Boston—Retail clinics, usually located in pharmacies, have been touted as convenient and cost-saving alternatives to physician offices and hospital emergency departments. But do they always save money?
A new study in the journal Health Affairs suggests they do not, because retail clinics might actually be boosting medical spending by creating demand for new medical services.
Research led by Harvard Medical School and The RAND Corportion found that in many cases, patients who visited retail clinics for low-severity illnesses such as urinary tract infections and sinusitis would have stayed home and not sought medical care if the facilities, the majority operated by large pharmacy chains, had not been available.
Study authors suggest that the convenience of retail clinics, both in terms of location and expanded hours of operation, makes them an attractive alternative to staying home and suffering through a minor illness.
On the other hand, past studies have shown that spending on retail clinic visits is lower than spending on office visits and much lower than ED visits, and the new study found that to be the case where visits were to less-expensive retail clinics instead of costlier physician offices. Those savings were outweighed, however, by the increased spending on new medical care.
“These findings suggest retail clinics do not trim medical spending, but instead may drive it up modestly because they encourage people to use more medical services,” said senior author Ateev Mehrotra, MD, MPH.
For this study, researchers examined information on Aetna health plan enrollees in 22 U.S. cities from 2010 to 2012, focusing on 11 low-acuity conditions that account for more than 60% of all visits to retail clinics.
Comparing 519,542 enrollees with at least one retail clinic visit with a random sample of 861,557 other enrollees who did not receive care at a retail clinic, study authors estimate that 42% of the visits to retail clinics for relatively minor conditions represented substitution for a visit to a physician office or ED. Another 58% were classified as new use of medical services.
Each use of retail clinics for new medical services increased per person spending by an average of $35 per year, according to the report. Although that was partly offset by $21 in savings among those people whose visit to a retail clinic substituted for higher-priced medical care, study authors point out, the overall spending increase prompted by retail clinics was $14 per enrollee annually.
As a result, Mehrotra suggested in a Health Affairs press release that “health plans may want to consider our findings as they decide whether and how to cover care at retail clinics. If the goal is to lower costs, then encouraging use of retail clinics may not be a successful strategy.”
Background information in the study notes that nearly 2,000 retail clinics are in the United States and receive more than 6 million visits annually.
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