The dictum “if you build it, they will come” apparently applies to retail health clinics, an innovation rooted in the Twin Cities. A new study says retail health clinics increase overall healthcare spending by increasing the first-time use of the primary-care service for routine medical conditions.

The study, which appeared in the March 8 edition of the health policy journal Health Affairs, questioned the presumption that retail clinics reduce healthcare spending by offering patients a low-cost alternative to physician office visits and trips to the hospital emergency room for non-emergent conditions like sore throats, ear aches and sinus infections.
 
Using claim data from Aetna, the researchers analyzed retail clinics visits, physician office visits and ER visits in 22 markets from 2010 through 2012. They estimated how many clinic visits were substitutes for physician office or ER visits—meaning patients went to the clinic rather than the doctor or hospital ER for a minor medical problem. And they estimated how many clinic visits represented new utilization—meaning patients went to the retail clinic rather than doing nothing.

They determined that 42 percent of the retail clinic visits were substitutions for the doctor or hospital ER and 58 percent were first-time, new visits. Patients who used clinics rather than doctors or hospital ERs saved an average of $21 per visit for the treatment of the common medical problems. But, patients who used clinics for the first time for the same problems spent an average of $35 per visit. In sum, spending on primary care for the non-emergent medical conditions increased an average of $14 per visit because of the availability of retail health clinics.

That’s a finding of note for health insurers and employers as the number of walk-in, retail clinics in big-box department stores, pharmacy chains and supermarkets continues to grow. According to a report from Accenture, the number of retail clinics is projected to double to more than 2,800 nationwide by 2017 from 1,914 in 2014 with the number of clinic visits climbing to 25 million from 16 million over that same period. 

Insurers and employers typically cover retail clinic visits and incent enrollees and workers to use them for common medical ailments in the hopes of saving money.

“If these interventions were driven by a desire to decrease health care spending, our results imply that they may not be completely effective,” the researchers said.

Minnesota has 57 retail health clinics, according to the latest data from the consumer health website Urgent Care Locations. The biggest brands are MinuteClinic, with 29 sites, and Target Clinic, with 23 sites. The first retail health clinic—QuickMedx, now MinuteClinic—opened in the Minneapolis-St. Paul market in 2000, according to CVS Health, which owns MinuteClinic.