Managed Care - March 2008 - (Page 33) care providers taking services directly to them. Jack Lord, MD, senior vice president and chief innovation officer of Humana, addressed this transition taking place in the patient/provider relationship, observing, “Too often we’ve asked people to conform to us and the way we want to do business, but consumers want health care to fit into their lives. Establishing retail clinics is a move in that direction.” (See “Consumers Receptive to Innovation,” at right.) creative approach to linking medical provider and consumer. “In London, where I spend a great deal of time, there are providers considering placing retail clinics in the Tube [subway] stations. This is another example of bringing health care directly into people’s lives.” Appropriate setting Regina Herzlinger, professor of business administration at Harvard Business School, an expert in The right care Retail clinics post a menu-like list of services for customers. This list includes the diagnoses and conditions they treat and the corresponding cost of care. The five most common conditions treated by the largest provider, MinuteClinic, are sore throat, bronchitis, sinusitis, conjunctivitis, and female urinary tract infections. With an average waiting time of 15 minutes, this formula of providing care for a predetermined and limited number of diagnoses allows retail clinics to deliver quicker, more efficient medical attention than found in an urgent care center or a busy primary care practice. Clinics will refer out people whose needs are serious, and consumers themselves seem to understand the concept of appropriate level of care when seeking treatment at a retail clinic, since only a small percentage of clinic customers are referred out for emergency care. The right place It appears that the convenience factor plays a significant role for the most frequent users of the retail clinic: moms age 28 to 42 and their children. Since most clinics are in grocery stores and large chain drugstores, their operators have put themselves directly in the path of their most important consumers. One should not underestimate the importance of convenience. “These clinics enable people who have very different lifestyles — for example, a mom with kids or someone with two jobs — to access care in their busy lives.” Retail clinics can provide care for people in varying economic and social circumstances. Lord cites an especially unconventional and Consumers receptive to innovation hen it comes to retail clinics, consumers are a pretty receptive bunch, according to findings from Deloitte’s 2008 Survey of Health Care Consumers. The findings from the survey indicate that consumers are comfortable seeking care from retail clinics, especially if the appropriate medical personnel staff it and up-todate computer equipment is used. Sixteen percent of consumers have used a walk-in clinic in a pharmacy, shopping center, store, or other retail setting, and 34 percent say they might do so again. If the clinic is staffed by a nurse practitioner, 44 percent say they would be comfortable with the accuracy, safety, and quality of care offered at the clinic. That comfort level rises to 45 percent if the nurse practitioner uses a computer-based system that enables him to access electronic patient records, check for drug or allergy interactions, or confirm treatment recommendations. Nearly half (48 percent) of consumers say they would be comfortable if the nurse practitioner were affiliated with a local physician’s office. Paul Keckley, executive director of the Deloitte Center for Health Solutions, says the growing prevalence of the retail clinic is not a fad, but a trend. “It’s consistent with other new innovations that are consumer-driven.” “The retail clinic model is a convergence of three processes: diagnostics and preventive care (a domain of managed care); lifestyle modification and medication adherence; and easy and convenient delivery of care.” He thinks the survey findings support health insurers’ efforts to improve the current primary care system, which is often episodic, not coordinated, and not often evidence-based. “Insurers should be favorably inclined toward the use of retail clinics,” says Keckley. “A retail clinic would help insurers reach their goals of coordinating care, reducing avoidable costs, improving medication adherence, and improving consumer satisfaction.” — Tony Berberabe W MARCH 2008 / MANAGED CARE 33
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