Retail Clinics, Urgent Care Centers and Employer Sites Increase Health Care Options/Reduce Costs

More and more, the delivery of health care is moving away from the hospital into outpatient clinics and surgery centers. The number of hospitals and hospital beds has been falling while outpatient options have increased. Now, consumers in many U.S. cities can go to the local discount store or drug store for basic health care.

Clinics in Retail Stores: In 2019, CVS Health Corp. and competitor Walgreens Boots Alliance, Inc. each announced plans to remodel hundreds of existing stores to offer consultations and lab tests for patients with chronic diseases such as diabetes, heart disease and hypertension. (The stores will continue to offer prescription drug fulfillment and stock a variety of personal care items, along with foods, beverages and sundries.) An estimated 60% of Americans have at least one chronic condition, according to the U.S. Centers for Disease Control and Prevention (CDC).

As of 2023, CVS operated more than 1,100 MinuteClinics, providing medicines, consultations and lab tests. In addition, the company offered more than 1,500 HealthHUB locations which offer a broader range of health care services, new product categories and digital tools in on demand health kiosks. Walgreens is partnering with startup VillageMD to open more than 600 physician-staffed clinics at Walgreens stores in 30 U.S. markets through 2025, resulting in Walgreens’ having a 63% stake in VillageMD (a $5.2 billion investment).

In late 2018, CVS completed its acquisition of Aetna, affording the drug store chain access to the insurer’s customers and making it easy to market these new in-store services. In 2020, Aetna dropped copayments for members who patronize the drug chain’s MinuteClinics. Walgreens is using software from Microsoft to manage patient engagement, and it is also working with Alphabet, Inc.’s Verily Life Sciences Unit to develop a system to encourage patients to take their medications as prescribed.

In 2022, CVS announced plans to acquire Signify Health, a leading healthcare platform that leverages advanced analytics, technology, and nationwide healthcare provider networks, for approximately $8 billion. Should the deal go through, CVS will significantly enhance its health services in primary care, provider enablement and home health. The change would also affect MinuteClinics and HealthHUBs in CVS pharmacies and Target stores, which will be revamped to cater to chronic illness in addition to giving flu shots and handling simple health issues such as colds and sore throats.

Meanwhile, Amazon acquired 1Life Healthcare, Inc., which operates One Medical (a primary care network) for $3.9 billion in February 2023. The deal afforded Amazon dozens of clinics in major U.S. markets for in-person as well as virtual care. One Medical offers memberships for monthly fees of a few dollars per month. Members receive 24/7 virtual communications via its app or chat, same or next day appointments (which may be virtual or in-person) and walk-in lab test services, along with help in navigating insurance and Medicare. Amazon also owns Amazon Clinic which offers telehealth services in 32 U.S. states for care of common conditions including allergies, acne, digestive upsets and hair loss. Earlier, Amazon spent $1 billion to acquire online pharmacy PillPack, Inc. in 2018, placing it in direct competition in the prescription drug market. In January 2023, the company launched RxPass for unlimited access to common generic drugs for Prime members in several U.S. states. These acquisitions and their competitive potential may have encouraged CVS and Walgreens to make the changes in their stores and in the way they do business.

Walmart has begun opening clinics in or nearby its supercenters in the U.S. Doctors and dentists are on site, with services such as primary care office visits, vaccinations, lab tests and dental x-rays at reasonable fees. The firm plans to expand the clinics across its 4,700 U.S. stores. The in-store clinics are typically operated by local hospitals. Walmart is also taking in-store treatment a step further, by providing primary medical care in a few locations. These facilities offer chronic disease management in addition to care for minor health problems. Walmart’s huge rural footprint may position the retailer to fill a gap long existent in towns where doctors are hard to find. Another plus is Walmart’s low prices.

In-store clinics offer reasonable costs and great convenience. Also, the setting may seem less intimidating to some consumers than a trip to a medical office center or full-scale clinic building. Visits to these new in-store clinics typically range from about $45 to $90 in cost. Many of the patients will be people with no health insurance coverage—cost will be a major consideration. However, since charges are generally much less than those of traditional doctors’ offices, health insurers will also be pleased with these clinics. Procedures provided tend to be basic, such as flu shots, a quick physical required for participation on a sports team, or treatment for a simple infection or a minor illness. However, in-store clinics are adding treatments for more complex illnesses such as asthma and osteoporosis. They tend to be staffed by nurse practitioners. These practitioners have extended educations and special licenses that in many states across the nation allow them to treat minor illnesses and write simple prescriptions. In some states, they must work in conjunction and consultation with MDs, but the MDs need not be present at the time of treatment.

Urgent and Emergency Care Centers: Thousands of urgent care centers, providing a higher level of service than the simple clinics found in retailers, are also growing at a significant rate. These well-equipped clinics are staffed by physicians who can provide emergency care and treat a wide range of conditions, while offering walk-in, no-appointment treatment. Location is a key element, so clinics typically open in high-traffic strip centers close to patients’ homes and workplaces. Most are open at least 12 hours a day, including weekends, and many are open 24/7. Total fees are typically much lower than those for a hospital emergency room visit. Some of the clinics are operated as outposts of major hospitals, while others are run by physicians who are owner/operators.

UnitedHealth Group, Inc.’s Optum unit offers health care services in practices in 25 U.S. states in addition to health data analytics services and pharmacy services. Meanwhile, Blue Cross & Blue Shield of Texas offers free primary-care visits to its members at its newly opened clinics in the Houston and Dallas, Texas areas.

Workplace Care Centers: CHS Health Services and Take Care Employer Solutions merged and then rebranded the company as Premise Health. The firm offers worksite health and wellness centers, serving corporations including Intel, Goldman Sachs, Continental Airlines and Toyota (in addition to its clinics in drug stores). The clinics provide annual check-ups, flu shots, x-rays and simple blood work and are staffed by two doctors, two pharmacists and a dietician, plus a number of nurses and technicians. Client companies typically expect to lower their overall health care costs by as much as 20%; since more employees are able to utilize preventive care, fewer emergency hospital visits are required and costs per visit to the on-site clinic average out to a very reasonable amount. Productivity is also expected to rise for firms with on-site clinics because employees take fewer sick days. The on-site clinics even offer health coaches to provide lifestyle advice to employees considered at risk for health problems.

Services generally include health screenings and immunizations. Some facilities include fully equipped gyms to promote wellness and preventive health measures. Another leader in worksite clinics is Marathon Health.

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