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Clinical Trials: ACA Expected to Boost Demand
Health care reform will mean added business for in-store clinics. Will more retailers get involved?
Carol Angrisani
September 2, 2013
6 Min Read
Today’s shopping list: bread, milk, eggs — and a physical.
While this may not sound like the typical supermarket offering, it’s exactly what’s available at 30 H-E-B stores with in-store medical clinics.
H-E-B’s RediClinics are among the 1,456 retail-based clinics in the U.S. CVS/pharmacy accounts for the bulk of them with 666 clinics, followed by Walgreens (372), Wal-Mart (108), Kroger (100), Target (54), H-E-B (30), ShopKo (16) and Rite-Aid (15), according to Merchant Medicine, Shoreview, Minn., a walk-in clinic research and consulting firm. The bulk of other supermarkets that have a clinic operate one or two.
Retail-based clinics are touted as a way to offer consumers easy access to affordable, high-quality health care.
The numbers are expected to double to 2,868 clinics by 2015, according to consulting firm Accenture.
Health care reform is a main reason for increased retail clinic demand. That’s because new features of the Affordable Care Act slated to go into effect Jan. 1, 2014, will grant coverage to millions of new Americans who may not have visited a doctor. Likewise, these newly insured could lead to longer wait times at traditional physician offices, motivating patients to seek medical help elsewhere.
“Obamacare will insure as many as 30 million more consumers who will need new places to get care, since our nation’s primary care delivery system is already overloaded,” said Web Golinkin, chief executive officer of RediClinic, Houston.
Another reason why Obamacare will increase demand for in-store clinics is because it encourages the formation of Accountable Care Organizations, which will urge members to use in-store clinics as the most cost-effective outlets for routine, acute and preventive care, Golinkin noted.
Thomas Charland, Merchant Medicine’s CEO, agrees that the ACA will lead to a rise in visits to in-store clinics. But he doesn’t believe the numbers will double by 2015. That’s because his research shows that about 20% to 30% of patients who use retail-based clinics are uninsured, so the increased availability of health coverage won’t drastically change the number of patients who seek out in-store clinics.
Still, in-store clinics will certainly benefit from the ACA, Charland said.
The supermarkets that house them profit, too, in the form of increased pharmacy sales. It’s estimated that 80% of prescriptions written at in-store clinics are filled in the store’s pharmacy.
Over-the-counter medicine sales can also jump, as clinicians often recommend them when a prescription is not necessary.
H-E-B, for instance, markets to RediClinic patients by placing displays of popular OTC drugs and other health-related products near the clinic entrance.
H-E-B’s RediClinics are performing well, averaging 200 to 300 patients a week, according to Golinkin.
Read more: Healthy Signs for Retail Clinics
Staffed by both nurse practitioners and physician assistants, RediClinics range from 400-800 square feet. They include two to four exam rooms and a restroom.
Each RediClinic provides treatment of nearly 30 common medical conditions, as well as preventive services like screenings, tests and immunizations.
RediClinics accept most insurance plans, so insured patients usually pay the same office visit co-pay they would pay at a physician’s office, which is typically lower than what they would pay at an urgent care clinic or at the ER, according to Golinkin. Uninsured patients pay a flat fee of $89 for all of the common medical conditions RediClinics treat. Preventive services start at $25.
'Weigh Forward'
What’s unique about RediClinics is that they offer “Weigh Forward,” a medically supervised weight/lifestyle management program offered in a supermarket. Developed for RediClinic by David Katz (founder and director of Yale University’s Prevention Research Center), the $499, 10-week program combines 15-minute weekly clinician visits, and patient access to an extensive online platform to help build the life skills they need to lose weight and keep it off.
Weigh Forward features an initial physical exam and regular biometric monitoring to measure health gains as well as weight loss; a proprietary behavior modification tool developed by Katz; weekly meal plans, recipes and related shopping lists; and a personal physical activity schedule, according to Golinkin.
“Because Weigh Forward is a ‘real food’ program, it is particularly well-suited for delivery in a supermarket, where patients can purchase the items they need to follow the weekly meal plans,” Golinkin noted.
United’s “Living Well” clinics range in size from about 275 to 600 square feet.
, Lubbock, Texas, got involved in the retail clinic business six years ago. Today, it operates four “Living Well” clinics in Amarillo, Lubbock and Coppell, Texas. A fifth clinic is slated to open in a new generation United store early next year in Amarillo.
The goal of the centers is to provide United shoppers with additional access to health care without breaking their normal shopping patterns, said Tim Purser, United’s business director of pharmacy.
“We are working to improve the overall health of our guests with the presence of nutritional information, prevention and then treatment using the synergies between food, pharmacy and medicine,” Purser said.
Staffed by mid-level practitioners and physicians, the clinics range in size from about 275 to 600 square feet. Its Amarillo clinic treated 3,768 patients during the past year.
Follow @SN_News for updates throughout the day.
The clinics are leased and run by community health care partners. The partner in Lubbock is Physician Network Services; Family Medicine Centers in Amarillo; and Texas Health Resources in Coppell.
Services are consistent with those provided at minor emergency clinics.
Hy-Vee, West Des Moines, Iowa, operates six clinics in the Omaha, Neb., metro area. Each Alegent Creighton Health Quick Care location provides urgent minor medical care, screenings and adult immunizations.
Last year, each location averaged 445 visits a month, or 103 visits a week.
SN Blog: Retail Clinic Outlook Lies in Fresh Meals History
The Alegent Creighton Health system — which operates area hospitals, medical centers and nursing facilities — runs the clinics.
Jodi Hoatson, an Alegent spokeswoman, told SN the clinics make sense for both consumers and Hy-Vee. Consumers get access to convenient, low-cost medical care, while Hy-Vee gets additional pharmacy and grocery business.
“If a patient has to wait, they can pick up groceries while waiting,” Hoatson noted.
Sidebar: Own vs. Lease
CINCINNATI — Kroger Co. is one of the few food retailers to own and operate its own in-store medical clinics.
Most other retailers lease the operation to a health care partner, said Thomas Charland, chief executive officer of Merchant Medicine, Shoreview, Minn., a walk-in clinic research and consulting firm.
The reason so few own and operate their own clinics is that it’s a challenging business. Retailers must deal with insurance issues, hire and oversee nurse practitioners or physician assistants, create fee schedules and more.
“It becomes overwhelming” Charland said.
Likewise, it can be tough profit-wise due to the seasonality of the business. Most people seek out clinics during cold-and-flu and allergy season. The rest of the year is slow, said Charland.
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