The Minute and Take Care clinics of the world are becoming a growing force in the health care industry. Just how will they reshape the business? Should hospitals be viewing them as a friend, foe or something else in between?
I'm just getting started on an upcoming feature for Hospitals & Health Networks, taking a closer look at the impact such retail clinics — stationed everywhere from Target to Walgreens, CVS and Rite Aid — are having on providers. One thing that's clear, as we reported last August, is that retailers aren't going anywhere. A study by the RAND Corp. last year found that visits to the three main clinic operators tripled from 2007 to 2009. In the last year of the study alone, visits totaled some 6 million and an estimated $460 million in health care spending. Convenience was a big driver in the surge, as about 44.4 percent of visits occurred late in the day or on the weekend when many doctor's offices are closed.
"For primary care doctors, as time moves forward and these clinics become more common, the question is going to be: How do they incorporate those into their practice?" Ateev Mehrotra, M.D. and policy analyst for RAND, told me last year.
Walgreens is taking the lead on that front, making a big splash last month by announcing that it's becoming the first retail clinic to start assessing, diagnosing and treating chronic conditions such as diabetes, hypertension and asthma. The recent expansion of services also includes certain preventative services to help patients catch those conditions before they worsen.
At last year's Health Forum-AHA Leadership Summit, David Lawrence, former CEO of Kaiser Foundation Health Plan and Kaiser Foundation Hospitals, pegged retail clinics as a major disruptor in the field that hospitals and health systems should pay close attention to.
"The physician-based primary care model is obsolete," Lawrence said. "We're trying to address it with medical homes. It's obsolete for two reasons. Number one, there aren't enough doctors to make it happen, no matter how we leverage them. And two, there are too many other ways that are less expensive and more reliable to do much of primary care.
"So what the retail people are doing, what many of the innovations we're focusing on, is ripping much of primary care away from the traditional model. If hospital systems don't understand that and invest in those models, you're going to lose a whole funnel of referral sources into your system."
Walgreens' announcement, though, makes it clear that the drugstore is bent on collaboration with providers, rather that competition. They've been forming affiliations with systems around the nation so clinics can grow as a piece of the care continuum puzzle and direct patients over to hospitals to better manage their care.
"Our goal is to coordinate with physicians in order to help patients manage their chronic conditions in alignment with their physician's treatment plan," Alan London, chief medical officer of Take Care Clinics, said in the announcement. "Walgreens and Take Care Health also continue to develop clinical affiliations with leading health systems to coordinate patient care and to help meet the triple aim of improving health outcomes and patient satisfaction while reducing health care costs."
Others, such as CVS' Minute Clinics, are also forming unique partnerships with providers. As we reported back in February, UCLA Health System has inked a partnership to serve as medical director of clinics in the Los Angeles County region, collaborating on "pre-primary" care patient education, and providing care at UCLA hospitals that's not available in clinics.
Other examples are too numerous to list. What I'm really interested is hearing what you have to say. How is your hospital or health system viewing retail clinics? Have you formed any unique relationships with such organizations? Email me your thoughts at firstname.lastname@example.org.