Does Convenience Simply Lead to More Health Care?

Is the ability to receive minor medical care at retail health clinics reducing overall health-care spending? It certainly is less expensive, but is the frequency of use offsetting any potential savings?
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Is the ability to receive minor medical care at retail health clinics reducing overall health-care spending? It certainly is less expensive, but is the frequency of use offsetting any potential savings?

Retail clinics (such as those found in several of the major retail pharmacy chains, big box stores, and grocery stores) are distinct from urgent care centers, which tend to offer more sophisticated tests and treat more complex conditions. In general, people go to retail clinics for simple conditions. Retail clinics serve as a convenient and flexible option for people during extended hours, weekends, while traveling, and for minor health needs. They are also a good option for individuals who do not have a primary care physician.

According to a new study in the journal Health Affairs, retail clinics (typically seen as an answer to more expensive doctor offices, urgent care, and emergency room visits) may actually increase medical spending by leading individuals to receive more care. The study examined how people insured by Aetna in 22 cities between 2010 and 2012 used health care.

According to a New York Times article researchers of the study concluded that the retail clinics led to
slightly higher spending because people used them for minor medical conditions they would typically have treated on their own. In other words, many of the conditions that drive people to seek care at retail clinics include symptoms that tend to resolve on their own, and the research suggests that individuals are going to clinics for care that they would not necessarily seek from a doctor.

The researchers calculated that 58% of retail clinic visits for 11 conditions were "new utilization," and concluded this finding not to be representative of a shifting of care from a more expensive location, but rather simply people taking advantage of the convenience of quick, cheap, on-demand care, resulting in a net increase in spending of $14 per person per year.

The study; however, may not be an accurate assessment of retail clinic cost savings and value since the study's authors could not assess the impact retail clinics have on overall medical use and total spending. Critics of the study point out that it used five-year-old data and did not include preventive care that makes up 40% of retail clinic care, which could hold down health spending. Such care can prevent a costly hospitalization, improve health and save resources that are not measured by this study.

Retail clinics, also, serve a crucial function due to a shortage of primary care doctors. Many folks who don't have primary care physicians and might not seek care go to retail clinics for treatment, potentially preventing a worsening condition.

The authors acknowledge that the study did not offer conclusions about whether the visits to the clinics prevented hospital stays or reduced the need for a prescription, which has the potential of reducing overall health spending. The question of whether the centers may reduce costs by improving care for people with chronic conditions like diabetes and asthma remains unanswered, and more analysis needs to be done to determine whether they save money in other ways.

Therefore, the question remains, "do retail clinics reduce overall health-care spending by preventing longer-term costlier health-care spend?" Although the study does not take into account the role the clinics play in treating people early and preventing a very expensive hospital stay, the findings raise questions about whether new sources of care like telemedicine will be able to save money. Retail clinics may also serve an important function by, perhaps, incenting health-care providers to offer lower prices and expanded hours if they want to retain patients?

Do you think retail clinics provide a valuable service? Is it true that when you make something more convenient, people are going to use more of it?

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