Like electronic health records, quality data reporting and emerging primary care models, retail clinics are here to stay. Physician practices, health plans and even hospital emergency departments must decide whether to compete or coexist. This week, Humana and Sutter Health — a payor and provider in the retail clinic space — gave us food for thought, sharing their experiences with reimbursing for and running retail clinics.
Dr. Steven Goldberg, corporate medical director at Humana, which includes MinuteClinic in its provider network, describes the very early feedback his organization has received:
Are retail clinics a good thing? Well, that depends on your vantage point. A couple things: the rate of clinic visits has dramatically increased over the past years. I believe recent published literature shows about 1,000 such clinics now, and hundreds of thousands of visits. In general, the consumer experience has been very good, and that’s a very positive thing. For the narrow scope of services, the experience has overall been consistently reported in sources as very, very positive. As a payor, we really look at this in the context of a range of approaches for these types of problems and settings. How does a retail clinic stack up for issues versus self management, versus urgent care, versus primary care, versus ER care? The public domain literature is very limited. Our findings are early. As far as quality, the general experience for the scope of services is very positive, and people in general seem to be pleased with cost. Frankly, they are walking with their feet and walking more and more every day. As far as continuity, that remains something that we have to follow more.
Offering the provider perspective was Dr. Thomas N. Atkins, medical director of Sutter Express Care, six drugstore-based medical clinics that are part of Sutter Health’s network of hospitals and doctors serving Northern California. There were enormous administrative and regulatory hurdles to overcome in the establishment of the clinics, Dr. Atkins said.
On clinics’ critical success factors:
It’s important if you want to be as successful as you can that you be first to market. I think it’s much more difficult to try and establish these behind another provider that puts these in in a community.
On fears voiced by health plans:
There’s some evidence that in some areas or for some conditions, patients will see someone in these retail clinics and then go see their doctor anyways, and that’s the kind of thing that increases utilization that is disturbing to the health plans. And the one health plan that didn’t contract with us, felt that that was what was going to happen. Now, their patients were really upset because we had that contract last year, we didn’t this year, and these patients have been coming in and being patronizing for us, and they were just, they were really upset about not being able to have this service covered for them. The patients to the clinics are quite loyal.
On why typical hospital marketing does not work for this kind of a project:
The nurse practitioner or the physician assistant is of course the patient care giver, educator, counselor, customer service rep. This piece here is really important. These people need to for the most part be extroverts; we really encourage them to walk around in the aisles and wear their clinic coat to Starbucks when they take a break. They have to take on a marketing role to help sell the clinics to their community. They often will go visit local stores and employers as well. …They are the face of Sutter Express Care.