NCPA - National Center for Policy Analysis

Retail Clinics May Play Important Role as Affordable Care Act Kicks In

February 22, 2011

Beginning in 2014, the Patient Protection and Affordable Care Act is expected to significantly extend health insurance coverage by increasing Medicaid enrollment and offering federal subsidies for the purchase of private health insurance.  However, there is no guarantee that the newly insured will be able to access the health care system in a timely fashion as new demand for services outstrips physician supply, says Paul Howard, a senior fellow at the Manhattan Institute.

Retail clinics may have a role in alleviating pressure on overcrowded physicians' offices and reducing inappropriate emergency room use, thereby lowering overall health care costs. 

  • Retail clinics offer readily accessible, high-quality care for a relatively limited set of basic health care ailments ranging from minor skin infections to sore throats and earaches.
  • For the services they offer, quality appears to be at least equal to -- and, in some cases, superior to -- that offered by other types of providers.
  • Total costs (to insurers and patients) of care at retail clinics appear to be significantly lower than those incurred by other types of providers such as physicians' offices, urgent care centers, and emergency rooms.
  • A significant percentage of emergency room visits could be safely and effectively redirected to retail clinics, saving millions of dollars annually.
  • Finally, retail clinics may be able to help reduce Medicaid patients' utilization of emergency rooms for minor ailments, although this would require retail clinics as well as Medicaid officials to create reimbursement and enrollment procedures that encourage appropriate retail clinic use.

Source: Paul Howard, "The Role for Retail Health Clinics in New York," Manhattan Institute, February 2011.

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