Is the Retail Clinic Boom Over?

In recent years, the number of store-based walk-in medical clinics has mushroomed. The clinics, typically staffed by nurse practitioners who treat routine medical problems, have been hailed by many in the healthcare field as a way to improve access to care and cut costs. Although located in big-name stores like CVS, Walgreens, and Wal-Mart, however, many of the clinics are bankrolled by third parties, and they’ve been pulling the plug on some that haven’t been profitable. The number of retail clinics nationwide dropped for the first time last month, falling from 981 to 969, leading some industry observers to speculate that the boom may be over. Last year, retail clinics were opening at a rate of one a day.

The trend may get a second wind, however, if initiatives by health insurers in Massachusetts spread nationwide. Harvard Pilgrim Health Care and Tufts Health Plan have already signed contracts with CVS Caremark to cover walk-in clinic visits, and negotiations are underway with Blue Cross and Blue Shield of Massachusetts, the state’s largest health insurer. Together, these insurers have close to five million members in the Bay State.

Insurance coverage is likely to give the clinics a shot in the arm, as copays will range from $15 to $25 a visit, compared to the cost of $60 to $75 a visit that the clinics would charge those without insurance. The patient’s out-of-pocket cost would also be far less than the $50 to $150 copay that insurers levy on emergency room visits. Although the Massachusetts Medical Society has opposed the clinics, citing patient safety and concerns about supervision of the caregivers, the Public Health Council approved them, saying that the society’s objections had been met by new regulations governing the clinics.