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El auge de la clínica de la conveniencia echa una red más ancha

por Loren Bonner, DOTmed News Online Editor | October 17, 2013
Retail clinics have grown tremendously since they started cropping up in chain drug stores like CVS and Walgreens back in the early aughts. There are roughly 1,400 retail clinics nationwide and that number is expected to grow to 2,800 by 2015, according to the consulting firm Accenture.

But competition abounds for retail clinics. During a health care summit last week organized by Forbes, panelists discussed how instant access to medical care is changing the business of health care. Independent urgent care centers, which can treat more serious conditions, are growing alongside retail clinics. Academic medical centers have taken notice too and have begun bringing specialized urgent care centers to patients.

Retail clinics, which are normally staffed by nurse practitioners, treat walk-in patients for common ailments like ear infections and bronchitis. Although public and private insurance is accepted for the most part (retail clinics are also included in some private plans on the state-based health exchanges), paying out-of-pocket is normally less expensive than it would be at a doctor's office, emergency room or even an urgent care center. Some insurers have even begun to waive co-pays for retail clinic visits. But what is most attractive to consumers is the convenience: getting medical treatment after-hours or on weekends and avoiding long waits at the doctor's office or emergency room.

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"Retail clinics are not going anywhere," said Dr. Andrew Sussman, senior vice president and associate chief medical officer at CVS' MinuteClinic. He said that MinuteClinics alone will grow to 1,500 clinics by 2017. They also plan to expand their scope of services to include telehealth services and wellness counseling.

The popularity of retail clinics has even caught the attention of big health systems like the Cleveland Clinic, which formed a partnership with MinuteClinic a few years ago to place Cleveland Clinic doctors inside select MinuteClinics.

Partly in response to the success of retail clinics, urgent care centers are finding a place in this market of convenient, walk-in health care. Urgent care centers are normally freestanding and similar to retail clinics except they provide additional services, like X-rays, for more serious conditions. They also have a board-certified physician on staff, which is one reason for the markup in price compared to retail clinics — and even some primary care doctor's offices.

"[Urgent care centers] are like the MinuteClinic plus," said Traver Hutchins, CEO of ASAP Urgent Care, a chain of urgent care centers in the New England region. He said that urgent care centers also fill a void in the American health care landscape and will grow in the coming years, especially as more Americans gain coverage under the Affordable Care Act (ACA). With more people insured under the ACA, access to primary care physicians, who are already in short supply, could decrease. This could lead to an increased demand in both retail clinics and urgent care centers.
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Sampson Lewis

Convenience clinic booms.

October 17, 2013 07:28

Consumers are terrified of what has happened with the government intervention in our privacy and healthcare and the cost of it. AAPS, (American Association of Physicians and Surgeons) has been fighting as hard as anyone with expensive legal challenges.
The ACA (Obamacare) has presented new surprises everyday including loss of existing health care, exponentially increased prices for premiums for less coverage and higher deductibles. Today, the President said he would veto any debt ceiling raise if it included provisions that the Presidents family would be subject to Obama care, his own unread illigitmate child. Personally, if it's not good enough for his family, it's not good enough for mine either. Ok, to the point.
A few years ago in California, workers compensation premiums were nuts and through the roof. When the government dumped their "golden boy" State Fund Insurance and allowed other insurers to compete, we saw premiums decrease over 1,000%.
It's just my opinion but having "self payer" patients go to clinics in Walmart or Target is better than not receiving any medical care at all. Since the ACA is in fact not free for anyone, it is my humble opinion that we step in and stop this train wreck and let the doctors that have been trained to save lives save lives.
If you want to improve the health care delivery system while reducing the cost of coverage, allow out of state insurance companies that are qualified compete in every states market. Government has no Constitutional right, or ethical right to be involved in any activity not specifically authorized under the Enumerations clause. Health care is not in that clause. Our health system is not the best but our technology is the best. The tax on researchers producing medical equipment is going to cost many lives. You can see the 3.8 tax on employers to fund Obama care has created a situation where 75% of all jobs created in America are part time, as well as major layoffs by major employers. If you want Walmart medical treatment you should be allowed to have it, but if you want medical professionals that practice in the state of the art facilities, you should have that too. It shouldn't be your governments choice, health care is a family issue. When you pay for what you get, you should be your own shopper, not Congress or the President that exempted themselves from this horrible piece of legislation. This isn't about the cost of healthcare. It's about repaying the Unions that spent over ONE BILLION Dollars to get this man reelected and they are promised that every medical facility will be and SEIU Union Shop creating over a billion dollars a year in revenue from workers.
Support me in passing the National Right to Work Act and allow employees who don't wish to participate in the Unions takeover in America to allocate their hard earned dollars to their struggling families.

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Galen Hiveley

Retail Clinics, boom or bust?

October 17, 2013 09:23

Like anything else, I can see this grow to the point of so many, they are in competition with each other. Not that competition is bad, but not all normally survive.

It also seems to me that reimbursment, especially concerning the unaffordable Care Act, will be questionable as who knows what and how much it will pay. And will any reimbursment be in a timely and orderly manner? If it can't even sign people up for the plan without a glitch, what will filing a claim be like? When will a provider be paid?

As far as paying strickly out-of-pocket cash for these services, those pocket books are shrinking and will continue to do so, mostly thanks to the increase in the cost health care coverage. Yes, I believe this may even effect retail clinics. When people have less money left monthly in their pockets, they tend to spend less, no matter what.

If for instance, the additional health care premiums are taking away any extra monthly cash from a household (and in some cases it's worse than that and even cutting other things they have now just to pay the premiums)then the people have little or no choice. They will seek a provider of services where the most reimbursment can be found. That only makes sense. You're certainly not going to pay cash out of your pocket(if you have any left). You're going to go to a full service provider as with higher premiums you feel like this is what you're paying for the privlege of.

To me, it seems to leave a lot to be seen. It's the unkowns that are the cause for concern. I just got a letter yesterday from my health insurance company. The letter said that due to more coverage that must be provided, my premiums will be going up. When people have to pay out, in some cases several hundred dollars more per month for something they are required to have, other things get cut. There goes that new car purchase or whatever it may be. The fallout from this and the effect on our overall economy is going to be quite significant.

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Brian Tunell

Urgent Care, Retail Clinics

October 18, 2013 06:22

Yes Galen, your premiums are going up because you now get to pay for birth control and other non-essentuals. But Obummercare requires that now.

I found it interesting in this article that the implication was made that Retail Clinics were first in the market, followed by Urgent Care Clinics. I have yet to see a retail clinic in any of my drug stores, yet I can remember in the 80's when Urgent Care Clinics were becoming so popular in SoCal that we referred to them as a Doc-in-the-box - it seemed they were on every corner like a fast food restaurant!

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