Navigating health reform
Retail Health Services Grow as Health Care Continues to Transform
The expansion and transition of retail health has been described in a wide variety of terms ranging from “disruptive innovation” to “radical convenience.” During CliftonLarsonAllen’s inaugural Health Care Leaders’ Forum last September, executives from across the health care continuum discussed how this topic relates to driving transformation across the continuum. However it is described, we all agreed that the growth of retail health services is on a significant upward trend that is projected to continue for some time. As it grows, some interesting questions come to mind.
First, what is it that is so attractive about retail health and second, what does this mean for the traditional primary care practice in the future? I think the answer to the first question is best summed up by a recent experience of my own.
My daughter had been feeling ill so we decided to take her to a CVS Minute Clinic located about a mile from our house. Within minutes of entering the clinic, my daughter was seen by a nurse practitioner, received a diagnosis, and had a prescription ordered and filled right there at the pharmacy. This personal experience demonstrates three key reasons retail health is so popular in the current transformation of health care:
There were several convenience factors associated with our visit. First of all, the location of the clinic was within one mile of our house. Second, we didn’t need a predetermined appointment, and were seen within minutes of walking through the doors. For the majority of families in today’s world, this kind of rapid service is important and valued. It would have been next to impossible to see a traditional physician on such short notice. Most likely, we would have been directed to the local urgent care clinic. In the typical urgent care environment, we would have had to wait for hours among dozens of other sick people exposing my wife and I to others who were ill.
In our minute clinic example, we were seen quickly, received antibiotics for treatment, and returned home all within a 30-minute time frame.
The cost for the visit was affordable — less than if we had gone to see our regular physician. As patients continue to take greater responsibility for their health care spending, pricing for services will remain a key consideration. The cost of health care has always been an issue for those who lacked coverage. For those fortunate to have insurance, there has long been an “insulation factor” from the true cost of care, because it covered a substantial portion of the full cost. As employers have pushed to gain greater control of their health care costs and started offering high deductible plans and health savings accounts, employees have become better consumers of health care services and are more aware of the total cost for services. The expansion of coverage is continuing to drive that awareness so pricing will remain a key issue for consumers.
The third attribute making retail health so attractive is transparency. When we entered the CVS Minute Clinic we were able to see — right on the door — the price we were going to be charged for the services. The true costs of a traditional physician visit are not known until the explanation of benefits is received in the mail, weeks or months down the road.
Health care is moving in the direction of greater transparency and pricing is just one component of it. Access to patient satisfaction information and quality information is becoming more readily available for physicians, hospitals, and others types of health care providers. As health care consumers continue to influence the market through their choices, transparency will continue to increase in importance.
What this means for traditional primary care
The advancement of retail health doesn’t have to equate to the demise of primary care physicians. As we think about the transformation of the health care delivery system, physicians are actually positioned to carry greater responsibility. There is a significant need to elevate chronic disease management in health care today, and this reality positions primary care physicians to operate at the very top of their license — that is, working at the highest level of expertise and contributing the greatest value. Chronic conditions such as diabetes, hypertension, and chronic obstructive pulmonary disease continue to rise and put excessive pressure on the costs of health care across the United States. The aging Baby Boomer population coupled with generally poor health habits of people of all ages provides the opportunity for physicians to lead the way in improving the health and well-being of our population, while leaving the strep-throat cases to the minute clinics. The success of primary care physicians in the future will depend on their ability to connect with their patient population, become more deeply engaged in helping to manage their overall health, deliver high-quality care, and ensure the highest level of patient satisfaction.
And yes, the traditional business model of being inconvenient, high-priced, and lacking transparency will also need to change.