Retail Clinic Treating Mostly Uninsured
Wal-Mart jumped into the healthcare arena with their retail clinic program called Convenient Clinics to provide improved access to care earlier this year and towards the end of last year when many media headlines broke the story of retail clinics. There was an immediate flurry of activity with store chains such as CVS in the Boston, MA area where some 2000 of these clinics were to be established over the coming months and year (2008). Since that time the retail clinic story has fallen to the wayside especially after some political contention between CVS and the Boston area legislators that stipulated no retail clinic would be erected within the city limits of Boston. Political leaders cited patient safety and quality of care concerns as the impetus for their negative stance on the issue.
The other item surrounding the retail clinic issue was concern for their financial viability in today’s fiscally constrained healthcare market. Fears of inadequate reimbursements from third party payers and insufficient customer quantities would force many to close their doors shortly after opening. In fact some retail clinics did just that earlier this year in a few of the Southern states. Nurse practitioners and other clinic staff showed up to work at their retail clinic to find the doors locked and the clinics closed.
In light of the turbulence surrounding the retail clinic issue Wal-Mart continues to operate their clinics. Recent profiles of patients visiting the clinics show most to be adults (79%) and less than one third to be children (21%); more than half of the patients seen at these clinics are uninsured, (55%). When patients were asked about other alternatives to seeking care at Wal-Mart about half said they would use their primary care provider (40-50%), a little more than a third said they would use an urgent care center (20-35%), less than a fifth of the patients said they would seek care in a local emergency department (10-15%), and 5-10% of the patients would just forego seeking treatment if the Wal-Mart clinic was not available to them.
A few questions need to be asked with respect to these numbers. If almost half of these patients would go to their primary care provider (PCP) in lieu of the retail clinic why didn’t they start there? Likely convenience played a role and obtaining access to their primary care provider in a timely fashion. Additionally their insurance status may have been a factor as well since more than half of these patients seen had no insurance. I suspect that these patients may have been seeking the best care they could find based on their out of pocket expenses. These retail clinics are likely to cost less than a local ER and less than an office visit with their PCP. The remaining question to be asked surrounds Wal-Mart’s clinic long term sustainability in light of the large percentage of uninsured patients being treated. Will Wal-Mart be able to see an acceptable ROI.
— Source: “Wal-Mart’s Perspective: Retail Care,” as presented by Dr. John Agwunobi, Wal-Mart Stores Inc., April 22, 2008, at the 5th Annual World Health Care Congress, via MCOL
About the Author
Mike Pringle is the author of Healthcare Today where he offers commentary and insight regarding today’s healthcare issues. Additionally he provides regular commentary for Red Scrubs and editorial content for Future Healthcare. He has over 20 years of nursing experience working both domestically and internationally. Mike has a Bachelor’s Degree in Nursing and a Masters Degree in Public Administration with a Healthcare emphasis. He specializes in both Emergency and Critical Care Nursing. He currently works at Falmouth Hospital as a Shift Manager for the emergency department.
