- Are retail clinics really a viable solution to overcrowded emergency departments packed primary care calendars? A new study from the American Journal of Managed Care (AJMC) indicates that retail clinics from pharmacy chains such as CVS Health, do indeed provide the same quality of care as urgent care centers and emergency departments for low-level complaints such as earaches and strep throat.
“As we all work to manage rising costs while dealing with a shortage of primary care physicians, identifying high quality health care delivery systems that provide convenient access to affordable care is increasingly important,” said William Shrank, MD, chief scientific officer, CVS Health. Shrank is listed as an author on the AJMC paper, and the study was supported by a research grant from CVS Caremark. Other authors are affiliated with Brigham and Women’s Hospital and Aetna Informatics.
“This study is the largest to date evaluating the quality of care for acute conditions at retail clinics such as MinuteClinic, and the findings are consistent with previous research in suggesting that care at retail clinics for common acute conditions is the same or better than the care delivered in more costly EDs and urgent care facilities,” Shrank added.
Chains like CVS and Walgreens have been touting their walk-in clinics as an alternative to traditional care settings for several years, and have bolstered their health IT infrastructure with advanced EHR technology, population health management and analytics applications, and health information exchange to ensure that patients say connected to mainstream healthcare providers. Their efforts seem to be paying off, according to the study, with high patient satisfaction levels and quality metrics that surpass EDs and ambulatory care facilities (ACFs) in at least seven categories.
The study used 14 quality of care measures developed by the RAND Corportation to match moer than 20,000 comparable patient visits between the three types of care settings. MinuteClinics tended to serve higher income patients and fewer children, with sore throat being the most common complaint.
MinuteClinics scored higher than ACFs and EDs across all quality measures in a multi-variable analysis, and scored higher than other facilities for ear infections, sore throats, and simple urinary tract infections. The retail clinics performed more poorly on complicated UTI cases that required long-term antibiotic therapy, but the study notes that such cases made up a small percentage of patient visits, and clinic staff are instructed to refer those cases to more acute care.
“In a healthcare system that sees 177 million ED and 577 million physician office visits annually, there is significant potential for retail clinics to play an increasingly important role in reducing the burden on our primary care channels,” the study concludes. “In light of a transforming healthcare system, more extensive studies exploring costs for chronic disease management and the role of retail clinics in improving care coordination and population health management are warranted.”