Retail clinics not substituting for EDs, study finds
- The proliferation of retail health clinics is doing little to reduce non-emergency visits to emergency departments, according to a new study in the Annals of Emergency Medicine.
- However, clinics are being visited and are thereby having the effect of increasing healthcare use, which poses implications for efforts toward value-based care, suggested an accompanying editorial.
- For better or worse, retail clinics have achieved major market penetration, having increased from 130 in 2006 to almost 1,400 in 2012, resulting in a third of the nation's urban population living within a 10-minute drive of a retail clinic, according to the American College of Emergency Physicians.
Retail clinics were initially promoted as a way to ease the burdens on hospital EDs, but that result has not come to pass, according to the study's findings.
Instead, retail clinics have filled a new niche, providing access to growing demand for healthcare, particularly after-hours, and without requiring a relationship with a primary care physician.
If much of that demand was created by the rise in people newly insured under the ACA, it remains to be seen what will happen to those numbers once the incoming Donald Trump administration settles on a new healthcare policy that may or may not involve the wholesale repeal of President Obama's signature healthcare law, or salvage certain elements of it that would impact how many millions ultimately keep or lose their coverage.
"Retail clinics may emerge as a way to satisfy the growing demand for health care created by people newly insured under the Affordable Care Act, but contrary to our expectations, they do not appear to be leading to meaningful reductions in low-acuity emergency department visits,” stated lead author Grant Martsolf of the RAND Corporation in Pittsburgh, Pa. “Although the growth in retail clinics has been significant in recent years, the only decrease in low-acuity visits to emergency departments was seen among patients with private insurance, and that decrease was very small.”
The editorial suggests retail clinics are increasing healthcare use because they fulfill previously unmet demand and serve different patient motivations in seeking care. Another reason is because those patients using EDs for low-acuity conditions are typically doing it because they lack access to other types of care, including retail clinics.
According editorial author Jesse Pines, FACEP, of the George Washington University School of Medicine and Health Sciences in Washington D.C., "The answer is not to build more convenience settings, but to improve the value of existing settings by increasing the connectivity among providers and with longitudinal care.”
- EurekAlert! Retail clinics do not decrease emergency department visits
- Healthcare Dive Convenient care, but at what price? The rise in retail health clinics
- Healthcare Dive How providers can reduce unnecessary ER visits