Managed Care - March 2008 - (Page 43) at 28 MinuteClinic facilities. The study showed that MinuteClinic practitioners adhered to clinical guidelines in 99.15 percent of patient visits by not prescribing unneeded antibiotics for patients with a negative rapid strep test result. What insurers want Certainly, insurers want to save money, but they have other concerns too. When considering providers for the Blue Cross Blue Shield of North Carolina network, says Bradley, “We try to lay out our expectations in terms of access, quality integration, price, and standards. We would prefer to use professionally derived standards — ultimately we would like to see the Joint Commission [formerly, JCAHO] or AAFP providing national standards for retail clinics. If necessary, we are also able to add our own standards and conditions over and above these national standards.” In 2005, when retail clinics started picking up speed in the marketplace, key medical associations (AMA, AAFP, and AAP) The next place to began to issue their own guidelines, which look for convenient Adding wellness care clinics is in the they wanted retail clinic providers to incorSome operators have reported plans to workplace, says Jack porate into their practice. Executives of Lord, MD, senior vice expand their scope of services beyond the MinuteClinic, Take Care Health Systems, president and chief limited “sick visit” care and into wellness and another retail operator, RediClinic, met innovation officer of services. Humana’s Lord sees an ongoing with AAFP’s Retail Medicine Workgroup to Humana. evolution in the relationship of retail clinwork together on the “Desired Attributes of ics and their insurance partners. “Managed Retail Health Clinics.” Last year, the Convenient care organizations are trying to work with retail Care Association issued 10 mandatory standards clinics in a number of ways, including collaborative that its members are required to meet and that the research regarding outcomes. industry says exceed standards recommended for “Managed care organizations will likely work the clinics by the medical associations. with retail clinic operators to bring clinics to large employers. These clinics will include routine care, as well as preventative services — and will provide Accreditation employees with the convenience of access at their MinuteClinic was the first and is still the only reown work sites.” tail clinic chain accredited by the Joint Commission, How managed care organizations will influence but other clinic operators are certain to follow. the evolution of retail clinics remains to be seen. Michael Kulczycki, executive director of the AmOne thing is clear: This innovative brings a new bulatory Care Accreditation Program, explains that type of care directly to the consumer, and it is gain“Joint Commission accreditation of retail clinics ing momentum. MC enhances their credibility within the payer community. The insurers are looking to see if their current care standards work in the retail clinic setting. Kathryn J. Alexander is a freelance writer and coIf retail clinics already have Joint Commission acauthor of the book Easy Labor (Random House). creditation, this will more than satisfy insurers’ Her work appears in various health care need to look at adding their own requirements.” publications and Web sites. Some primary care physicians have expressed concern that it will be difficult to provide accurate and thorough clinical oversight of their patients if they are treated at a retail clinic in addition to their own practice. Barry Schwartz, MD, vice president for network management at Blue Cross and Blue Shield of Florida, says, “We don’t want fragmented care. There must be communication between the clinic providers and our primary care physicians. This gives patients better care and, in the process, it keeps the primary care physicians happier.” Most clinics will fax a copy of the client’s visit records directly to the primary care physician. In addition, the Convenient Care Association has included in its industrywide quality and safety standards that all retail clinic members of the association “build relationships with traditional health care providers and hospitals and work towards a goal of using [electronic health records] to share patient information and ensure continuity of care.” MARCH 2008 / MANAGED CARE 43
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