Retail Clinics Do Not Equal Lower Health Care Costs

Retail clinics may not cut down on the amount of visits to the emergency room for minor ailments after all.

The widespread opening of retail clinics came with hopes ofreducing health care costsby diverting patients away from higher-cost emergency departments (EDs). However, new findings published inAnnals of Emergency Medicineprovides evidence that this may not be true.

Researchers examined more than 2000 EDs over a 5-year period across 23 states. The results showed that despite the opening of retail medical clinics, there was no significant reduction in visits to EDs for 11 low-acuity ailments, such as ear aches and respiratory infections.

“One hope for the retail clinics was that they might divert patients from making expensive visits to the emergency department for minor conditions such as bronchitis or urinary tract infections,” said lead study author Grant Martsolf. “But we found no evidence that this has been happening.

“Instead of lowering costs, retail clinics may be substituting for care in other settings, such as primary care practices, or spur some patients to seek care for problems they previously would have treated on their own.”

For the study, researchers gathered information from 2006 to 2012 from the federal Healthcare Cost and Utilization Project State Emergency Department Databases to combine ED use with information about the opening of retail clinics that came from the research firm, Merchant Medicine.

Retail clinical penetration was measured as the percentage of an EDs’ catchment area that overlapped with a 10-minute drive to a retail clinic. The 11 low-acuity conditions used for the study are commonly found in both EDs and retail clinics.

Although there was no significant reductions seen overall, there was one exception among patients with private insurance. Researchers detected an extremely small reduction in ED visits among this population. Even when there was a substantial increase in patient access to retail clinics in the area served by an ED, the reduction in ED visits for these low-acuity conditions among privately insured patients was less than 1%.

“Retail clinics may emerge as an important location for medical care to meet increasing demand as more people become insured under the Affordable Care Act,” said study co-author Dr Ateev Mehrotra. “But contrary to our expectations, we found retail clinics do not appear to be leading to meaningful reductions in low-urgency visits to hospital emergency departments.”

These walk-up medical providers first started popping up in the year 2000, and since then has reached a total of nearly 2000 clinics across the United States, receiving more than 6 million patients per year.