MinuteClinic, operated by CVS Health, is one of the nation's largest retail clinic chains. It challenged the accuracy of the study.
"Half of our MinuteClinic patients do not have a physician and these patients need low-cost sites of care, such as retail clinics. The authors' conclusion that this represents new care and new costs is a step backwards, and fails to recognize that reaching this underserved population is not excess utilization; rather it is the underlying objective of many health system innovations," MinuteClinic said in a written response to HealthLeaders Media.
"In addition, millions of newly insured Americans are seeking care under the ACA. With the profound shortage of primary care physicians, retail clinics can help keep patients healthy and provide overall health care savings. A patient with the flu who does not have a physician can get convenient, inexpensive care at a retail clinic, even on the weekend, before their condition worsens. This care can prevent a costly hospitalization, improving health and saving resources that are not measured by this limited study design. Other peer-reviewed research has demonstrated the significant value and overall cost savings for patients who use retail clinics."
MinuteClinic said its retail clinic visits are 40 to 80% less costly than physician office and emergency room visits.
"According to the authors, the majority of retail clinic expenses replace more-costly sites of care, covering all but $14 per capita," MinuteClinic said. "This tiny difference, a little more than one tenth of one percent of total health care spending, is more than made up by overall total medical expense savings, which was not evaluated by these authors."
MinuteClinic said the study also relies on data that is 5 to 10 years old, and doesn't consider that 40% of retail clinic care now provided for preventative services, wellness and chronic disease, which keep costs down.
"For example, identifying a patient with high blood pressure at MinuteClinic and referring them for follow up care to a physician practice should be viewed as an investment in health and prevention of more-costly illness, not as an excessive cost," MinuteClinic said. "Despite the flawed conclusions of this study, many millions of patients and their insurers appreciate all the medical care access benefits and expense savings that retail clinics provide."
'Voting with Their Feet'
Rather than focusing on retail clinics adding costs, Ashwood says the rapid growth of the clinics across the nation show they're addressing an unmet demand.
"Patients are voting with their feet. They are coming to the clinic and using it when it's there," he says. "Some of the clinics view themselves as a source of community care. Some clinics are in urban areas that may not have convenient access to other kinds of care. We focused on a particular set of conditions, low-acuity care. In that case, retail clinics have met that need. If you spend more on it, then that's not such a bad thing because there is some value that is being added as well."
John Commins is a senior editor at HealthLeaders.