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Health Aff (Millwood). 2016 Mar;35(3):449-55. doi: 10.1377/hlthaff.2015.0995.

Retail Clinic Visits For Low-Acuity Conditions Increase Utilization And Spending.

Author information

1
J. Scott Ashwood is an associate policy researcher at RAND in Santa Monica, California.
2
Martin Gaynor is the E. J. Barone Professor of Economics and Health Policy and chair of the Governing Board of the Health Care Cost Institute, both at Carnegie Mellon University, in Pittsburgh, Pennsylvania.
3
Claude M. Setodji is a senior statistician at RAND in Pittsburgh.
4
Rachel O. Reid is a medical resident in the Department of Medicine, Brigham and Women's Hospital, in Boston, Massachusetts.
5
Ellerie Weber is an assistant professor of management, policy, and community health at the University of Texas School of Public Health, in Houston.
6
Ateev Mehrotra (Mehrotra@hcp.med.harvard.edu) is an associate professor of health care policy at Harvard Medical School, in Boston.

Abstract

Retail clinics have been viewed by policy makers and insurers as a mechanism to decrease health care spending, by substituting less expensive clinic visits for more expensive emergency department or physician office visits. However, retail clinics may actually increase spending if they drive new health care utilization. To assess whether retail clinic visits represent new utilization or a substitute for more expensive care, we used insurance claims data from Aetna for the period 2010-12 to track utilization and spending for eleven low-acuity conditions. We found that 58 percent of retail clinic visits for low-acuity conditions represented new utilization and that retail clinic use was associated with a modest increase in spending, of $14 per person per year. These findings do not support the idea that retail clinics decrease health care spending.

KEYWORDS:

Cost of Health Care; Health Spending; Organization and Delivery of Care

Comment in

PMID:
26953299
DOI:
10.1377/hlthaff.2015.0995
[Indexed for MEDLINE]

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