Tag Archives: urgent care

Seeking Primary Care Elsewhere

Patients who can’t get in to see their primary care physicians on a timely basis–or when it’s convenient for them–seem to be increasingly voting with their feet, seeking care at retail clinics or after-hours urgent care centers.  And that seems to be one factor that’s expected to drive down the cost of health care next year, says PriceWaterhouseCoopers.

Image Courtesy CVS Caremark

The accounting and consulting behemoth released its annual “Behind the Numbers” report on health cost trends. Health spending has been lower than expected for the last three years and will likely stay low, rising by about 7.5% in 2013, according to the report.

PwC found that one of the slowest areas of growth is physician spending. From 2007-2012, spending on physician services by private health plans grew only 5.4%–compared to 8% growth for inpatient care and 10% for outpatient hospital care.  They slowdown in doctor spending “is expected to continue in 2013 as consumers choose alternatives to the traditional doctor’s office visit,” said the report. Those alternatives include “lower-cost options such as workplace and retail health clinics, telemedicine, and mobile health tools,” which are viewed by employers and consumers “as cost effective and convenient.”

In 2010, about 17% of consumers said they had sought care at a retail clinic; by 2011, that had risen to 24%, according to a PwC survey conducted each year to help flesh out the medical spending picture.

It’s no secret that use of retail clinics and urgent care centers has skyrocketed. Last fall, the RAND Corp. reported that there was a ten-fold increase in use of those retail clinics between 2007 and 2009. Using data from a commercially-insured population of 13.3 million, RAND determined that 3.8 million made at least one clinic visit between 2007 and 2009. Monthly visits jumped from 0.6 per 1,000 in January 2007 to 6.5 per 1,000 in December 2009.

Interestingly, availability of primary care physicians did not seem to be a factor in determining use. Those who went to retail clinics tended to be in good health, between 18 and 44, and have a higher income.

In other words, those are paying customers who are choosing to spend their money elsewhere for their care. PriceWaterhouseCoopers advises physicians to make their pricing “defensible” to help stem the tide of patient outflow to these clinics.

One reason why consumers may be going to a lower-priced environment: because employers are increasingly asking workers to shoulder more of the costs of their care. And that is expected to continue.

“We’re seeing long-term trends that could keep cost increases in check,” said Michael Thompson, principal, human resource services at PwC in a press release.  ”As employers shift expenses to their employees, for example, these workers are pursuing lower-cost alternatives. Even as the economy strengthens, changes in behavior by employers and consumers may help limit medical growth.”

Alicia Ault

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Filed under Family Medicine, Internal Medicine, Practice Trends, Primary care

Selling Health & Cigarettes?

  The American Medical Association doesn’t believe medical services should be served up next to an array of tobacco products in retail outlets, and it appears that the American Osteopathic Association agrees.

Meeting this week in Chicago, representatives of the nation’s more than 67,000 osteopathic physicians will consider a policy that calls on legislators to ban or discourage placement of medical practices in retail settings that promote or sell tobacco products.

 The placement of medical clinics in these settings convey a message contrary to the efforts of health care providers, said Dr. Joseph Yasso, D.O., chair of the AOA’s bureau of state government affairs.

 “These types of clinics are proliferating rather rapidly and since that is the case, we certainly don’t want these popping up in areas where a patient comes in to see a nurse practitioner and is diagnosed with acute bronchitis or a respiratory infection and is advised not to smoke and they walk out the door past a counter that sells cigarettes,” he said.

 That ship has likely sailed, with Walgreens Take Care clinics alone treating more than 300,000 cases of acute respiratory conditions from 2008 to 2009, according to a press release announcing that patients with respiratory illnesses, ages 2 years and up, can seek nebulizer treatments year round at these clinics.

 The Convenient Care Association has developed quality and safety standards for its roughly 1,200 retail health care clinic members that include providing patients with health promotion and disease prevention education, but they do not tackle the issue of tobacco sales.

While store-based health clinics provide a service to patients,  should there be conditions on where they’re placed or the products sold in the next aisle? If so, where does one draw the line? What do you think?

— Patrice Wendling (on Twitter @pwendl)
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Filed under Dermatology, Emergency Medicine, Family Medicine, IMNG, Internal Medicine, Pediatrics, Polls, Practice Trends, Primary care