Could NP-Run Retail Health Clinics Produce Cost Savings?

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H!X LogoTwo recent developments in the healthcare industry could combine to produce cost savings for consumers seeking more affordable care.

These factors are: looser standards for physician extenders, specifically nurse practitioners, and the proliferation of retail health clinics.

A recent study found that retail health clinics save money if nurse practitioners are allowed to run them autonomously, writes Andrew M. Seaman of Reuters, resulting in lowered costs for both the consumer and the community.

“Researchers found care related to retail health clinic visits cost $34 less in states that allowed nurse practitioners to prescribe and practice independently than in states that required them to be supervised by a doctor,” he reports.

Although that figure sounds rather paltry, Seaman continues, “the researchers estimate there could be cost savings of $472 million by 2015 if nurse practitioners are allowed to independently practice at retail health clinics.”

Savings among retail health clinics could be pivotal in coming years, as their presence multiplies throughout the country. By the end of this year alone, 6,000 retail health clinics are expected to be spread across the country, and experts are predicting that patients will pay less to visit a retail clinic than a doctor’s office, especially when NPs are managing them.

“The average cost of treatment in the 14 days after a traditional doctor’s office visit was $704,” Seaman writes. “That includes the cost of the original appointment, plus any prescriptions and follow-up care. In states where nurse practitioners had no independence and could not prescribe medication, the average cost of care during and after a retail clinic visit was $543. [That] compared to $484 per visit in states where nurse practitioners were allowed to practice without the supervision of a doctor.”

One particularly fascinating finding within the study revealed there was a greater chance of people filling a prescription received from a retail clinic than a physician’s office, simply because “people are more likely to fill their prescription before they leave the store.”

Joanne Spetz, lead author of the study and professor at the University of California, San Francisco’s Philip R. Lee Institute for Health Policy Studies, made the following observations:

First, she said, “It appears there are cost savings when those nurse practitioners are allowed to operate autonomously in the retail clinic settings.”

Second, Seaman writes, “The researchers found no difference in a patient’s chance of being hospitalized after a retail clinic visit based on whether states allowed nurse practitioners to independently practice.”

And finally, Spetz concluded, “There is also no evidence that the states that have more restrictive scope of practice laws have better patient outcomes… I think there is a broader piece of literature and this is another little piece of that literature that there is no good reason to have those restrictions (on nurse practitioners).”

I know many of the healthcare leaders we interview on a daily basis have been expanding patient access by improving or integrating health clinics within their organization. Retail health clinics, however, are relatively new players on the field.

What are your feelings about this trend? Will they prove to be significant competition for the basic care provided by hospitals and doctor’s offices?

Regarding physician extenders, should the law allow them to run these clinics? What are the pros and cons that you foresee?

-by Pete Fernbaugh

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