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Retail Clinics 1.0: Selling the Care Model to Payors and Providers
Retail Clinics 1.0: Selling the Care Model to Payors and Providers
Retail Clinics 1.0: Selling the Care Model to Payors and Providers
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Retail clinics: boon or bane for healthcare? While payors and providers examine the model, large numbers of satisfied consumers have already voted with their feet, flocking to the 1,000-plus retail clinics in the United States and sampling from their narrow menu of medical services.

Retail Clinics 1.0: Selling the Care Model to Payors and Providers offers advice from the retail clinic trenches, where many health plans already reimburse for services dispensed at retail clinics and providers are partnering with or launching their own retail or "convenience" clinics.

This 40-page special report will guide health plans and healthcare providers in their interactions with retail clinics. Helping to assess retail clinics' role in the healthcare continuum are two organizations that are exploring how these clinics fit into their strategic plan. Dr. Steven Goldberg, corporate medical director at Humana, describes the changes in the healthcare landscape that resulted in the retail clinic opportunity and discusses Humana's decision to include MinuteClinic (a national chain of retail clinics) in its provider network.

Offering the provider perspective is Dr. Thomas N. Atkins, medical director of Sutter Express Care, a drugstore-based chain of medical clinics launched by Sutter Health, a network of hospitals and doctors serving Northern California. Dr. Atkins shares Sutter Health's retail clinic launch plan and the business and clinical lessons Sutter Health is learning from the experience.

While consumers generally agree that retail clinics fill a well-documented gap in primary care, organized medicine's opinions on retail clinics are as varied as positions from the College of Emergency Physicians (CEP), the American Academy of Family Practice (AAFP), the American Society of Internal Medicine (ASIM) and the American Academy of Pediatrics (AAP), many of which are included in this special report. Against a backdrop of HIN e-survey results on retail clinics' impact on healthcare, Dr. Atkins and Dr. Goldberg also provide details on:

  • Defining a retail clinic: what it is, and what it is not;
  • Determining the scope of care and measuring quality and clinical services;
  • Ensuring continuity of care and integrating care provided by retail clinics into the provider network;
  • Practical considerations ó clinic location, staffing, hours and pricing;
  • Building the relationship with the retail partner and competing with commercial retail clinic operators;
  • Modifying marketing when the usual hospital strategy doesn't work;
  • Selling the idea to other providers in your network;
  • and much more.
PLUS, this report contains 13 pages of Q&A for retail clinic payors and providers on handling repeat patients, assessing impact on ER admissions, and deciding whether a retail clinic counts as a medical home.

This report is based on a 2008 audio conference on the role of retail clinics in the healthcare continuum.

Table of Contents

  • The Healthcare Industry Reacts to Retail Clinics: HIN e-Survey Results
    • Retail Clinics: Threat or Opportunity?
    • Competing with Retail Clinics
    • Health Plans and Retail Clinics: An Uneasy Partnership
    • The Consumerís Comments
  • The Payorís Perspective on the Emerging Trend of Retail Clinics
    • Defining a Retail Clinic
    • Putting the Debate into Perspective
    • Looking Toward the Future
  • The Sutter Express Experience: How a Provider Network Launched Its Own Retail Clinics
    • Program Design Elements
    • Clinical Administrative Protocols
    • Making an Impact with Marketing
    • Quality Oversight
    • Compliance in California
    • Clinical Challenges
    • Business Model Considerations
  • Q&A: Ask the Experts
    • Location, Location, Location
    • Retail Clinics and the PCP
    • Out-of-Network PCPs
    • Operational Challenges
    • PCP Follow-Up
    • Quality Assurance Monitoring
    • Retail Clinics and Medicare/Medicaid Beneficiaries
    • Marketing Retail Clinics
    • Repeat Patients
    • Reducing ER Admissions
    • Patient Education
    • Financial Deficits and Breaking Even
    • Patient Volume
    • Member Feedback
    • Reimbursements and Copayments
    • The Retail Clinic's Role in the Medical Home
  • Glossary
  • For More Information
  • About the Presenters
Publication Date: April 2008
Number of Pages: 43
ISBN 10: 1-934647-30-6 (Print version); 1-934647-31-4 (PDF version)
ISBN 13: 978-1-934647-30-1 (Print version); 978-1-934647-31-8 (PDF version)
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Implementing Innovative Visit Models Into Physician Practices, Audio Conference
Implementing Innovative Visit Models Into Physician Practices, Audio Conference
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