Retail Clinic Visits For Low-Acuity Conditions Increase Utilization And Spending

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Health Affairs
Vol. 35, No. 3
March 2016
Ashwood, J.S., Gaynor, M., Setodji, C.M., Reid, R.O., Weber, E., and Mehrotra, A.

Policymakers and health insurers generally view retail clinics as a delivery model that may reduce health care spending by substituting for more costly visits to physician offices or emergency departments (EDs). However, given their lower price and convenience, retail clinics may also lead to new utilization of health care services by patients who otherwise would not seek care, thus increasing spending. In a study funded by the Robert Wood Johnson Foundation Changes in Health Care Financing and Organization (HCFO) initiative, Ateev Mehrotra, M.D., M.P.H., Harvard Medical School, and colleagues analyzed utilization and spending data from Aetna enrollees, including users and nonusers of retail clinics. They assessed whether retail clinic visits for low-acuity conditions represented substitution for more expensive care or new utilization of health care services, and whether they subsequently reduced health care spending. The researchers found that 58 percent of retail clinic visits for low-acuity conditions represented new utilization of health care services by patients who otherwise would not seek care. They concluded that retail clinic utilization was associated with a modest increase of 21 percent higher spending for low-acuity conditions.

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