May 18, 2012

CVS banking on MinuteClinics

The CVS pharmacy chain is hoping that an ambitious flu vaccination program will provide a shot in the arm in another way — by drawing first-time customers to its stores and clinics.

With a goal of delivering 1 million flu shots this year, the company recently launched a high-profile advertising campaign that, for the first time, puts its MinuteClinic outlets front and center.

National TV ads promoting the flu vaccinations began airing in October and showed up during such marquee broadcasts as the Major League Baseball playoffs. The company declined to say how much it had spent on the campaign, which centers on prime-time television with some radio and print.

“We’re trying to build awareness of MinuteClinic,” said Bari Harlam, vice president of pharmacy marketing for CVS Caremark Corp.

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In-store health clinics’ popularity grows

As in-store health clinics continue to expand in the Pittsburgh market, research is raising concerns about their long-term viability.

Featuring upfront, no-frills menus limited to routine needs, retail clinics embrace a 15-minute, fast-food approach to health care that has gained in popularity.

Since the first such clinics opened here two years ago, the number has grown. The Pittsburgh area is expected to have 24 retail clinics by the end of the year, almost evenly divided between Take Care centers at Walgreens and MinuteClinics at CVS.

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Health Plans Continue to Eye Retail Clinics to Build Market Share and Reduce the Costs of Care

Walk-in retail clinics, launched in Minnesota eight years ago, continue to carve a niche as providers of basic, uncomplicated health care. Despite recent missteps, slower than anticipated growth and opposition from physician groups, the clinics are becoming an established member of the nation’s health care delivery system, and health plans increasingly are contracting with them.

The reasons: cost, convenience, growing consumer and employer acceptance, generally high-quality care, and a recognition that these clinics can help relieve pressure on overburdened (and expensive) hospital emergency rooms (ERs). Large and small insurers (as well as Medicare) cover their services, typically with modest copayments. Blue Cross and Blue Shield of Minnesota recently dropped its required copays to encourage member use of local retail clinics.

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Convenient healthcare

When people look at the US healthcare system, they imagine that private healthcare has to be hugely expensive. But the reason it’s expensive is because it’s hugely over-regulated. Tax and regulatory rules promote insurance through employers – reducing individual choice and meaning you lose your insurance when you change jobs. You can’t buy insurance across state lines – live in New York and you have to have a Rolls-Royce insurance plan of the kind New York specifies: you can’t buy a SmartCar plan, even if that suits you better.

And of course a rising part of the US healthcare system is the federal Medicare and Medicaid plans – bigger than the UK National Health Service, and growing fast:, according to the CBO, Medicaid and Medicare alone will absorb 20% of GDP in 70 years’ time.

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‘Doc-in-the-box’ no longer the rage as in-store concept stalls

Despite all the hype, the rise of mini-clinics on every street corner that once seemed so inevitable appears to have stalled, or at least has lost some of its initial steam, in parts of the Metroplex.

For instance, in February, when the world’s largest retailer, Wal-Mart, announced plans to build 400 health clinics at its supercenters nationwide by 2010, it seemed that the “doc-in-a-box” phenomenon was destined to take off. Wal-Mart identified Dallas, Atlanta and Little Rock as among the first markets to open clinics by April. Target was another big-box retailer that had thrown its hat into the ring in select locations nationwide.

Wal-Mart leased space in dozens of stores to outside companies to operate the medical clinics. And the company initially stated that it expected to open the clinics with RediClinic and an unnamed local hospital system in Dallas by the summer of 2008.

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Retail medicine

John White was running a low fever, his sinuses and ears felt full and he was tired, so he walked into a Bradenton medical clinic.

Valerie Fortunato asked a series of questions about his medical history, then performed an examination including checking his ears, eyes and throat, and listening to his lungs and heart.

In about 30 minutes, White left with a diagnosis of a sinus infection and prescriptions for antibiotics, antihistamine and a nasal steroid.

Fortunato is an advanced registered nurse practitioner, and her clinic is a gray-walled box inside a Publix supermarket.

Welcome to another facet of the future of medicine.

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Some walk-in clinics closing after boom

When retail clinics promised to be the next big thing in medical care, everyone from start-ups to national retailers opened their own versions of the walk-in clinics.

Often little more than a kiosk in a pharmacy, the clinics are staffed by a nurse practitioner treating simple ailments such as strep throat.

Now the building boom is leveling off, with several high-profile players closing outlets around the country. Those in the industry say it was simply supply outstripping demand, with too many clinics opening too quickly.

The industry, started eight years ago in Minnesota with a MinuteClinic precursor, is going through a mini shakeout.

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Blue Cross and Blue Shield of Minnesota Eliminates Co-Pays at Retail Clinics

Blue Cross and Blue Shield of Minnesota is eliminating co-pays for patients who use retail clinics like MinuteClinic and Target clinics.

Blue Cross and Blue Shield announced the Tuesday, which is available on most small and large group full insurance plans.

The company says the program is an attempt to encourage patients to use retail clinics for treating common ailments like allergies, sore throats and vaccinations.

“We created this new option because it helps hold heath care costs down and is responsive to consumers’ wide acceptance of retail clinics,” the company said, in a statement.

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Feel good about retail medical clinics

Most Americans can share horror stories of trying to schedule a doctor’s appointment — if you want to get in quickly, well, good luck.

You have about as much chance as getting a private audience with the pope.

Routine checkups often must be scheduled weeks or even months in advance. Once there, better find a magazine and expect to wait some more.

I’ve never understood why doctors’ offices make people wait so long. Don’t they know we have jobs, lives?

If an appointment is for 1:30, patients should expect to be seen at that time — and if the doctor is running behind, the customer deserves an update or apology.

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NPs Ride the Convenient Care Clinic Wave

Driven by consumer demand, the convenient care clinic (CCC) tsunami seems unstoppable. Despite initial resistance to the nurse practitioner-staffed CCC concept from many physicians, NPs and the CCC industry have pushed forward. They now stand in a national spotlight that is highlighting an innovative and successful approach to delivering affordable, accessible, quality care for minor conditions.

“NPs are the best kept secret in health care, but the healthcare system cannot afford these types of secrets. The CCC industry puts NPs front and center,” says Susan Apold, RN, PhD, ANP, immediate past president of the American College of Nurse Practitioners. The secret is officially out, and Convenient Care Association member clinics are employing NPs to staff 80% to 85% of clinics.

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Retail Healthcare Clinics Offering Most Convenient Solution

Kroger Co. says it has made a “significant” investment in The Little Clinic LLC to support a rollout of the in-store health centers across its locations nationwide.

Currently, Little Clinic operates 26 walk-in clinics inside Kroger-owned stores. The clinics handle minor illnesses and injuries like bronchitis, sinus infections and sprains, and also provide physicals, screenings and vaccinations.

Kroger, headquartered in Cincinnati, operates more than 2,400 supermarkets and multi-department stores in 31 states.

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Satisfaction with Retail-Based Health Clinics Remains High

According to the American Public Health Association, there were approximately 700 retail-based healthcare clinics operating in the U.S as of December 2007. These clinics, also known as convenience care clinics, are typically found in stores such as Walgreens, Target and Wal-Mart, and are usually staffed by Nurse Practitioners and Physician Assistants.

According to the latest WSJ.com/Harris Interactive health care study, U.S. adults who have used these health clinics in a pharmacy or retail chain are generally pleased, as almost all are very/somewhat satisfied with the quality of the care (90%), cost (86%) and staff qualifications (88%). As in prior surveys on this topic, the biggest driver of satisfaction appears to be convenience, with 73 percent very satisfied and another 20 percent somewhat satisfied with the convenience of these clinics. These clinics continue to be a destination for comparatively routine services like vaccinations and care of respiratory infections, and while public acceptance is increasing, they not particularly appealing for attention to more serious conditions.

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