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Retail clinics vs. urgent care — it’s a numbers game

BY Jim Frederick

A few months ago, I found myself commenting on another website focused on healthcare-related news about the future growth potential for retail clinics versus urgent care centers. Actually, I was on the verge of a full-on debate with some other user, saved only by the grace of a site error. It is an ironic example of how technology can make humans more efficient — even if by mistake.


So in a way, I was kind of happy when I saw the report Marketdata Enterprises released in late September, “The market for retail health clinics and urgent care centers." It gave me a legitimate, work-related reason to revisit this issue.


First, it’s important to note that this isn’t really so much a debate — it’s not necessarily a matter of either retail clinics or urgent care centers. There are more than enough patients to go around — and, I’m not even just talking about the 32 million patients who currently don’t have insurance. 


According to the Department of Health and Human Services, nearly 67 million people in the United States live in a primacy care shortage area. “And for Americans who do have a regular physician, only 57% report having access to same or next-day appointments and 63% [have] difficulty getting access to care on nights, weekends or holidays without going to the emergency room. … 20% of adults waited six days or more to see a doctor when they were sick in 2010,” Marketdata noted.


Certainly both models are capable of expanding access and improving cost, and in a relatively small percentage of instances, urgent care centers are the most appropriate site of care. But if the question is “which model has the greatest potential to significantly improve cost and access to care?” — it’s kind of a no-brainer.


While urgent care centers significantly outpace retail clinics today in both locations and annual revenues, you’d be fooling yourself to think that couldn’t and won’t change dramatically in the coming years. When CVS, Walgreens, Kroger, Target, Walmart and others decide to flip the switch and go full-bore on clinic expansion, these companies will be able to roll out new clinics at a much faster clip than urgent care operators. It will even force many urgent care centers to close.


Why? It’s a simple numbers game.


First, these retailers are already sitting on some of the best real estate in America — tens of thousands of stores, to which they can just add a clinic tomorrow. Even now, with retail clinics still in the very early stages, this advantage plays out pretty clearly in the current figures. The top three clinic operators — CVS/MinuteClinic (569), Walgreens/Take Care (360) and Walmart (150) — outnumber almost 2-to-1 the three leading urgent care chains Concentra (310), U.S. HealthWorks (135) and MedExpress (77).


Right now, according to the Marketdata study, the average cost to open a retail clinic is about $20,000 to $100,000 for the host retailer to make the existing space ready, and about $25,000 to $145,000 for the clinic operator to construct the actual clinic, depending on the number of exam rooms. By contrast, it costs anywhere from $750,000 to $1 million to open an urgent care center. 


Then factor in the additional labor costs. Retail clinics require physician oversight, but that doesn’t mean you need to have a doctor on-site. In two-thirds of all urgent care centers there is at least one physician on-site at all times. According to the American Academy of Urgent Care Medicine, in 2006 the average urgent care physician made anywhere from $155,000 to $208,000 a year. The average nurse practitioner working in a retail clinic makes about $90,000 a year.


It’s a numbers game. In the end, it’s going to be a lot more cost-
effective for retail clinics to provide all this extra care America is going to need to make healthcare reform work — regardless of what shape it takes or what you call it.


Rob Eder is the editor in chief of The Drug Store News Group, publishers of Drug Store News, DSN Collaborative Care, and Specialty Pharmacy magazines. You can contact him at [email protected].

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Wasson, Magnacca discuss vision for transformation

BY DSN STAFF

As part of its exclusive Executive Viewpoint video series, DSN editor Rob Eder interviewed Walgreens president and CEO Greg Wasson and president of health and daily living solutions Joe Magnacca for DSN.TV. In this special three-part installment, sponsored by Jubilant Cadista Pharmaceuticals, Wasson and Magnacca discuss the vision that is guiding the transformation of Walgreens’ business and its stores, and what it all means for patients, payers and suppliers.

For part 1 of DSN’s interview with Greg Wasson, click here.

For part 2, click here.

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All-star DSN Industry Issues lineup

BY DSN STAFF

Seats are going fast for the annual Drug Store News Industry Issues Conference, slated for Nov. 27 in New York City at the New York Athletic Club. Anchored by an all-star lineup of leading retailers and featuring a special lunch keynote presentation from TV’s Larry Kudlow, host of CNBC’s primetime “The Kudlow Report,” DSN Industry Issues offers a full day of thought leadership and important networking opportunities with many of the industry’s leading merchandising and marketing executives.


Participating retail panelists include Ahold, CVS, Costco, Family Dollar, Giant Eagle, Good Neighbor, H-E-B, Health Mart, McKesson, Rexall Canada, Rite Aid, Sam’s Club, Shopper’s Drug Mart, Walgreens, Walmart and Winn-Dixie.


In all, the day includes three separate panel discussions, including:


Issues Summit: Now in its 14th year, the theme for this year’s discussion will be “Finding tomorrow’s ‘whitespaces’ to optimize future growth in health and wellness.” What’s a whitespace? “It’s an area where a company has room to maneuver and innovate in what is normally a crowded environment,” explained guest moderator Dan Mack, a partner of The Swanson Group and founder of the Mack Elevation Forum. 


Diabetes Leadership Forum: The ninth annual installment of the forum will invite panelists to share and explore innovative and progressive approaches to empowering community pharmacy to play an advanced role in coordinating and managing care for patients with diabetes. The group will be moderated by Dave Wendland, VP of Hamacher Resource Group.


Health, Wellness and Technology Summit: The second annual technology panel — once again hosted by savvy retail pharmacy vet Bob Dufour, currently COO and partner of Blue Ocean Innovative Solutions — will examine new and emerging solutions to drive improved patient care using technology as an enabler. 


To register to attend, visit 
DSNIndustryIssues.com; for sponsorship information, contact Wayne Bennett at [email protected]

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