More signs that 2012 is tipping point for convenient care industry

WHAT IT MEANS AND WHY IT'S IMPORTANT — Just days after Drug Store News reported — once again — that 2012 is proving to be a significant year for the convenient care industry, yet another turn of events further solidified what we’ve been saying for quite some time.

(THE NEWS: Report: South Carolina allowing clinics to enroll as providers in Medicaid. For the full story, click here.)

The Post and Courier has reported that, beginning this month, South Carolina is allowing retail-based health clinics to enroll as providers in Medicaid, a move that will enable Medicaid patients to use clinics for wellness visits, preventive services and to treat acute ailments. The state currently has 25 retail-based health clinics, all of them CVS Caremark-owned MinuteClinics.

The reason is simple: To expand access to care and keep those patients with basic health issues from using high-cost emergency departments, as South Carolina Medicaid director Tony Keck explained.

In fact, a Rand Corp. study published in late 2011 in the American Journal of Managed Care found that care initiated at retail clinics is 30% to 40% cheaper than similar care at physician offices and approximately 80% cheaper than similar care at emergency departments.

The Post and Courier reported that MinuteClinic already is considered “in network” for some South Carolina Medicaid patients who have managed care plans, the article stated, and Medicaid programs in several other states already cover care at retail-based health clinics.

The move in South Carolina comes on the heels of major legislation in Massachusetts.

As reported by Drug Store News, Massachusetts lawmakers passed a massive healthcare bill that brings expanded scope of services, in such areas as monitoring of chronic diseases and prevention and wellness offerings, to patients of limited-service clinics — marking not only a significant milestone for the state’s healthcare system but also for the convenient care industry at large.

The new definition of limited services includes diagnosis treatment, management and monitoring of acute and chronic disease, and wellness and preventive services, all within the scope and practice of nurse practitioners.

We’ve said it before and we’re saying it again — 2012 is shaping up to be a major tipping point for the convenient care industry.