Retail Clinic Visits For Low-Acuity Conditions Increase Utilization And Spending

Area of Science:

• Health Services Research
• Healthcare Economics
• Public Health Policy

Background:

• Retail clinics are proposed to reduce healthcare costs by replacing pricier emergency department or physician visits.
• Concerns exist that retail clinics might increase overall healthcare spending by generating new utilization.

Purpose of the Study:

• To determine if retail clinic visits for low-acuity conditions represent new healthcare utilization or a substitution for more expensive care.
• To assess the impact of retail clinic utilization on overall healthcare spending.

Main Methods:

• Analysis of Aetna insurance claims data from 2010-2012.
• Tracking healthcare utilization and spending for eleven low-acuity conditions.
• Comparing retail clinic visits against traditional care settings.

Main Results:

• 58% of retail clinic visits for low-acuity conditions constituted new healthcare utilization.
• Retail clinic use was associated with a $14 per person per year increase in healthcare spending.
• Findings do not support the hypothesis that retail clinics decrease healthcare spending.

Conclusions:

• Retail clinics may not achieve the intended cost-saving goals for policymakers and insurers.
• The expansion of retail clinics could potentially lead to increased overall healthcare expenditures.
• Further research is needed to understand the long-term economic impact of retail clinics on the healthcare system.