Retailers like Walmart, CVS getting into primary care, eyeing the prize that awaits if health reform takes effect in 2014
Last week, a document leaked showing Walmart‘s intention to become the country’s largest provider of primary health services, but the company’s interest is not unique. Drug retailers like CVS Caremark and Walgreens are eyeing the same prize: “the millions of Americans with costly illnesses such as diabetes and heart disease,” reports Julie Appleby of Kaiser Health News. CVS already has 550 retail clinics, the most in the country. Walgreens has also set up programs aimed at diabetic customers, which includes counseling with pharmacists.
Costs at retail clinics are “roughly 30 percent to 40 percent less than similar care at a doctor’s office and 80 percent cheaper than at an emergency room,” Appleby reports, referring to a study in the American Journal of Managed Care. Those savings appeal to insurers. Retail clinic use by people with health insurance increased tenfold from 2007 to 2009, with clinics accounting for 7 percent of all medical visits for 11 common acute conditions, the study found. “If these trends continue, health plans will see a dramatic increase in retail clinic utilization … particularly among young, healthy and higher income patients living close to retail clinics,” the study concluded.
Some states prevent clinics from employing physicians, nurse practitioners or physician assistants. “Other states cap the number of nurses each doctor can oversee,” Appleby reports. The vast majority of clinics are staffed not by doctors, but physician assistants and nurse practitioners. A report by the Convenient Care Association shows 95 percent of the clinicians are nurse practitioners. With these practitioners able to provide basic care, part of the fear among doctors is they will be left to treat only the sickest patients and won’t be reimbursed accordingly.