patterson) without increasing hospitalizations; savings may be greater in states where nurse practitioners are allowed to practice independently (Spetz 2013). However, retail clinics also may raise overall health care costs by bringing in patients who would not have otherwise sought treatment (RAND-Weinick 2010). Additional study is needed to determine the effects of retail clinics on health care costs.

Early proponents of retail clinics suggested such clinics might improve access to health care among disadvantaged populations (Salinsky 2009), but retail clinics appear to be most frequently located in more advantaged neighborhoods (Rudavsky 2010, RAND-Mehrotra 2010, Pollack 2009). As patients are more likely to visit retail clinics if they are close by, such placement may reduce the likelihood of use by lower income individuals (Ashwood 2011).

Implementation

United States

Retail clinics,  such as CVS/Caremark’s MinuteClinics, Walgreen’s Take Care clinics, and clinics at select Walmart and Target locations, provide basic primary care at locations across the country. 

In 2009, the two largest retail clinic chains administered 1.8 million flu vaccines (Uscher-Pines 2012), and in 2012, the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention launched a pilot providing HIV testing and counseling in community pharmacy and retail clinics in areas with a high HIV prevalence (CDC-NCHHSTP 2012).

Wisconsin

Bellin Healthcare’s FastCare Clinics are affiliated with local medical practices and use electronic health records to connect the retail clinic’s medical records to the records at the affiliated practice (Feder 2011).

Citations - Description

Ahmed 2010 - Ahmed A, Fincham JE. Physician office vs. retail clinic: Patient preferences in care seeking for minor illnesses. Annals of Family Medicine. 2010;8(2):117–23. Accessed on November 24, 2015
Rudavsky 2009 - Rudavsky R, Pollack CE, Mehrotra A. The geographic distribution, ownership, prices, and scope of practice at retail clinics. Annals of Internal Medicine. 2009;151(5):315–20. Accessed on May 20, 2016
Wang 2010 - Wang MC, Ryan G, McGlynn EA, Mehrotra A. Why do patients seek care at retail clinics and what alternatives did they consider. American Journal of Medical Quality. 2010;25(2):128–34. Accessed on May 24, 2016

Citations - Evidence

AHRQ HCIE-Patterson - Patterson A, Smith KL. Retail walk-in clinics provide easy access to low-cost primary care services. Rockville: AHRQ Health Care Innovations Exchange. Accessed on January 26, 2016
Ashwood 2011 - Ashwood JS, Reid RO, Setodji CM, et al. Trends in retail clinic use among the commercially insured. American Journal of Managed Care. 2011;17(11):e443–8. Accessed on December 12, 2015
Feder 2011* - Feder JL. Charting a life-and-health cycle and expanded primary care options for patients in Wisconsin. Health Affairs. 2011;30(3):387–9. Accessed on February 4, 2016
Jacoby 2011* - Jacoby R, Crawford AG, Chaudhari P, Goldfarb NI. Quality of care for 2 common pediatric conditions treated by convenient care providers. American Journal of Medical Quality. 2011;26(1):53-58. Accessed on March 7, 2016
Mehrotra 2008 - Mehrotra A, Wang MC, Lave JR, Adams JL, McGlynn EA. Retail clinics, primary care physicians, and emergency departments: A comparison of patients’ visits. Health Affairs. 2008;27(5):1272–82. Accessed on March 3, 2016
Mehrotra 2009 - Mehrotra A, Liu H, Adams J, et al. The costs and quality of care for three common illnesses at retail clinics as compared to other medical settings. Annals of Internal Medicine. 2009;151(5):321–8. Accessed on March 14, 2016
Mehrotra 2015* - Mehrotra A, Gidengil CA, Setodijl CM, Burns RM, Linder JA. Antibiotic prescribing for respiratory infections at retail clinics, physician practices, and emergency departments. American Journal of Medical Quality. 2015;21(4):294-302. Accessed on March 7, 2016
Patwardhan 2012* - Patwardhan A, Davis J, Murphy P, Ryan SF. After-hours access of convenient care clinics and cost savings associated with avoidance of higher-cost sites of care. Journal of Primary Care & Community Health. 2012;3(4):243–5. Accessed on May 20, 2016
Pollack 2009 - Pollack CE, Armstrong K. The geographic accessibility of retail clinics for underserved populations. Archives of Internal Medicine. 2009;169(10):945–9. Accessed on March 1, 2016
RAND-Mehrotra 2010 - Mehrotra A, Adams JL, Armstrong K, et al. Health care on aisle 7: The growing phenomenon of retail clinics. Santa Monica: RAND Corporation; 2010: Research Brief 9491. Accessed on May 24, 2016
RAND-Weinick 2010 - Weinick RM, Pollack CE, Fisher MP, Gillen EM, Mehrotra A. Policy implications of the use of retail clinics. Santa Monica: RAND Corporation; 2010:Technical Report 810. Accessed on November 9, 2015
Reid 2012* - Reid RO, Ashwood JS, Friedberg MW, et al. Retail clinic visits and receipt of primary care. Journal of General Internal Medicine. 2013;28(4):504–12. Accessed on November 9, 2015
Rohrer 2009* - Rohrer JE, Angstman KB, Furst JW. Early return visits by primary care patients: A retail nurse-practitioner clinic versus a medical office walk-in clinic. Primary Health Care Research & Development. 2009;11(1):87–92. Accessed on May 20, 2016
Rohrer 2012* - Rohrer JE, Garrison GM, Angstman KB. Early return visits by pediatric primary care patients with otitis media: A retail nurse practitioner clinic versus standard medical office care. Quality Management in Health Care. 2012;21(1):44–7. Accessed on May 24, 2016
Rudavsky 2010* - Rudavsky R, Mehrotra A. Sociodemographic characteristics of communities served by retail clinics. Journal of the American Board of Family Medicine. 2010;23(1):42-48. Accessed on March 7, 2016
Salinsky 2009 - Salinsky E. Medicine, big business, and public health: Wake up and smell the Starbucks. Preventing Chronic Disease. 2009;6(2):A75. Accessed on November 9, 2015
Spetz 2013* - Spetz J, Parente ST, Town RJ, Bazarko D. Scope-of-practice laws for nurse practitioners limit cost savings that can be achieved in retail clinics. Health Affairs. 2013;32(11):1977–84. Accessed on January 28, 2016
Wang 2010 - Wang MC, Ryan G, McGlynn EA, Mehrotra A. Why do patients seek care at retail clinics and what alternatives did they consider. American Journal of Medical Quality. 2010;25(2):128–34. Accessed on May 24, 2016

Citations - Implementation

CDC-NCHHSTP 2012 - National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). National center for HIV/AIDS, viral hepatitis, STD, and TB prevention: Annual report 2012. Atlanta: Centers for Disease Control and Prevention (CDC); 2012. Accessed on November 24, 2015
Feder 2011* - Feder JL. Charting a life-and-health cycle and expanded primary care options for patients in Wisconsin. Health Affairs. 2011;30(3):387–9. Accessed on February 4, 2016
Uscher-Pines 2012* - Uscher-Pines L, Harris KM, Burns RM, Mehrotra A. The growth of retail clinics in vaccination delivery in the U.S. American Journal of Preventive Medicine. 2012;43(1):63–6. Accessed on November 19, 2015

Page Last Updated

September 23, 2015

* Journal subscription may be required for access.