Sometimes it may feel like there are very few things everyone can agree on – but one universal truth is that healthcare in the United States is unique and constantly evolving. The system has a dynamic history of morphing delivery mechanisms to fit the capabilities and needs of a changing population, from the emergence of public hospitals to the advent of Medicaid/Medicare programs, to the Affordable Care Act. Over the past several years we have seen a convergence of the online lifestyle of the American public with healthcare delivery with the rise of telehealth services. This transition has created an opening for another evolution of service delivery: retail care.
Retail clinics emerged in 2000 as an option for diagnosis, rapid testing, and prescription issuance for common illnesses for a flat rate, and with the goal of avoiding a long wait time in an ER or a physician’s office. As they have evolved from the first iteration, these clinics now follow a similar model: a 200 to 500 sq ft space with the bare minimum equipment to serve their clients as a means of avoiding unnecessary overhead costs. The appeal of these clinics – in addition to their modest set up costs – is that they occupy un-optimized retail space, utilizing anything from old video game arcades to the least-trafficked areas of a pharmacy. These clinics provide an opportunity for retail stores to monetize under-utilized space and to regain foot traffic as store owners grapple with the constant rise in online shopping. As these care providers shift to meet the demand for in-person services and experiences despite the growth of telehealth, it is important to understand what aspects of consumer preferences have enabled them to thrive.
Who is the typical user of this new delivery channel? The following 5 questions will indicate if you’re a target consumer for retail clinics (and the answer may surprise you).
Have you ever utilized the services of a retail clinic compared to your physician office because of the locational convenience of the clinic?
“Location, Location, Location”. The time-honored retail truism applies to these clinics: two identical outlets can have vastly different levels of success solely based on their location. These clinics can adapt to any environment they are put in, whether they are sharing space with a retail store or taking over vacant spaces that once held retail stores. The pandemic has brought an opportunity for these clinics to embrace a retail strategy through the advent of lower rents (created by an oversupply of retail space), and medical providers moving into storefronts for increased foot traffic. These clinics have gained the trust of city residents (61%), rural residents (52%) and suburban residents (48%).
Do you compare costs of care, and have you found a retail clinic to be your best option?
These opportunities can lead to much needed improvements in health outcomes for consumers in rural areas, as two of their main barriers to accessing medical care are location and cost. In these areas, the retail clinic has the upper hand over ERs or physician offices as they are likely the most convenient option for non-urgent care. Beyond the locational convenience, the cost saving aspect of these facilities benefit consumers as well. One area of healthcare that has the most potential benefit from these clinics is offloading non-emergency visits from EDs, as up to half of these visits could have been treated at a different healthcare site. These unnecessary visits are considerably more costly to treat in the ED compared to other sites, eventually putting the burden on consumers as the cost of healthcare rises.
Have you gone in-person to a retail health clinic to receive medical care services during the pandemic?
The COVID-19 pandemic has highlighted the strength of these clinics in two areas: testing and vaccinations. Retail clinics across the country transformed their clinics into drive-through testing sites, leveraging one of the key advantages of their locations (traditionally having large parking lots to set up tents and the capability to easily change the layout of the store to suit a new need).
Have you received a vaccination at a retail clinic?
As the peak of the pandemic has passed, these clinics still play an important role in prevention through the convenience in providing vaccinations. The retail industry itself thrives on revenue from impulse buys and as that same mindset is brought into the clinics it may serve to make more people get care. Influenza vaccinations are a ready example, as many individuals who would not have gotten their flu shot if it required a physician visit now have a more convenient and cost-effective option. Taking away several impediments that previously existing for vaccination access can increase vaccination rates, protecting the individual and the community around them.
As these clinics have been part of the healthcare delivery spectrum for over 20 years and growing at a consistent rate, they should be seen as an adjunct to existing care. These centers were not created to take patients away from existing care facilities to make a profit but rather to offload simple procedures. By doing so, physicians can dedicate more time to administer the level of care that only they are qualified to render to their patients. The providers at retail clinics are typically nurse practitioners with physician oversight. These clinics are traditionally staffed by nurse practitioners with a physician onsite or on call for oversite, which is an area of their design that allows for cost saving without sacrificing care. While there is minimal evidence regarding the quality of care at these clinics, nurse practitioners are often used to provide the same services at traditional healthcare centers. So, the attractiveness of the lower cost and better appointment times offered in retail clinics appears to have little downside with respect to obtaining the same services at a physician’s office.
Has there been a time where you were un- or under-insured but required care and relied on a retail clinic?
Many traditional providers require patients to demonstrate insurance coverage (unless the center is categorized as Federally Qualified Health Center or Community Health Center, which may not always be the most accessible option.) For non-emergency issues, retail clinics fill the gap for individuals who are uninsured by accepting cash or credit cards for payment. Addressing this patient population helps to alleviate the burden on community health centers so they can focus their efforts on providing the kinds of care that these clinics are not designed to provide.
If you answered “yes“ to at least one of these questions, you qualify as a retail clinic user! You might not expect to be one of their target consumers but at least one facet of their care model has won you over. Like all retail businesses, their ultimate success will lie in their ability to obtain repeat visits. And unlike traditional healthcare providers, retailers are well equipped with techniques to get you back into the store.