Retail Clinics

Retail Clinics PowerPoint PPT Presentation

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Outline. How Did We Get Here?Retail Clinic Business ModelPlayersDriving ForcesConsumer Appeal Potential IssuesWhere to Next?Policy Issues. How Did We Get Here?. . Barber/Doctor. Traditional Family Doctor. Steps Along the Way. Healthcare of Future ProjectGMENAC Study of mid 1980'sUrgent Care CentersPhysician Offices in Shopping MallsFast Track Emergency Department Call Center Triage Software.

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Retail Clinics

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1. Retail Clinics Presentation to TAHP Annual Meeting October 17, 2007

3. How Did We Get Here?

4. Barber/Doctor

5. Traditional Family Doctor

6. Steps Along the Way Healthcare of Future Project GMENAC Study of mid 1980s Urgent Care Centers Physician Offices in Shopping Malls Fast Track Emergency Department Call Center Triage Software

7. Hospital Emergency Departments Emergency Departments Still the New Family Doctor Average Waiting Time = 240 minutes (2006) Texas = 249 minutes in 2006 Waiting Time Up from 186 minutes in 2003 12+ Hours in Flu Season National Examples of Waits in Excess of 18 Hours

8. Hospital Emergency Departments Hospital EDs 13.9% of Visits in 2005 Were for Non- Urgent Matters Such as Bladder Infections and Fevers Well, Worried Well, Near Sick and Sick

9. Driving Forces Convenience Focused Society Time Off Work Issues Single Parent Families Economics

10. Tired of Waiting for a Doctor? Try the Drugstore or Grocery Store!

11. Which Would You Pick? Wait 4-5 Hours in the ED and Pay $300+ OR Go to the Retail Clinic, Wait 20 minutes and Pay $50?

12. Retail Clinic---What is It? Rental Space in Retail Store 80-400 square feet Mid Level Practitioner Nurse Practitioner Posted Retail Price List Convenient Hours 8A-7P M-F/9-5 Sat/10-5 Sun Fast Service 15-25 minute wait

13. Typical Patient Sore Throat Ear Ache Sinus Infection Bronchitis/Cough Fever Bladder Infection

14. Business Model Replace Loss of Walk- In Store Volume Mail Order Pharmacies Drive New Customers to Retail Chains Impulse Retail Buys Defensive Strategy with Competitors Business Model is to Bring More Walk-Ins to the Store Retailers Gain From Rent

15. Players MinuteClinic Physician Founded CEO former Arbys Executive CVS and Target 300 Sites Planned

16. MinuteClinic

17. MinuteClinic Locations

18. Players MinuteClinic Physician Founded CEO former Arbys Executive CVS and Target 300 Sites Planned Take Care Health Systems Travel Agent Founded Osco, Rite Aid and Eckerd Drug Stores 1,400 Sites Planned

19. Take Care Health Systems

20. Players RediClinic Steve Case, former CEO of AOL Duane Reed, H-E-B 75 Sites Planned

21. RediClinic Locations

22. Players The Little Clinic Kroger and Publix 50 Sites Planned Open in Kentucky, Indiana, Florida, Georgia, Ohio Wal-Mart 400-2000 Sites Planned

23. Wal-Mart

24. Another Player

25. Your Neighborhood?

26. Your Neighborhood?

27. Your Neighborhood?

28. Roll Outs Much Slower than Announced Approximately 700 Open* Wal-Mart Has Been Debating Healthcare for 10 Years Beauty Shop/Barber/Nail Salon/McDonalds/Optical Shop Why Not Add a Retail Clinic to the Mix

29. Consolidation Business Units Already in Play CVS Acquired MinuteClinic 2006 Walgreens Acquired Take Care 2007 Next in Line?

30. Consumer Appeal No Waits Quick in and Out No Time Lost from Work Relief from Medical Problem Low Cost Possibly No Co-Pay

31. Consumer Opinions Convenience 92% Satisfied Quality 89% Satisfied Staff Qualifications 88% Satisfied Cost 80% Satisfied

32. Access to Primary Care Physicians U.S. Getting Further Behind the Curve in Access to PCPs

33. Primary Care Physician Shortage Hierarchy Issues Compensation Factors $180,000 for IM, $160,000 for FP versus $250,000+ for Specialists (2005) Reduced Residency Slots FMGs/Non-US Citizens Foreign Medical Schools for US Citizens

34. Primary Care Physician Shortage Only 20% of Internal Medicine Residents Choosing to be Generalists

35. Shortage of Primary Care Physicians US = 1928 open searches TX = 278 open searches

36. Do You Have a PCP? In Some Geographical Areas, Up to 50% of Population Do Not Have a Primary Care Physician Not Taking New Patients Practice is Full Insurance Network Medicaid/Medicare Uninsured

37. Wait for an Appointment Generally Weeks

38. Working Families/ Single Moms Tough to Get Off Work

39. Retail Clinics Filling a Void Meeting a Need Filling a Niche Convenient

40. Advice to Clients Develop Owned Primary Care Network Include an Alliance with Retail Clinics Geographically Dispersed Locations Leverage with Mid Level Practitioners

41. Primary Care Network Benefits For Hospitals/Health Care Organizations Base for Referrals Improve Access Open to low income/uninsured Improves Prevention/Early Detection Reduces Charity Care Write offs Reduces Cost of Care in the Long Term

42. Alliance With Retail Clinics Hospitals/Healthcare Organizations Should: Develop an Alliance With Retail Clinics Offer to Provide Medical Direction Source of Referrals to Physicians

43. Retail Clinic Issues Oversight Physician vs. Retail Corporation Licensing Issues Continuity of Care Medical Records Professional Stimulation Retail Pharmacy Patient Steerage Staffing

44. Performance Standards Scope of Service Evidence Based Medicine Team Based Referral Mechanism EHR Compatible Records

45. Evidence Based Comparison Americans receive evidence-based care 55% of the time from conventional health-care source . MinuteClinic's analysis of 58,000 sore-throat cases seen at their clinics conformed to evidence-based guidelines 99.15% of the time.

46. Nurse Practitioners Retail Clinics Reliant on NPs Patients Give These Professionals High Marks Spend More Time Seem more Caring Highly Trained

47. Nursing Shortage 118,000 shortfall of RNs 2007 55% plan to retire 2011-2020 Shortages of Nurse Practitioners with Growing Demand

48. Nurse Practitioners Nurse Practitioner Supply = 141,000 (2004) Retail Clinics May Need 10,000

49. Retail Clinics: Passing Fad or Here to Stay? Retail Clinics Most Likely to Be Here in One Form or Another But Will They be a Sustainable Financial Model for Corporate America?

50. Policy Issues US Needs to be More Aggressive in Prevention and Early Detection Additional Emphasis on Primary Care Increase Supply and Access to PCPs Leverage PCPs with NPs and PAs Increase Nursing Supply

51. Policy Issues Lifestyle Changes Access to Affordable Drugs Universal Health Insurance/Coverage US Uninsured Increased from 44.8M to 47M (2005) 15.8% of US Population Now Uninsured 34% of US Households Pay More than $1000/Year in Out of Pocket Medical 14% in Canada

52. Maybe Next Year? Drive Through Starbucks and Primary Care at the Window? . .

53. Retail Clinics Presentation to TAHP Annual Meeting October 17, 2007

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