Shanda Johnson, right, a nurse practitioner, interviews patient Bill Gilligan at a MinuteClinic at the CVS drug store in North Brunswick, N.J.
Shanda Johnson, right, a nurse practitioner, interviews patient Bill Gilligan at a MinuteClinic at the CVS drug store in North Brunswick, N.J. Mike Derer/AP
For years, there's been a debate about how walk-in clinics at stores fit into the health care mix. Are they an adequate substitute for a visit to the doctor?
Through it all, the number of clinics has kept growing, numbering 1,355 at the beginning of 2012, a 10.4 percent annual increase, according to consultants Merchant Medicine.
MinuteClinic, a division of CVS Caremark and the largest clinic operator by far, is on track to nearly double the number of clinics it operates to 1,000 by 2016.
The companies expect plenty of demand. "We have a primary care shortage," says Tom Charland, CEO of Merchant Medicine. The operators of clinics, he says, are "betting on the extra capacity they have with their nurse practitioners, who in many states practice with the full authority of a doctor."
In addition, by expanding the number of MinuteClinics, which are located inside CVS drugstores, the company increases foot traffic and potential sales of medicines and other merchandise.
There's another big factor in walk-in clinics' favor, says MinuteClinic President Andrew Sussman, in an interview about plans for the clinics. A clinic can provide care at less expense than a doctor's office, urgent care center or hospital emergency room, he says.
A 2009 study by researchers at the Rand Corp. found that the cost to treat three common illnesses — sore throat, ear infection and urinary tract infection — was at least 30 percent lower at a walk-in retail clinic than in other settings.
A walk-in clinic visit, including follow-up care, cost $110, on average, according to the study. That compared with $156 at a physician's office, $166 at an urgent care clinic and $570 at an emergency department. The quality of care was at least as good in a retail clinic as in other settings, the study found.
To be sure, not all clinics succeed. Some close, even as others open up. Merchant Medicine's June report on the state of the industry put the total number of clinics at 1,357, a decline of of eight from the previous month.
Even so, clinics' ability to provide routine care cheaply may make them especially attractive to hospitals and physicians that are forming accountable care organizations, say experts. Under these alliances, providers agree to take responsibility and get paid for keeping a group of people healthy rather than providing services a la carte. They share in any cost savings they achieve.
"If physicians are being paid not by the volume of services but on keeping people healthy, then they might embrace retail clinics," Charland says.