Do Retail Clinics Reduce Spending for Low-Acuity Conditions?

HealthDayNews –   Retail clinics have been promoted as cost-effective alternatives to emergency departments (EDs) for the evaluation and treatment of low-acuity conditions. However, a study found that because retail clinics represented new care utilization they actually increased healthcare spending per person per year, according to a study published in the March issue of Health Affairs.

Noting that retail clinics have been seen as a mechanism to decrease health care spending, but that they can increase spending if they drive new health care utilization, J. Scott Ashwood, PhD, from the RAND Corporation in Santa Monica, Calif., and colleagues examined costs associated with retail clinic use. Insurance claims data from Aetna for 2010 to 2012 were used to track utilization and spending for 11 low-acuity conditions.

The researchers found that 58 percent of retail clinic visits for the 11 low-acuity conditions resulted in new utilization. Consequently, retail clinic use correlated with a $14 increase in spending per person per year.

“These results should help inform payers’ coverage decisions for retail clinics and other care options that increase convenience and access,” the authors write. “Future research should investigate how retail clinics affect the coordination of care, care for chronic illnesses, and overall spending.”

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Summary and Clinical Applicability

Retail clinics are now a part of the health care landscape in the United States, offering convenient weekend and after-hours care. However, issues such as decreased continuity of care, lack of medical record integration with hospitals and outpatient offices, and disruption of the doctor-patient relationship need to be addressed. 

“Though retail clinics have been promoted as a means of reducing health care spending by substituting for more expensive providers, we found that most retail clinic visits represented new utilization and therefore increased health care spending per person per year for low-acuity conditions”, the authors concluded.

Reference

Ashwood JS, Gaynor M, Setodji CM, et al. Retail Clinic Visits For Low-Acuity Conditions Increase Utilization And Spending. Health Aff. March 2016 vol. 35 no. 3449-455