On the brink of Clinics 2.0

Since the inception of retail-based health clinics in 2000, the concept has grown to more than 1,300 locations throughout the United States and, in more recent months, has celebrated several significant milestones that prove clinics are not only an integral part of the U.S. healthcare system but also are a viable model for retailers when handled correctly. The real question now: Are we on the brink of clinics version 2.0?


Recently, CVS Caremark’s MinuteClinic surpassed its 10 millionth patient visit and, during the third quarter, inked its 11th clinical affiliation; the Convenient Care Association celebrated its five-year anniversary; and the fellowship of the College of Physicians of Philadelphia elected the first nurse practitioner to its ranks — Sandy Ryan, chief nurse practitioner officer for Walgreens’ Take Care Health Systems. These are just a few of the more recent milestones, and clearly are not all-inclusive.


Now the industry is trying to make sense of Wal­mart’s request for information sent to strategic partners. Walmart has denied that it is building a national, integrated, low-cost primary care healthcare platform; however, the retailer reportedly has not disputed that it is looking for new partners for its 140 clinics nationwide. According to published reports, Walmart is looking to partner with outside healthcare companies to treat and manage a range of medical conditions — including HIV, diabetes, arthritis and clinical depression. (See "Higher healthcare calling motivates.")


The bottom line: Such developments provide a glimpse into what retail-based health care, which has estimated clinic sales of $733.4 million, could look like come version 2.0.


“In terms of the acute care potential in the coming healthcare world with a broader section of the population, I think that is a true opportunity for retail clinics; and then if they can figure out pathways to really expand their services to chronic care patients, then they become an even greater destination for an even wider swathe of patients,” said Larry Kocot, deputy director of the Engelberg Center for Health Care Reform at the Brookings Institution.


Already the business model is no longer entirely dependent on simple, acute ailments, but is becoming increasingly integrated with medication therapy management, OTCs and nontraditional therapies, and dispensing. Not to mention the fact that clinics, especially worksite clinics, can serve as an alternative for employers looking to lower healthcare costs.


For example, Take Care Health Systems offers specialty medication injections and infusions for patients with asthma and osteoporosis in select Tampa, Fla.; 
Orlando, Fla.; and Pittsburgh locations.


“I think we are crossing the bridge from 1.0, which was a nurse practitioner with a computer hoping to get 20 visits a day, to now a more sophisticated business model that is going to become, I think, a staple in the industry,” said Paul Keckley, executive director for the Deloitte Center for Health Solutions.


Keckley believed that, going forward, it isn’t inconceivable that clinics could become accountable care organizations and operate as medical homes. “I’m very excited about the prospects of the industry. … I think these folks have matured in their business model, and I’m going to be fascinated when they are contracting directly with major employers to provide a whole suite of primary care services — and when they, in some markets, become the exclusive primary care network for a health plan,” Keckley said. “I think those are inevitable.”