NCPA - National Center for Policy Analysis


September 15, 2009

Walk-in medical clinics run by CVS, Wal-Mart and other retailers provide care for routine illnesses that is as good as, and costs less than, similar care offered in doctors' offices, hospital emergency rooms and urgent care centers, according to a new Rand Corp. study.  The cost savings over emergency rooms, in particular, was quite dramatic.

Located in retail stores, such as pharmacy, discount or grocery chains, these clinics require no appointments, are open on weekends and evenings, report little waiting time, and offer services limited to immunizations and treatment of minor acute conditions, according to RAND.  The clinics, which are usually staffed by nurse practitioners and physician assistants rather than doctors, tend to serve a population that is younger, more likely to be uninsured, and less likely to have a primary care physician.

RAND examined the cases of 2,100 patients from 2005 to 2006 who were treated for routine illnesses -- ear infections, sore throats or urinary tract infections -- and compared them to patients treated for similar problems at doctors' offices, ERs and urgent care centers.  RAND used claims from a large Minnesota health plan that has allowed enrollees to use retail clinics for more than five years.

  • The costs of care in retail clinics were 30 to 40 percent lower than in physician offices and urgent care centers and 80 percent lower than in emergency departments of hospitals.
  • The cost differential was sharpest in the area of "evaluation and management" by medical personnel.
  • That cost averaged about $66 at a retail clinic, compared with $103 in a physician's office and $358 in a hospital emergency department. In the area of laboratory and radiology tests, the average cost per episode was $15 in a clinic, $33 in a doctor's office and $113 in an ER.
  • For prescription drugs, there was little or no difference in average costs.

As for quality, RAND evaluated care based on 14 indicators, including tests given, whether antibiotics were prescribed and whether follow-up treatment occurred.  In general, the researchers found that the scores of retail clinics were equal to or higher than those of other care settings.  They could not independently assess the accuracy of diagnoses, but noted that if a patient's condition is misdiagnosed, they expected more patients to have a follow-up visit -- which was not the case.

Source: Margaret Shapiro, "Study Gives High Marks To Retailers' Clinics Walk-In Sites Are Thrifty for Routine Ills," Washington Post, September 15, 2009.

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