Implications of the Retail Clinic Model for Conventional Healthcare

by | Published on Oct 25, 2013 | Healthcare News

Implications of the Retail Clinic Model for Conventional Healthcare
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According to a new study by Accenture, the number of retail clinics will increase rapidly over the next few years as the Affordable Care Act (ACA) seeks to extend heath coverage to millions of uninsured U.S citizens. The report states that the number of retail clinics will double by 2015, and also that they will handle around 10% non-primary care outpatient visits. Accenture researchers found that the growth rate of retail clinics increased in recent years and reached 14.7% in 2011 and 2012.

These walk-in medical clinics at big box retail stores are expected to offer an additional channel for newly insured patients to receive primary care services. It is convenient to approach these clinics for minor health problems. They generally do not require prior appointment and have shorter wait times than ER rooms. A recent study published in JAMA Pediatrics reported that families with children prefer retail-based clinics for pediatric needs. Staffed by nurse practitioners and assistants and with offsite physician supervision, these clinics are popular for their convenience and easy access.

The increasing growth of retail clinics initially posed several challenges for physicians and was regarded as competition. However, Accenture’s recent study points out these retail clinics have now changed from foe to friend. In fact, new approaches are focusing on developing complementary links between retail clinics and hospitals and PCPs. While retail clinics can help to manage general patient volume, hospitals can focus on complex treatments and cases which need more serious attention. As PCPs are in short supply relative to demand, physicians can refer lower acuity cases to retail clinics. Hospital ERs facing capacity constraints can also refer cases of a less demanding nature to retail clinics. Retail clinics are also conveniently located in shopping centers, allowing patients to shop while they wait. Moreover, they are also open longer hours. Many clinics offer follow-on care, which can reduce the incidence of readmissions. This has important financial implications for the nation at large. Even insurance companies are recognizing the benefits of retail clinics and are rewarding plan members who use retail clinics with preferential payment options.

However, the retail clinic concept is not without its disadvantages. Pediatricians, supported by the American Academy of Pediatrics, “strongly discourage the use of retail-based clinics.” Problems identified include lack of consistency, the lack of the physician-patient relationship, and most importantly, absence of knowledge, files and records on patient history on site.

Regardless of whether retail clinics are complementary or competitive, as their number continues to grow, your practice needs to stay financially stable. Entrust your AR management to a professional medical billing company and enjoy peace of mind, more time to focus on patient care, higher reimbursement, and enhanced ROI.

Meghann Drella

Meghann Drella possesses a profound understanding of ICD-10-CM and CPT requirements and procedures, actively participating in continuing education to stay abreast of any industry changes.

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