Convenient Care in the USA

Good Health and Well Being Industry, Innovation and Infrastructure
Case Study Submitted by: Diane Pyle, MSN, NP
Imagine a culture that empowers everyone to live the healthiest lives that they can, even when they are dealing with chronic illness or other constraints. Imagine a health care system that couples treatment with care, and considers the life needs of patients, families, and caregivers, inside and outside the clinic. – Risa Lavizzo-Mourey, Robert Wood Johnson Foundation observation of Convenient Care Clinics during the research study.[i]

Despite the introduction of the Affordable Care Act in the United States (enacted in 2010), in 2014, 12.4 percent of the U.S. population remained uninsured.[ii] Even those who are insured have high out-of-pocket expenses. Other considerable challenges in the United States in regards to the provision of primary healthcare including access to care, shortages of healthcare workers, and consumers who are pressed for time and convenience.

Diane Pyle, MSN, is a Nurse Practitioner (NP) at a MinuteClinic®, a walk-in convenient care clinic (or “retail clinic”) located within a CVS/pharmacy® store.  These convenient nurse-managed health clinics provide an accessible, affordable entry point into the healthcare system for those who previously were restricted access.[iii]

The National Nurse-led Care Consortium and the Convenient Care Associate have partnered together to establish over 2,200 of these retail clinics across the country. There are now approximately 5,000 Nurse Practitioners working in retail clinics and another 1,000 Advanced Practice Nurses working in Nurse Managed Health Clinics. The innovative, successful retail clinic model provides abounding benefits for NPs, including direct access to a broad variety of patients and conditions, experience in independent business management, and an upward career trajectory. The clinics provide care to 20 million people annually and have a large proportion of patients from medically underserved and low-income communities.

Retail clinics have changed the way in which primary health care services are offered and delivered in the United States by providing a solution for consumers who are uninsured or underinsured, for families with immediate care needs on weekends and evenings; and for employers, health systems and insurers who are looking for cost efficient and highly accessible care.

Generally located within high-traffic retail outlets like retail pharmacies, grocery stores and large retailers, they are primarily staffed by Nurse Practitioner and Physician Assistants who diagnose and treat minor and acute illnesses and chronic disease conditions. They also offer many wellness services such as smoking cessation, weight management, lifestyle modification and coaching.

Patients attending Diane’s clinic range from 18 months old to adulthood. Diane and her colleagues ensure patients receive high quality, holistic care. Recently, she earned two prestigious awards for her life-saving intervention of a patient, who, at 33 weeks pregnant, came into Diane’s clinic complaining of a mild sore throat. Diane quickly detected a significantly more severe diagnosis of pulmonary edema. At Diane’s insistence, the patient was transported to a hospital where she delivered a premature, yet healthy, baby by emergency C-section.

Convenient Care models such as the Minute Clinic have shown to improve accessibility with nearly 30% of the United States population living within 10 minutes of a clinic. Studies have shown that between 50-60% of people attending the clinics do not have a primary health care provider.[iv] These clinics have also led to a reduction in emergency department presentations with 12-14% being able to be seen on location.[v] The Clinics have stringent quality controls and utilize electronic health records to continually monitor and report on outcomes.


References

[i] Bachrach, D., et al. (2015). “The Value Proposition of Retail Clinics.” Robert Wood Johnson Foundation

[ii] Ibid.

[iii] Hansen-Turton, T., et al. (2007). “Convenient care clinics: the future of accessible health care.” Dis Manag 10(2): 61-73

[iv] Mehrotra, A. and J. R. Lave (2012). “Visits to retail clinics grew fourfold from 2007 to 2009, although their share of overall outpatient visits remains low.” Health Aff (Millwood) 31(9): 2123-2129

[v] Weinick, R. M., et al. (2010). “Many emergency department visits could be managed at urgent care centers and retail clinics.” Health Aff (Millwood) 29(9): 1630-1636

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