In the past few years, convenient care clinics have seen greater acceptance by health systems, providers and the public. A recent study published in the journal Health Affairs found that visits to convenient care clinics have increased greatly.1 This could spell relief for a healthcare system that will soon be strained by a huge influx of patients.
In a study of electronic health record data from Take Care Clinics, MinuteClinic and The Little Clinic, Mehrotra and Lave found that from 2007 to 2009, visits increased an average of 102% per year - to 5.97 million visits in 2009. They also noted that preventive care visits rose sharply, especially for influenza vaccinations. Visits from patients older than 65 doubled from 7.5% to 14.7%.
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Sandra Ryan, RN, MSN, CPNP, FAANP, chief nurse practitioner officer and clinical advocate for Take Care Health Systems of Walgreens, explained that the increase in visits by older patients could be tied to convenient care marketing strategies.
"Historically the retail clinics have used immunizations as a trial vehicle to get patients in - with flu, Pneumovax and Zostavax, so patients are becoming aware of the clinics being there through those mechanisms and they are coming back for repeat visits," she said.
Legislator Support Grows
A decade ago, lawmakers heard more of their constituents saying that convenient care was a disruption to healthcare. Since the advent of the convenient care clinic, 16 state legislatures have tried to pass legislation that would affect convenient care clinics, and two states passed laws that limited them. Massachusetts was one of those states, and its 2008 law stipulated the types of conditions that could be treated in what the law called "limited service clinics."2
This year, the Massachusetts Legislature passed a second law that addresses convenient care clinics. The new law allows limited service clinics to treat any condition within the scope of practice of a nurse practitioner.3
"Seven years ago you couldn't get anybody to talk to us," Ryan said of legislators and key healthcare stakeholders. But now convenient care operators are involved in many initiatives to create an outcome-focused healthcare system.
Convenient Care & PPACA
Convenient care operators are looking for ways to respond to market demands, i.e., patient needs. To address the increase in older patients' interest, in 2012 Take Care Clinics began offering Medicare wellness visits. Take Care Clinics, along with other convenient care clinic operators, are moving into the chronic disease monitoring space as well.
In August, CVS Caremark invited Health and Human Services (HHS) Secretary Kathleen Sebelius to visit a CVS store and MinuteClinic in Jacksonville, Fla., to kick off a partnership between HHS and CVS Caremark, Walgreens, Thrifty White, Walmart, and Sam's Club to raise awareness about new benefits in the Patient Protection and Affordable Care Act (PPACA) and to provide Medicare information for seniors. The partnership will involve educational materials and discounts, such as a drug discount provided by CVS/pharmacy to patients who had reached the Medicare part D donut hole. To see a video of the visit go to http://info.cvscaremark.com/sebelius-video.
Preventive and wellness care is going to be at a premium as the PPACA is enacted. If convenient care operators follow through with plans to offer more chronic disease management and wellness visits, especially for older patients, they will meet a desperate need.
1. Mehrotra A, Lave JR. Visits to retail clinics grew fourfold from 2007 to 2009, although their share of overall outpatient visits remains low. Health Aff. 2012;31(9):1-6.
2. National Conference of State Legislatures. Retail health clinics: State legislation and laws. http://www.ncsl.org/issues-research/health/retail-health-clinics-state-legislation-and-laws.aspx.
3. Wolfgang K. Massachusetts law expands access to NPs and PAs. Adv NPs PAs. 2012;3(9):10.
Jennifer Ford is the senior associate editor and convenient care columnist. Reach her at firstname.lastname@example.org.