Retail clinics make their pitch

(CVS-Caremark) The health policy world has a love-hate relationship with retail clinics, the medical facilities based in stores like Wal-Mart or CVS. It loves the idea of delivering care faster and cheaper, and that potential has made inroads with skeptics like the Incidental Economist’s Aaron Carroll. But there’s also a decent amount of disdain from doctors: Will care provided in a retail store really be as good as that given in a physician’s office? Can stand-alone clinics survive in a health-care system that is becoming increasingly more integrated?

Pharmacy chain CVS-Caremark, which owns the country’s largest chain of retail clinics, is doing its best to convince its investors that the answer to these questions is yes. A source passes along slides from the company’s investor day last week, where Andy Sussman, president of CVS’s retail chain Minute Clinic, presented on the future of retail clinics. You can watch the presentation in full here. But the short version is that research suggests that such clinics can deliver high-quality care, and there’s a plausible vision in which such clinics fit into the larger health-care system, rather than operating separately from it.

First, Sussman takes on the quality question: Can retail clinics deliver care that’s as good as a traditional doctor’s office? Research suggests they can: The slide atop this post, drawn from a 2009 Annals of Internal Medicine study, shows that retail clinics deliver results relatively similar to those of physician offices and markedly better than emergency rooms. The data come from a comparison of Minute Clinics in Minnesota and those providing similar care in different situations.

One of the the other big criticisms lodged against retail clinics is that they’re isolated: A patient walks into a retail clinic and walks out, and her primary care provider is none the wiser to any treatment he or she may have had or new medications prescribed. And although that’s certainly an obstacle, it’s far from an insurmountable one: CVS has begun setting up partnerships with its Minute Clinics and large health-care networks across the country to address that exact problem, where medical professionals in retail clinics and doctors in nearby health-care systems have a formal relationship with each other.

The idea here is that they can share information, and both participate in managing a patient’s care. There’s some chatter that retail clinics could become part of the much buzzed-about Accountable Care Organizations. Here’s a map of the infrastructure that’s been built up so far:

(CVS-Caremark)

Electronic health records make the transfer of data all the easier. Here’s a mock-up of how CVS sees a retail clinic fitting into an electronic health record:

(CVS-Caremark)

CVS probably won’t convince all retail clinic skeptics with this presentation. But investors are confident about where the model is headed: CVS-Caremark’s stock surged last Tuesday afternoon in the hours after this presentation. Retail clinics aren’t the health-care system we’re used to — but when what we’re used to are long wait times and expensive care, that could be a welcome change.