Posted: 5:28 a.m. Thursday, Nov. 7, 2013
By Marissa Evans
Convenience. Accessibility. Peace of mind. Those were the things Reza Marashi was looking for a year ago when he was searching for a new medical provider.
As the 32-year-old sat in the One Medical Group waiting room in Washington, D.C., for his annual check-up, he said that the ease of making appointments and communicating with doctors at the retail clinic “makes it so you don’t have to bend over backwards” to get care.
“All of the doctors have been really nice so far, and they listen…you don’t feel like they’re checking a box, which is always great,” Marashi said.
Marashi, who works within blocks of the downtown D.C. clinic, is among the many patients discovering and using retail health clinics, according to a new report by the Center for Studying Health System Change, a non-partisan policy research group. The study was funded by the Robert Wood Johnson Foundation.
The percent of American families using retail clinics in the previous year nearly tripled between 2007 and 2010, from 1.2 percent of U.S. families to 2.9 percent, the study found. However, despite increased use, the study found overall utilization of the clinics remains modest.
Ha T. Tu, a senior health researcher for the center and one of the study’s co-authors, said one reason clinics haven’t taken off is that patients who already have a primary care doctor don’t see a need to visit one.
“Even though consumers over time have become more comfortable with the idea of using clinic services in a retail setting, there’s still some resistance or discomfort,” Tu said. “The trust in retail clinics as a place to get high quality care is not a universal thing. A lot of people would still rather use their own regular primary care provider.” He added that “there’s no question that when you don’t have a regular provider there’s less continuity of care.”
The study found that the main reasons patients chose to use retail health clinics included the convenience of evening and weekend hours walk-in appointments and nearby locations.
Retail clinics have done a better job making themselves convenient to higher income families. The study found 37 percent of families with incomes at least six times the poverty level lived near a retail clinic in 2010 compared to 25 percent with incomes no more than twice the poverty level.
While it might make sense to have more clinics closer to lower-income areas where people need more preventive care services, Dr. Ateev Mehrotra, a policy analyst at the RAND Corporation and an associate professor in the Department of Health Care Policy at Harvard Medical School, said it comes down to the business model and what consumers can afford.
“From a retail clinic perspective the question is, who can pay for that visit? … It’s people with a commercial health plan and or people willing to pay for it out-of-pocket,” he said. “Wealthier individuals typically have retail clinics covered by their health plans, but poorer individuals who could probably benefit do not have that coverage.”
Mehrotra said someone on Medicaid — the state-federal health insurance program for low-income individuals – might find visits to retail clinics are not covered.
Tu said that the Affordable Care Act may increase demand for retail services as more people become insured and it becomes “increasingly difficult to find access to primary care.” According to the study, nearly seven in 10 patients reported that the primary purpose of their most recent clinic visit was diagnosis and treatment of a new illness or symptom. Other reasons included vaccinations and prescription renewals.
Nurse practitioners and physician assistants provide much of the primary and preventive care services in retail clinics but Tu said that continuity of care isn’t as consistent as it is with a regular primary care doctor.
“You see whoever is there at the time, and that’s part of the business model that makes it more affordable, but that’s also kind of the drawback…having a regular provider is not part of the equation,” she said.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.