Retailing in Healthcare's Impact on Cost, Quality, and Access
and
Walmart and Target's Competitors
This week we will focus on the cost, quality, and access components of Retailing Healthcare as well as one of Wal-Mart and Target’s major competitors, the physician practices.
The growing emergence of clinics in retail settings offers patients affordable healthcare for routine medical issues and preventative care. Retail clinics provide greater affordability than physician’s offices and emergency rooms and they accept most forms of insurance. Even without insurance, costs are reasonable; treatment for a common illness such as a bladder or ear infection would range from $49-$59.
The clinics offer 15-minute sessions on a first come first served basis with no appointments and no waiting. Since patients will be able to seek medical attention when their own physicians are not accessible, they will not be clogging up emergency rooms with minor illnesses. This will allow hospitals to treat real emergencies in a more expedient manner. Access to health services will be better for both patients who go to the clinics and patients who go to the hospitals.
Retail clinics also provide high levels of quality. For example, MinuteClinic has formed a National Clinical Quality Advisory Council to bring together nationally recognized health care leaders from a variety of specialties and backgrounds to contribute strategic creativity, clinical guidance, and quality improvement ideas and to evaluate the company’s current clinical performance. MinuteClinics are also regulated by a variety of agencies and are licensed by the Agency for Health Care Administration (AHCA) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
Due to these reductions in costs, increased access to services, and improved quality, physician practices are being forced to compete with the burgeoning retail clinics. Many practitioners feel threatened by in-store clinics and cite concerns about the quality of care provided by physicians who are not “familiar with a patient’s medical and pharmaceutical history” (Abelson, 2006). Despite their reservations about retail clinics, many physicians are preparing to contend with the leaders of the new industry, Target and Wal-Mart, by improving access to services, decreasing the costs of visits and treatments, improving quality offered and even, possibly, expanding services to include subspecialist work, such as colonoscopies (Bachman, 2006).
References
Abelson, Jenn. (July 14, 2006). CVS looks to buy operator of in-store clinics. Knight Ridder Tribune Business News, 1. Retrieved, September 26, 2006 from ABI/INFORM Dateline database.
Bachman J. (2006, May). What do retail clinics mean for family medicine? Family Pracitce Management, 13 (5), 19-20.
Birchall, J. (2006). Financial Times. London (UK): Take Care to roll out retail healthcare model FUNDRAISING; [ASIA EDITION] pg 20. Retrieved October 10, 2006 from
http://proquest.umi.com.ucfproxy.fcla.edu/pqdweb?RQT
Crounse, B. (2006). Healthcare goes retail: In-and-out check-ups. Retrieved October 10, 2006 from http://www.microsoft.com/industry/healthcare/providers/businessvalue/housecalls/retailhealthcare.mspx#ENC
Msfmillie, Retail HealthCare: Healthcare with a Consumer Focus
Close
Report this Lens
Our members are instrumental in helping to keep the Squidoo neighborhood a clean, well-lighted place! Please report this lens if it contains obscene or illegal content, if it's unquestionably a spam lens, or if it has mature content and the lens is not marked as Adult..
Sorry, you can't report your own lens.Hide this message
http://www.squidoo.com/retailhealthcarereview/
Healthcare Access; Healthcare clinics open at CVS/pharmacy stores in Columbus; Lab Business Week. Atlanta: Mar 26, 2006. p. 94. Retrieved October 10, 2006 from http://proquest.umi.com.ucfproxy.fcla.edu/pqdweb?RQT
Group 1
Michelle Au
Sara Ca
Janet Co
Kari Fl
Diane Fu
Shakeitha He
The growing emergence of clinics in retail settings offers patients affordable healthcare for routine medical issues and preventative care. Retail clinics provide greater affordability than physician’s offices and emergency rooms and they accept most forms of insurance. Even without insurance, costs are reasonable; treatment for a common illness such as a bladder or ear infection would range from $49-$59.
The clinics offer 15-minute sessions on a first come first served basis with no appointments and no waiting. Since patients will be able to seek medical attention when their own physicians are not accessible, they will not be clogging up emergency rooms with minor illnesses. This will allow hospitals to treat real emergencies in a more expedient manner. Access to health services will be better for both patients who go to the clinics and patients who go to the hospitals.
Retail clinics also provide high levels of quality. For example, MinuteClinic has formed a National Clinical Quality Advisory Council to bring together nationally recognized health care leaders from a variety of specialties and backgrounds to contribute strategic creativity, clinical guidance, and quality improvement ideas and to evaluate the company’s current clinical performance. MinuteClinics are also regulated by a variety of agencies and are licensed by the Agency for Health Care Administration (AHCA) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
Due to these reductions in costs, increased access to services, and improved quality, physician practices are being forced to compete with the burgeoning retail clinics. Many practitioners feel threatened by in-store clinics and cite concerns about the quality of care provided by physicians who are not “familiar with a patient’s medical and pharmaceutical history” (Abelson, 2006). Despite their reservations about retail clinics, many physicians are preparing to contend with the leaders of the new industry, Target and Wal-Mart, by improving access to services, decreasing the costs of visits and treatments, improving quality offered and even, possibly, expanding services to include subspecialist work, such as colonoscopies (Bachman, 2006).
References
Abelson, Jenn. (July 14, 2006). CVS looks to buy operator of in-store clinics. Knight Ridder Tribune Business News, 1. Retrieved, September 26, 2006 from ABI/INFORM Dateline database.
Bachman J. (2006, May). What do retail clinics mean for family medicine? Family Pracitce Management, 13 (5), 19-20.
Birchall, J. (2006). Financial Times. London (UK): Take Care to roll out retail healthcare model FUNDRAISING; [ASIA EDITION] pg 20. Retrieved October 10, 2006 from
http://proquest.umi.com.ucfproxy.fcla.edu/pqdweb?RQT
Crounse, B. (2006). Healthcare goes retail: In-and-out check-ups. Retrieved October 10, 2006 from http://www.microsoft.com/industry/healthcare/providers/businessvalue/housecalls/retailhealthcare.mspx#ENC
Msfmillie, Retail HealthCare: Healthcare with a Consumer Focus
Close
Report this Lens
Our members are instrumental in helping to keep the Squidoo neighborhood a clean, well-lighted place! Please report this lens if it contains obscene or illegal content, if it's unquestionably a spam lens, or if it has mature content and the lens is not marked as Adult..
Sorry, you can't report your own lens.Hide this message
http://www.squidoo.com/retailhealthcarereview/
Healthcare Access; Healthcare clinics open at CVS/pharmacy stores in Columbus; Lab Business Week. Atlanta: Mar 26, 2006. p. 94. Retrieved October 10, 2006 from http://proquest.umi.com.ucfproxy.fcla.edu/pqdweb?RQT
Group 1
Michelle Au
Sara Ca
Janet Co
Kari Fl
Diane Fu
Shakeitha He
posted by Retailing in Healthcare @ 10:21 AM
11 comments
11 Comments:
The revolutionary idea of the retail-based clinics is being measured to “the iron triangle” of health care, addressing cost, quality and access in many ways. According to an article this May in the journal of Family Practice Management, the lower cost and greater accessibility provided by these clinics can prove to make them successful and here to stay. The idea may grow in years to come especially if the increase of Health Savings Accounts continues. Since the accounts will force people to comparison shop, they will definitely rely on these clinics to take care of minor ailments. Linda Whitman, previous CEO of MinuteClinics compares prices in this article. A $40 service will cost 109 at a doctor’s office, 120 at an urgent care and 325 at the ER. I think that is a remarkable difference that will encourage people to use them, especially those without insurance. What I’m not so sure about is what kind of resources they use for labs or if any at all? If they don’t know if upper respiratory symptoms are viral or bacterial, will they still prescribe antibiotics? If they do, this will contribute to the already increasing resistance that we now face.
Bachman, John. M.D. (2006, May) What do retail clinics mean for family medicine? [Electronic Version]. Family Practice Management, 13 (5). Retrieved on November 5, 2006 from http://www.aafp.org/fpm/20060500/65reta.html
Maria Ro,
Thank you for your post. You raise a legitimate question regarding the testing. Proper diagnosis of illness is crucial. As you point out, antibiotic resistant drugs are a big problem facing the health care industry so drugs cannot be doled out without ensuring their need. Lab testing is divided up into three major categories, waived, moderately complex and high complexity. Most of the testing that would be done by a small clinic would fall into the waived category. Waived testing is defined by The American Academy of Family Physicians to employ methodologies that are so simple and accurate as to render the likelihood of erroneous results negligible; or pose no reasonable risk of harm to the patient if the test is performed incorrectly; are cleared by the Food and Drug Administration for home use. Offices and clinics using these tests must apply for a Certificate of Waiver and may be subject to inspection by the state regulating agencies.
So, when there is a need for a quick screening test, the clinics could use a kit in the waived category. If there is a need for a more complex test, many reference laboratories would be happy to pick up the samples for testing at their sites.
Janet C
Reference:
The American Academy of Family Physicians, Practice Management web site
Retrieved 11/6/06 from http://www.aafp.org/online/en/home/practicemgt/pt/clia/cliawaiveddefined.html
I think that the idea of having Wal-Mart and Target hire nurse-practitioners to help customers with simple health problems such as flu, strep throat and other ailments that can be treated by following strict protocols makes sense. Some, on the other hand have called this paradigm shift just another “disruptive innovation in healthcare.” It would, it seems keep some of the above patients out of the emergency rooms and keep them open for true emergencies. Many of these patients do not have primary care physicians to begin with and have no place else to go. I do think it is neat that Wal-Mart housing and hosting this innovation is ironic since many of its own employees don’t have health insurance, can’t afford to have a primary care physician and most likely will become Walt-mart’s primary group of customers for such services. So I don’t think that this idea is going to compete with anyone. Could it possibly be that it is just going to provide “good enough” care for those who can’t afford to go anywhere else?
TimothyRi
In case you haven't noticed...There is something posted that doesn't belong here. Please remove it.
Couple of comments
1. Point of clarification --Wal-Mart, Target, and other retailers do not hire nurse practitioners, etc. They have lease agreements with companies such as Minute Clinics. Many of these companies are owned by physician entreprenurs.
2. I believe that they prescribe antibiotics according to standardized protocols, which were developed and approved by physicians and others. Most are equipped to do tests for strep throat, but I am unclear about the lab facilities issue. Good point.
I find it very interesting that physicians feel threatened by these mini clinics and their accessibility. Most physicians are portrayed as overworked, overbooked and undermanaged. The fact of money is the "only" issue they are concerned with. Most physicians that I work with do not even know their patients or their history by just seeing them, so why are they concerned about someone going to an independent caretaker for a simple ailment. If the patient is on any medications, they would be able to tell the caretaker so they can prescribe without any issue. Also, our pharmacies are well equipped with cross referencing technology that would find medications that would interact with another.
I say a big thumbs up to our retailers stepping in to help alleviated our over crowded emergency rooms. I do think that once the word gets out that they are in business, the luxury of "no wait" will go away, but hopefully it will be better than the 6 hours one waits in the emergency department.
Thank you for bringing this issue forward and the good research you are presenting.
One thing I would caution you about (JCAHO) is not a licensing organization, they are a accrediting entity which charges a fee for their service to award their seal of approval for the healthcare facility.
www.jointcommission.org.
I watched a news special on Nightline about a month ago on this very topic. I was unaware that Wal-Mart and Target were getting involved in the retail-based urgent care clinics. What a great concept to provide health clinics at a reasonable rate and convenience. Nightline interviewed a patient and he said that he had insurance, but for the price and ease of being seen without an appointment he would rather visit Wal-Mart's clinic than to make an appointment with his primary care physician.
It will be interesting to see if these clinics will put a strain on urgent care clinics or if they can create their own niche. Also if urgent care clinics wiil be forced into pricing wars with insurance companies over capitation, and if these centers will become profitable.
From my own personal experience, having a catastrophic injury it can be very frustrating to wait for an appointment when an emergency arises. It is nice to have insurance, but also too have multiple choices if you so desire.
Sorry, I meant to preview instead of publish.
Scott Rimmer
Retail clinics are definitely becoming more commonplace in our healthcare system. I believe that they have their place in the medical field and can benefit our society, but I am not sure I completely understand your explanation or evidence of improved healthcare quality. For example, the hospital at which I work at, as well as many others, are licensed by AHCA and accredited by JCAHO. The hospital system also has constant quality improvement measures and inspections to ensure quality of care. These are examples you mentioned as evidence of improved quality. If both are licensed and accredited by the same organizations, how are retail clinics improving quality? Also, as you previously mentioned in other blogs, many retail clinics use nurse practitioners, and don’t necessarily have a medical doctor on site which can be seen as a possible source of concern. The examples you mentioned show how are these clinics are evaluating and showing they meet quality standards, but I am not sure I understand how they show improved quality vs. doctor’s offices and emergency rooms.
Another issue with the statement of retail improving healthcare quality, is the question of overall improved quality of healthcare management. I agree that retail clinics provide a good option for relief of common ailments. But, for those who are uninsured, these visits may be just a “band- aid” placed on a bigger problem. According to Dr. June Delgado, president of the National Alliance for Hispanic Health, retail clinics, “…give people a false sense that they are receiving healthcare. They’re not—they’re getting a spot check” (Capozza 2006). These comments echo the suggestions of the America Medical Association (AMA) and the American Academy of Family Physicians (AAFP) to “encourage all patients to have a ‘medical home’” (AAFP 2006). The idea of a personal medical home ensures continuity of care with a primary care physician (AAFP 2006). Questions arise such as, Will these uninsured patients follow-up with a PCP? or Will they just return to a low-cost clinic the next time they have a medical problem? Improving access does not necessarily improve quality, and may even harm retail clinic users by giving them a false sense of security about their health treatment: in fact, Dr. Rick Kellerman, president of the AAFP flat-out states, “Patients cannot get …top-quality, customized care at a retail facility” (AAFP 2006). Though these clinics improve access to an aspect of healthcare, without other changes in our healthcare system to bridge clinic services to general practice, they may not improve the overall quality of healthcare delivery or its management.
DebbiMi
“America’s Family Physicians Urge Retail Health Clinics to Put Patients’ Health First.” The American Academy of Family Physicians. June 22,2006. Accessed 11/7/2006 from: http://www.aafp.org/online/en/home/press/aafpnewsreleases/06192006mayprelease/20060622retailhlth.html
and http://www.aafp.org/online/en/home/policy/policies/r/retailhealthclinics.html
Capozza, Korey. “Retail Clinics Catering to Uninsured Hispanics” Health Currents. October 23, 2006. California Healthline. Accessed 11/7/2006 from http://www.californiahealthline.org/index.cfm?Action=dspItem&itemID=126688&classcd=CL126
Quality of care seems to be a very big argument against the retail clinic industry. Consequently, it only makes sense that retail clinics align themselves with recognized organizations such as the American Academy of Family Physicians (AAFP), which has set guidelines for retail health clinics. It is also mentioned in this week’s post that MinuteClinic is accredited by Joint Commission on Accreditation of Healthcare Organization (JCAHO). As a result, I decided to verify that information by performing a quality check at http://jointcommission.org. I also began searching for other major retail clinics, specifically those that form the Convenient Care Association, a trade organization. Some were accredited due to there hospital affiliations, others, for example RediClinic, were not. However, it is possible that those organizations not found are listed under another.
It is most interesting that these retail clinics will be able to provide services at costs lower than a primary care physician. Are the costs actual prices without the cloak of insurance? Or is there some other reason, other than overhead, that these prices are considered low relative to a doctor’s office. Ultimately, my search of the retail clinic market, led me to believe that they are gaining popularity, rather their beginnings were stimulated, because of the introduction of Health Savings Accounts (HSA). Consider the 550,000 Minnesotans enrolled in High Deductible Health Plans (HDHP) where MinuteClinic is prevalent and has its main site. There may be places with similar scenarios but MinuteClinic was chosen because it was your focus this week.
ChinemeSw
Reference:
1. Retail Health Clinics Form Trade Organization. (2006). Retrieved November 11,
2006 from
http://healthdecisions.org/News/default.aspx?doc_id=89734
2. Phelps, David. (2006). Comparing health care costs gets easier. Retrieved
November 12, 2006 from
http://healthdecisions.org/News/default.aspx?doc_id=72750
3. Desired attributes of retail health clinics. (2006). Retrieved November 12, 2006 from
http://www.aafp.org/online/en/home/policy/policies/r/retailhealthclinics.html
4. Quality Check. Retrieved November 12, 2006 from
http://www.qualitycheck.org/consumer/SearchQCR.aspx?
5. Robeznieks, Andis. (2006). AAFP denies endorsement. Modern Healthcare, 36(9),
18.
Is this blog centrally focused on clinics inside Walmart/Target/Publix? Because there is a major shift in the retailing of surgical procedures to India, Thailand, and other countries where procedures are being done for 1/4 to 1/10th the cost and they are of the latest cutting-edge technology. If you google "medical tourist" you will see what I mean. The reason that I mentioned this is because several small companies in NC and elsewhere are offering these services to employees. These procedures include knee and hip replacements, spinal fusions, heart bypasses, and a plethora of elective surgeries, such as cosmetic procedures. A Time article that I pulled from back in May covers a couple of individuals and their stories in India. Both had nothing but positive experiences. Time points out that all of the MDs have been trained in the US (whereas in the US 25% of MDs have been trained outside of the US), the facilities are very modern and cutting-edge, the hospitals have either been or are in process of Joint Commission International accreditation, and the techniques and materials used are the latest and most preferred. The increase in these medical tourist operations is amazing. As Time reports ", a growing stream of uninsured and underinsured Americans are boarding planes not for the typical face-lift or tummy tuck but for discount hip replacements and sophisticated heart surgeries. Bumrungrad (Hospital) alone, according to CEO Curtis Schroeder, saw its stream of American patients climb to 55,000 last year, a 30% rise. Three-quarters of them flew in from the U.S.; 83% came for noncosmetic treatments. Meanwhile, India's trade in international patients is increasing at the same rate." What is alarming to hospital administrators is that elective surgery, which usually brings in the high dollars, is being outsourced to India, Thailand, Singapore, etc. When a hospital's richest patients are taken away, the change in profit margin can be astonishing. The ability to offer lower prices while providing excellent care and facilities stems from the location as a developing country, income disparities, and capped awards for malpractice. As private payers recognize the savings that can be had for identical or better treatment, US providers will be forced to make changes to remain competitive. Otherwise, they will be as GM is to Toyota.
Kher, Unmesh "Outsourcing Your Heart Elective surgery in India? Medical tourism is booming, and U.S. companies trying to contain health-care costs are starting to take notice" Time May 2006
Post a Comment
<< Home