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More Urgent Care, Retail Clinics Offer Low-Cost Patient Care Access

Urgent care clinics have increased by eightfold, while retail clinics have tripled, supporting low-cost patient care access.

urgent care clinic retail clinic

Source: Thinkstock

By Sara Heath

- Urgent care clinics and retail clinics are on the rise across the state of Massachusetts, offering more convenient patient care access for a low cost, according to a recent report from the Massachusetts Health Policy Commission (HPC).

The Commission’s 8th DataPoints report revealed that the number of urgent care clinics in Massachusetts has increased eightfold since 2010. The number of retail clinics has tripled during that timeframe.

Urgent care clinics are defined as care sites staffed by physicians and other clinicians, that offer walk-in appointments, and provide diagnosis and treatment of pressing healthcare needs.

Retail clinics usually exist in smaller retail spaces, are normally staffed by nurse practitioners, and deal with low-acuity cases. In Massachusetts, retail clinics are explicitly prohibited from providing surgical services, dental services, physical rehabilitation services, mental health services, substance use disorder services, or birth center services.

These trends come as good news for patient care access advocates who say alternative care sites make patient care access more convenient.

READ MORE: What are the Pros and Cons of Retail, Urgent Care Clinics?

In total, Massachusetts is home to 145 urgent care centers, up from 18 centers in 2010. There are currently 58 retail clinics throughout the state, up from just 20 in 2010.

And although these care sites are still largely aggregated in the eastern parts of the state, more clinics – particularly retail clinics – have cropped up in rural regions in central and western Massachusetts. Given population density in these areas and the previous dearth of treatment options in central and western Massachusetts, the past seven years have demonstrated considerable growth, the report contended.

This highlights opportunities for more convenient patient access to care at a lower price tag.

Urgent care clinics and retail clinics are significantly less costly than the emergency department (ED), the report revealed. The average ED visit cost in Massachusetts totaled at $900 with a $118 patient copay.

Urgent care visits cost $149 with patient copays averaging at $33, and retail clinics cost $69 with patients paying an average copay of $20.

READ MORE: 3 Lessons from Retail to Enhance Consumer-Centered Healthcare

These extreme cost disparities persist even with the most minor of health ailments, the report continued. When looking at a set of minor health concerns that can be treated in all settings, the report found that ED costs average at $688 with patient copay averaging at $130. This report did not account for patients with health plans that do not reimburse for what the plan deems an unnecessary ED visit.

Urgent care clinic costs for minor health ailments average at $147 with a $32 patient copay. In retail clinics, costs average at $78 and patients pay $26 for copays.

Retail clinics tended to see more visits than urgent care centers, the report showed, although urgent care clinics see a greater diversity of ailments.

The retail clinic tends to be more popular for patients with a sore throat or common cold symptoms. Nearly 30 percent of all retail clinic visits were for sore throat or acute sinusitis symptoms. And while cold symptoms such as cough and sore throat were among the most common issues presenting at the urgent care clinic, they still accounted for under 15 percent of all visits.

Instead, the urgent care clinic fielded high-acuity care concerns such as pains, wounds, and ankle sprains, most of which do not turn up in retail clinics at all.

READ MORE: Retail Clinic Access Bumps Patients Receiving Flu Shots Rate

Those figures show that patients are largely using retail and urgent care clinics for their intended purposes. Much has been made of over-utilization in these care settings given their convenience and low cost.

Industry experts have pushed for better patient education about urgent care and retail clinic use to ensure patients are not using a service that is unnecessarily high-acuity – like visiting urgent care for a papercut, to offer an extreme example.

However, these results suggest that patients somewhat understand the differences between these alternative care sites and when to access each of them.

There are also changes in urgent care center and retail clinic ownership, the report continued.

Specifically, an influx of urgent-care-specific companies have taken a large clinic market share. Currently, 61 percent of urgent care clinics are owned by non-hospital chains such as American Family Care and Carewell Urgent Care. In 2010, most urgent care centers were owned and operated as a part of a larger hospital chain.

That is not to say hospitals have neglected their urgent care clinics, the report showed. In 2017, hospital groups opened 15 new urgent care clinics, up from 11 in previous years. Currently, Partners Healthcare is the leading hospital group, owning 16 urgent care clinics across Massachusetts.

As noted above, the influx of urgent care and retail clinics across Massachusetts demonstrate a national trend toward more convenient and cost-effective patient care access.

“The growth of retail clinics and urgent care centers, both in Massachusetts and around the nation, represents an effort to provide alternative, convenient points of access to health care beyond the traditional hours and sites of physician offices, community health centers, and hospitals,” the report authors concluded. “Greater access to these alternative care sites holds the promise of reducing avoidable and costlier emergency department (ED) visits.”

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