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Study: Limiting NPs’ scope of practice leads to higher costs

BY Antoinette Alexander

NEW YORK — Shedding more light on the important role that retail-based health clinics — and the nurse practitioners who work in them — play in the U.S. healthcare system, a new study suggests that eliminating restrictions on nurse practitioners’ scope of practice could have a “large impact” on the cost-savings.

The study, titled “Practitioners Limit Cost Savings That Can Be Achieved in Retail Clinics,” was published in the November issue of Health Affairs.

“Using multistate insurance claims data from 2004–2007, a period in which many retail clinics opened, we analyzed whether the cost per episode associated with the use of retail clinics was lower in states where NPs are allowed to practice independently and to prescribe independently. We also examined whether retail clinic use and scope of practice were associated with emergency department visits and hospitalizations,” researchers stated.

The bottom line: Researchers found that visits to retail clinics were associated with lower costs per episode, compared with episodes of care that did not begin with a retail clinic visit. Furthermore, the costs were even lower when NPs practiced independently.

More specifically, an article by FierceHealthcare on the study reports that, according to researchers, in states where physicians oversaw nurse practitioners, costs averaged $543, versus $484 in states where nurse practitioners practiced independently. Costs averaged $509 in states where nurse practitioners had independence in practice and prescribing.

The article also states that according to researchers, if retail-based clinic visits make up for 10% of all outpatient primary care visits by 2015, national cost savings would be $2.2 billion. If nurse practitioners in all 50 states practiced independently, that would add on an additional $810 million. That savings could grow even more — by $472 million — if nurse practitioners could prescribe on their own too.

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Costco sales, comps increase in October

BY Alaric DeArment

ISSAQUAH, Wash. — Sales at Costco Wholesale in October were up by 6% over last year, the club retailer said Thursday.

Costco said sales for the month were $8.15, compared with $7.66 billion in October 2012. For the nine-week period that ended Sunday, sales were $18.01 billion, a 6% increase over the $17 billion the chain had during the same period last year.

Same-store sales for the month and the nine-week period that ended Sunday increased by 4% for the company’s U.S. division and by 3% for the chain overall, including downward pressure from gas prices and currency exchange rates. Costco operates 642 stores, including 457 in the United States, 86 in Canada, 34 in Mexico, 25 in the United Kingdom, 18 in Canada, 10 in Taiwan, nine in Korea and three in Australia. The company plans to open seven more stores before the end of 2013.

 

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October sales up at Fred’s, but discounter prepping for tough holiday with tighter inventory and targeted promos

BY Michael Johnsen

MEMPHIS, Tenn. — Fred’s Super Dollar on Thursday reported sales gains for the four weeks ended Nov. 2, reaching $143.4 million on 2% growth. Comparable store sales for the month increased 0.8% versus a decline of 0.8% in the same period last year.

"Sales for October were at the lower end of our guidance as general merchandise sales were sluggish and consumable driven," commented Bruce Efird, Fred’s CEO. "Poor weather around Halloween hurt sales and consumers tightened spending during the recent budget crisis, with the combination affecting sales and gross margins in the back half of the month," he suggested. "On the positive side, we experienced strong pharmacy sales and a solid performance from our reconfigured departments, especially Hometown Auto & Hardware." Efird noted that reported sales also were reduced by higher comparable layaway sales, which are not recognized for accounting purposes. 

Total sales for the third quarter of 2013 were $460.5 million, up 2%. And comparable store sales for the quarter increased 1.4% compared with a decline of 2.5% in the third quarter of 2012.

Fred’s is now expecting third quarter earnings to be up 5% to 10% over last year. "Forecasts for the upcoming holiday season project a very tough retail environment," Efird said. "In anticipation of these challenges, Fred’s merchandising team has maintained inventories at or below last year’s levels and has initiated an aggressive and targeted marketing program for the fourth quarter."

During the month, Fred’s opened two stores with relocated pharmacies and closed one Xpress pharmacy locations.

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