Bronson Healthcare Group’s second FastCare clinic in Southwest Michigan will add to the growing lineup of retail medical centers that offer convenient access to patients seeking treatment for minor conditions.
The Kalamazoo health system opened its first Bronson FastCare retail medical clinic two years ago inside a Meijer Inc. store in Portage. The location sees an average of 30 to 35 patients daily — many of whom already see a Bronson doctor. Executives say the concept has done well enough for the health system to open a second retail clinic in June on West Main Street in Kalamazoo, just west of U.S. 131.
“It’s a great model and it solves problems for people quickly,” said John Jones Jr., senior vice president and chief operating officer at Bronson Medical Practices. “As we continue to look for ways to better serve people that come to the health system, it’s been very successful. And access is a very big, big deal for folks. We continually work to try to improve access and this has really helped out. It’s just a great access point.”
Retail medical clinics like Bronson FastCare treat minor conditions such as sore throats, fevers, colds, ear and sinus infections, skin rashes and allergies. They’ll typically also offer services such as sports physicals and strep and urinalysis tests.
Staffed primarily by physician assistants and nurse practitioners, the retail clinics are billed as offering patients convenience, particularly during off hours or weekends, or if they can’t make the time needed to see their primary care doctor.
The Bronson FastCare clinic charges $69 per visit, a fee that is covered by most health insurers and is much less than what it would cost to treat a patient at an urgent care center or ER, Jones said.
The prevalence of retail medical clinics has grown steadily for more than a decade across the U.S.
CVS Corp. is the largest operator of retail medical clinics in the country with more than 1,100 MinuteClinic locations in 33 states and the District of Columbia, including 17 around metro Detroit.
Grand Rapids-based retailer Meijer houses four retail clinics, including the FastCare locations in Portage with Bronson and in Royal Oak with Beaumont Health. Meijer also has clinics in stores in Richmond, Ind. and Normal, Ill. The retailer plans to partner with Sparrow Health System on additional clinics in the Lansing area, as well as with a Milwaukee health system for in-store locations there.
A Meijer spokesperson did not respond to an inquiry from MiBiz.
Bronson partners on its retail clinics as a franchisee with FastCare, a part of Bellin Health Care Systems in Green Bay, Wis. FastCare has 37 locations in 10 states, including four in Michigan.
COST SAVINGS OR NOT?
While retail medical clinics are billed as lower-cost options for minor conditions, research indicates they can contribute to higher health care spending.
Using 2010 to 2012 claims data for the same condition from health insurer Aetna Inc., researchers from Rand Corp. found retail medical clinics cost 30 percent to 40 percent less than if a patient had gone to physician’s office and 80 percent less than an ER visit.
Yet the improved access offered by the nearly 2,000 retail clinics in the U.S. leads to increased utilization and overall spending, the researchers concluded. Rand researchers estimated that 42 percent of patient visits to a retail clinic in the period they examined were in lieu of a higher-cost visit to a physician office or ER, and 58 percent were for new uses of medical services.
“These findings suggest retail clinics do not trim medical spending, but instead may drive it up modestly because they encourage people to use more medical services,” said Dr. Ateev Mehrotra, an associate professor at the Harvard Medical School and an adjunct researcher at Rand Corp. who served as senior author on the study. “Retail clinics do offer benefits such as easier access to medical care, but the widely expected cost savings may not be realized.”
Still, authors of the report did say that retail clinics offer value because they provide access to people who otherwise may not seek or obtain timely care.
“People, when they are ill and want to be seen, they’re going to go somewhere probably. This is a great alternative to get checked out,” Jones said. “The access is great and the value is great.”
Retail medical clinics also have been criticized in the past over concerns about quality, and the continuity of care and the connectivity they have with a patient’s primary care physician.
That concern has been eased by the emergence of hospitals and health systems to provide medical oversight and clinic staff, in some cases. Bronson’s FastCare locations also are connected to the health system’s electronic medical records, Jones said.
Retail medical clinics, which first began appearing across the country in the early 2000s, have come to have an appropriate role in the care continuum, said David Krhovsky, president of the Michigan State Medical Society. As long as patient cases are tracked and processes are in place to measure quality, “then the Medical Society would be absolutely supportive,” Krhovsky said.
“They have a place,” he said. “The Medical Society, in a general sense, is very much in favor of improving the access to care wherever we can, and as long as the care is appropriate and safe. If this makes it easier for patients to get care and it decompresses our emergency rooms a bit, I think that’s a good thing. Obviously, the devil is in the details.”
Care providers who staff retail clinics “have to understand what their limitations are and they have to know when they are dealing with something more complex” and a patient needs to be referred to an urgent care center or ER, Krhovsky said.
Those kinds of procedures are in place at Bronson FastCare, according to Jones. He notes the retail clinic Bronson runs does not perform X-rays or stitches and instead refers those patients to a higher-acuity setting.
Bronson will consider the potential for launching more retail clinics in its market, although there presently are no plans for additional locations, Jones said.
“We’ll keep looking,” he said. “We keep evaluating locations and places. We’ll see how the West Main site works to see if there’s room to do it in other places this area.”