Because of health insurance expansion and the need to offer lower primary care costs, the number of retail clinics is projected to double over the next five years in the U.S. to 3,000, said Tine Hansen-Turton, executive director of the Philadelphia-based Convenient Care Association.
Hansen-Turton said the Affordable Care Act is stimulating growth because 40% to 50% of the people who use retail clinics don't have a primary care physician, and many are uninsured.
"We expect to increase services as people become insured and seek lower-cost options of retail clinics," Hansen-Turton said. Costs for comparable services at retail clinics are 40% lower than in physician offices and urgent care centers and 80% less than emergency departments, she said.
"People will be more cost-sensitive because they will have higher out-of-pocket costs before they hit their deductibles," she said.
Like retail clinics, urgent care centers—which provide higher levels of care than retail clinics but less than hospital emergency departments—are also growing in numbers in Southeast Michigan to accommodate expected demand, said Dr. Mohammed Arsiwala, president of the Lansing-based Urgent Care Association of Michigan.
Under the Affordable Care Act, over the next several years, nearly 900,000 uninsured people in Michigan are expected to either purchase private health insurance through healthcare.gov or qualify for Medicaid.
"We won't see much more growth in the next year," Arsiwala said. "But the second year, 2015, we will start to see growth" in patient volumes at urgent clinics, he said. It will take time for newly insured patients to learn how best to access the healthcare system.
One concern has been that the influx of newly covered patients will overload the primary care delivery system. Primary care physicians, hospitals and other providers have been ramping up care recently for the expected increase in volume.
Besides CVS, pharmacies including those inside Walgreen Co. and Rite Aid Corp. stores have started retail clinics in various ways to take advantage of national changes in healthcare that are projected to add 16 million privately insured patients and 16 million Medicaid beneficiaries starting in 2014.
In a 2-year-old pilot program that began in Detroit, Rite Aid has established virtual NowClinics in nine stores in Michigan. NowClinic uses computers and telemedicine to link customers with remotely based advanced-practice nurses and physicians.
"Our online clinics have computer kiosks adjacent to the pharmacy in a private room with a computer," said Ashley Flower, senior manager of public relations for Camp Hill, Pa.-based Rite Aid.
Flower said customers can talk with nurses for free, but a 10-minute consultation with a physician costs $45. Customers also can consult with medical providers using their home computer, she said.
While Deerfield, Ill-based Walgreen doesn't currently operate its Take Care retail clinics in Michigan, the nation's largest pharmacy chain operates more than 400 clinics in 21 states—including Illinois, Indiana, Ohio and Pennsylvania—as well as the District of Columbia, said Jim Cohn, a Walgreen spokesman.
The company also has contracted with 15 health systems to integrate its clinics with system hospitals. Those health systems include Baltimore-based Johns Hopkins Health System and Indianapolis-based Community Health Network.