Published on FierceHealthcare (http://www.fiercehealthcare.com)
Retail clinics: Concept expands–not threatens–primary care
Retail health isn’t an isolated part of healthcare and the industry should view it as part of the solution, says Nancy Gagliano, M.D., senior vice president of CVS Caremark and chief medical officer for CVS MinuteClinic, the largest retail clinic provider in the country.
Gagliano (pictured right), one of the panelists at this year’s American Hospital Association’s annual meeting, told attendees that retail clinics provide patients with access to basic healthcare, eliminating unnecessary visits to emergency rooms.
“If a patient has a fever of over 103, the retail clinic is not the right place. If you arrive with a drill stuck in your hand, we will send you to the hospital,” she says.
CVS provides walk-in care, seven day a week, evenings and holidays in 1,500 MinuteClinics across the country, which provides 60 percent of the U.S. population access to healthcare. Nurse practitioners run the clinics and use evidence-based guidelines embedded into the electronic health record to treat patients, Gagliano says.
The clinics, she says, are accredited by the Joint Commission and connect patients with medical home practices and primary care physicians within 24 hours of a visit. And if patients who don’t have a primary care physician arrive for care, the clinics provide them with a list of potential providers.
It’s staggering how many of these patients don’t have primary care providers, Gagliano says. Fifty percent of patients who use the clinics report they don’t have one and the reasons for that vary, she says. Perhaps they couldn’t get an appointment or they don’t like primary care doctors. But, she says, the problem will grow due to the shortage of primary care providers.
“Our role is a safety net. We provide access at low cost, high quality and get patients to primary care,” she says. If the patient does have a primary care provider, the physician will receive a copy of the MinuteClinic record. Patients who don’t have one receive a list of local providers in the community.
Patients don’t like taking time off from work to see a doctor, so the clinics provide them with a convenient alternative. “It’s also an extension of primary care without costing a lot of money,” Gagliano says.
CVS is in the process of integrating its electronic medical records with affiliated practices and systems so that physicians have easy access to the record of the visit. The integration also will allow MinuteClinic staff to easily pull up the patient’s medical record to view allergies and prescribed medications.
“It will allow us to communicate information from our organization to our affiliated health systems and back and forth,” Gagliano says.
While the retail clinics generally operate via leases with area hospitals, Walmart owns and operates the new clinics. Unlike other primary care providers, they will be open 12 hours a day on weekdays and at least eight hours a day on weekends, Forbes reports. Moreover, Walmart is able to provide care at much lower rates, with the new clinics charging patients only $40, and employees covered under the company health plan only $4. Moreover, they accept Medicare and, in some locations, Medicaid, according to Fortune.
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The company’s move signals yet another shift in healthcare delivery that create more competition for traditional providers like doctors and hospitals. Public and private health insurance exchanges under the Affordable Care Act mean patients have more control over their own healthcare than ever before, Rob Lazerow, a practice manager with the Health Care Advisory Board, told Forbes.
“This is a very different competitive landscape than what most executives have faced previously–and hospitals risk losing volumes at each decision point,” Lazerow said.
A study last year found many patients visit retail clinics for the very advantages the Walmart clinics offer, with 74 percent saying they visited a clinic rather than a pediatrician either because of the more convenient hours, lack of appointment availability with the pediatrician, not wanting to bother the pediatrician, or the problem’s perceived lack of seriousness, FierceHealthcare previously reported.