Are Community Retail Health Clinics Being Used Properly?

Eager to reduce costly emergency department visits, insurers have tried to lure consumers toward using retail health clinics by giving them insurance coverage and in some cases even waiving copayments for using them, said study coauthor Dr. Ateev Mehrotra, an associate professor of health care policy at Harvard Medical School.

But according to a policy researcher at the Rand Corp., although retail clinics are crucial for providing easier, more timely access to primary care services, they aren’t the answer that policy experts have been hoping for to decrease costly but unnecessary visits to the emergency department.

For low-level problems like bronchitis or urinary tract infections, consumers are more likely to go to the emergency department than to a health clinic located less than a 10-minute drive away, a new study suggests.

The study included more than 2,000 emergency departments across 23 states. Researchers examined data on emergency department visits for 11 minor health conditions between 2007 and 2012. The rate of visits for low-level problems, such as sore throat, and ear infections were analyzed over time to see whether the opening of a nearby retail clinic led to a reduction in those visits.

The researchers found that opening of nearby clinics didn’t decrease the rate of ER visits, even though their geographic overlap with emergency departments more than doubled during the length of the study. A slight reduction was seen in ER visits by privately insured patients with minor ailments, but there was no decrease in visit by patients with other types of insurance.

Often located in grocery stores and super centers, retail health clinics are usually staffed by nurse practitioners, who treat minor injuries and ailments, administer vaccines or sports physicals and provide preventive care. Rand research estimates up to 20% of emergency department visits are for minor conditions that could be treated in retail or urgent care clinics. Moving those visits out of the emergency department could save $4 billion annually.

A separate study found about 40% of retail clinic visits were replacements for emergency department or primary care visits, while the rest were new health care use that might not otherwise have taken place. 

This study suggests that insurers may want to rethink that strategy, Mehrotra said. In other research he found that about 40 percent of retail clinic visits were substitutions for primary care or emergency department visits; the rest represented new health care use that might not otherwise have taken place. To put it simply, if it wasn’t for the comfort of a retail clinic, people might have stayed home and treated their own minor ailments.