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convenient care models

convenient care models

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convenient care models

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  1. convenient care models 3/25/2014 Amer Kaissi, Ph.D.

  2. Outline • Convenient care • Retail clinics • Other convenient care models • Future

  3. "There's a place where ancient animals are roaming around near extinction. They are completely clueless about their future fate. Then there is Jurassic Park."

  4. 61% of primary care physician offices do not have an arrangement where patients could be seen after hours Schoen et al. (2009)

  5. 68% of emergency room visits are neither “immediate” nor “emergent” in nature Cunnigham (2011)

  6. Government Accountability Office (2009)

  7. 46,000 expected primary care physician shortage by 2025 Bodenheimer (2012)

  8. Convenient Care • Care that is cheap, effective, and delivered in more convenient settings than traditional physician offices

  9. Disruptive Innovations

  10. Outline 10 • Convenient care • Retail clinics • Other convenient care models • Future

  11. Retail Clinics • Walk-in clinics located in grocery stores, drugstores and general merchandise retailers • Care is usually delivered by a Nurse Practitioner or Physician Assistant • Up-front menu-style pricing

  12. Cost per visit Emergency room $570 Urgent care Physician office Retail clinicl $103 $106 $66 Mehrotra et al. (2012)

  13. Quality scores Mehrotra et al. (2009)

  14. Net Promoter Score

  15. 2013 Consumer Survey-RC

  16. “What would you have done today if the retail clinic was not an available option?” Wang et al. (2012) 22

  17. 61% of patients that visit a retail clinic indicate that they don’t have a primary care physician Mehrotra et al. (2012)

  18. Outline 24 24 • Convenient care • Retail clinics • Other convenient care models • Future

  19. Outline 25 25 • Convenient care • Retail clinics • Other convenient care models • Future

  20. Urgent Care Centers • Usually free-standing • At least one MD is present at the clinic all the time • Care is typically delivered by MD+ NP or PA • Can treat serious conditions such as sprains, strains, lacerations, contusions, fractures

  21. 2013 Consumer Survey- UCC

  22. Online Health Services • 24/7 access to provider • Minor medical conditions • Answer questions based on algorithm/protocol • E-mail/text/video communication • Low fee

  23. Example: Hello Health

  24. House Call Services • Provider visits home/work on evenings and weekends • Contracts with employers/ insurance companies • Annual membership + low visit fee

  25. Outline 36 36 • Convenient care • Retail clinics • Other convenient care models • Future

  26. “Prediction is very hard, especially about the future” Yogi Berra

  27. Predictions 38 38 • Increased utilization • New models

  28. Predictions 43 43 43 A two-tiered health care system: • Basic primary care delivered by NP/PA in convenient locations/ways • Complex primary care & specialty care delivered by MDs in more traditional locations

  29. ‘Flipping’ Health Care: Retail Clinics and Other Convenient Care Models Amer Kaissi 44