Retail clinic visits have almost doubled among its commercially insured members during the past five years, according to a study by Blue Cross Blue Shield Association (BCBS).
Nearly 30% of emergency room (ER) visits could probably be treated in retail clinics, according to the study.
The study showed a significant disparity between clinic use by BCBS members who purchased their insurance through an employer versus on the individual market, with 19% lower clinic usage among those who were individually insured.
The healthcare industry has increasingly emphasized the “right care at the right place at the right time” concept. It’s an approach that typically saves money both for healthcare plans and their members, so we would expect the cost-conscious individually insured to be leading the trend. However, it’s consumers who get their insurance through their jobs who are taking advantage of the convenience and relatively low prices of retail clinic visits, according to this study.
Furthermore, the individually insured are going to the ER much more often than those who are insured through their employers. "From 2013 to 2015, the growth rate in retail clinic visits per 1,000 members in the individual market was only 2.6%, compared to strong growth rates in utilization of office and ER visits of 15.5% and 35.8%, respectively," the study found. Taken together, these results suggest that the individually insured are not, as a group, moving away from the old (and expensive) habit of waiting to see a doctor until becoming very ill, and then using the ER instead of more appropriate alternatives.
A recent study found that the proliferation of retail health clinics is doing little to reduce non-emergency visits to emergency department. Still, the concept of wellness care has continued to expand, with new startups taking it beyond the traditional emphasis on primary care. Forward, for example, is offering a concierge-style service that provides basic clinic care for $149 per month. It appears that the most vulnerable healthcare consumers (many of whom are individually insured through ACA marketplaces) may not be exposed to or able to understand the advantages of using these less expensive, more convenient care options.