Migration of health care to retail accelerates

If there's any clear trend emerging from the murky waters swirling around a reforming U.S. healthcare system undergoing fundamental transformation, it's the fact that more of that system is migrating from emergency rooms and doctors' offices to retail clinics and pharmacies.

The trend has spawned its own clunky but descriptive term: the “retailization” of health care. As the shortage of primary care physicians grows critical, wait times to see a general practitioner grow ever longer and the costs of routine office visits and lab screenings climb to unsustainable levels, accessibility and lower costs for patients and payers have become high priorities.

In the new retail healthcare paradigm, pharmacists, nurse practitioners and physicians' assistants are becoming ever more critical as the front line of defense for routine care, chronic disease maintenance treatments and preventive health and wellness.

The growing menu of health services on display at chain and independent pharmacies — immunizations, health screenings, medication therapy management, etc. — is both a driver and a reflection of health care's increasing migration to retail. Also contributing mightily to the shift: the convenient care industry. Retail health clinics appear poised for another big growth spurt as high costs, market forces and the physician shortage drive more patients and payers to seek alternative sites of primary care.

A Rand Corp. study found that the care provided by NPs and Pas in retail clinics costs 30% to 40% less than similar care at physicians' offices. The study, published in late 2011 in the American Journal of Managed Care, also found that the costs of front-line care in retail clinics is approximately 80% cheaper than similar care at emergency departments.

Public and private health plans have taken notice. Among recent developments that are making 2012 "a tipping point for the convenient care industry," according to Drug Store News senior editor Antoinette Alexander: South Carolina now is allowing retail-based health clinics to enroll as providers to Medicaid, meaning beneficiaries now can use clinics for wellness visits, preventive services and to treat acute ailments. A new healthcare overhaul in Massachusetts has significantly expanded the scope of health, preventive and diagnostic services nurse practitioners in clinics legally can provide. And California lawmakers are considering similar legislation.

Are similar measures being considered in your state? And are clinics and pharmacies in your region truly participating in the retailization of health care?

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