Retail clinics
Retail clinics offer rapid access to basic health care services for minor illnesses such as sore throats or skin conditions, along with immunizations, pregnancy testing, and preventive care like routine lab tests, including cholesterol and diabetes screenings1. Some also offer behavioral health screenings and chronic disease management2. Services are usually provided by non-physician providers such as nurse practitioners (NPs) or physicians assistants (PAs)3, and care prices are posted and available before patients see the provider4. Retail clinics are usually open for longer hours than physician practices, including evenings and weekends, offering on-demand appointments in accessible locations3. Clinics are generally found in more affluent metro and suburban areas, and are located within retail stores such as CVS, Target, and Walgreens. Clinics may be owned by the retailer or associated with local physician practices or health care systems. Retail clinics are also known as retail pharmacy, walk-in, or convenient care clinics5.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased access to care
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Reduced emergency room visits
Reduced health care costs
What does the research say about effectiveness?
Retail clinics are a suggested strategy to increase access to health care6. However, additional evidence is needed to confirm effects.
Available evidence suggests that retail clinics may provide care to patients without a medical home7. Retail clinics appear to increase access to care and provide care equal in quality to traditional clinics8, 9, 10, 11, 12 without decreasing receipt of preventive care13. Retail clinics hosted by a health system may bring new patients into that system and establish patient relationships with primary care providers14. However, some retail clinic patients may be less likely to visit their primary care physician in the future, decreasing continuity of care13, 15.
Some researchers suggest that retail clinics may reduce health care costs through reduced visits to emergency departments4, 14, 16, 17, primary care physicians14, 16, and urgent care providers16. Such clinics can, in some circumstances, reduce total cost per episode compared to other settings18, 19, 12, 20 without increasing hospitalizations19, and may lower out-of-pocket costs for patients21. Savings may be greater in states where nurse practitioners (NPs) can practice independently19, 22. However, other studies indicate that retail clinics may modestly raise health care spending by bringing in patients who otherwise would not have sought treatment for minor conditions23, 24, and one study did not find a reduction in emergency department visits for non-emergency care25.
Retail clinics treat patients of all ages; convenience factors including location, on-demand appointments, and upfront pricing may be particularly appealing to adolescent and young adult patients21, 26.
Early proponents of retail clinics suggested such clinics might improve access to health care among disadvantaged populations6, but retail clinics appear to be most frequently located in more advantaged neighborhoods in metro and suburban areas27, 28, 29. As patients are more likely to visit retail clinics if they are close by, such placement may reduce the likelihood of use by individuals with lower incomes30.
Implementation Examples
As of 2018, more than 2,700 retail clinics provide care in 44 states and Washington, D.C., accounting for over 40 million patient visits each year31. Over 1,100 CVS Health MinuteClinic locations in 33 states and Washington, D.C. provide over 125 different services to patients32. Target also partners with MinuteClinic in Florida, Illinois, Maryland, Minnesota, North Carolina, Texas, and Virginia; in Target’s southern California clinics Kaiser Permanente provides the clinical services33. Walmart Care Clinics offer primary care, including physicals and additional health screenings, in Georgia, South Carolina, and Texas34. Walgreens’ retail clinics are frequently operated by local health systems, such as Piedmont QuickCare in Atlanta, GA; Vanderbilt Health Clinic in Nashville, TN; Community Clinic in Indianapolis, IN; and Aurora Clinic in Wisconsin35.
Many retail clinics have been able to offer drive-through testing during the COVID-19 pandemic, aided by large parking lots for lines of cars and space for testing tents; Walgreens, Kroger, Rite Aid, and Target all have at least one drive-through testing site36, and CVS MinuteClinic offers tests at sites in 33 states37. The Centers for Disease Control and Prevention offers guidance for retail clinics located within pharmacies or grocery stores to safely continue general care and offer COVID-19 testing38.
Implementation Resources
CVS MinuteClinic - CVS MinuteClinic. Our convenient services and experienced practitioners make health care easier. CVS Health.
CCA - Convenient Care Association (CCA). About CCA: The national trade association of companies and healthcare systems that provide consumers with accessible, affordable, quality healthcare in retail-based locations.
CDC-Health care facilities COVID-19 - Centers for Disease Control and Prevention (CDC). Coronavirus Disease 2019. Healthcare facilities: Managing operations during the COVID-19 pandemic; June 2020.
Footnotes
* Journal subscription may be required for access.
1 Win 2016 - Win AZ. The changing face of pharmacies in America: Retail clinics. Perspectives in Public Health. 2016;136(3):130-131.
2 Chang 2015a - Chang JE, Brundage SC, Chokshi DA. Convenient ambulatory care — Promise, pitfalls, and policy. The New England Journal of Medicine. 2015;373:382-388.
3 Hoff 2019 - Hoff T, Prout K. Comparing retail clinics with other sites of care: A systematic review of cost, quality, and patient satisfaction. Medical Care. 2019;57(9):734-741.
4 Alexander 2019 - Alexander D, Currie J, Schnell M. Check up before you check out: Retail clinics and emergency room use. Journal of Public Economics. 2019;178.
5 RAND-Retail clinics 2016 - RAND Corporation. The evolving role of retail clinics. Santa Monica: RAND Corporation; 2016.
6 Salinsky 2009 - Salinsky E. Medicine, big business, and public health: Wake up and smell the Starbucks. Preventing Chronic Disease. 2009;6(2):A75.
7 Mehrotra 2008 - Mehrotra A, Wang MC, Lave JR, Adams JL, McGlynn EA. Retail clinics, primary care physicians, and emergency departments: A comparison of patients’ visits. Health Affairs. 2008;27(5):1272–82.
8 Mehrotra 2015 - Mehrotra A, Gidengil CA, Setodijl CM, Burns RM, Linder JA. Antibiotic prescribing for respiratory infections at retail clinics, physician practices, and emergency departments. American Journal of Medical Quality. 2015;21(4):294-302.
9 Rohrer 2012 - Rohrer JE, Garrison GM, Angstman KB. Early return visits by pediatric primary care patients with otitis media: A retail nurse practitioner clinic versus standard medical office care. Quality Management in Health Care. 2012;21(1):44–7.
10 Jacoby 2011 - Jacoby R, Crawford AG, Chaudhari P, Goldfarb NI. Quality of care for 2 common pediatric conditions treated by convenient care providers. American Journal of Medical Quality. 2011;26(1):53-58.
11 Rohrer 2009 - Rohrer JE, Angstman KB, Furst JW. Early return visits by primary care patients: A retail nurse-practitioner clinic versus a medical office walk-in clinic. Primary Health Care Research & Development. 2009;11(1):87–92.
12 Mehrotra 2009 - Mehrotra A, Liu H, Adams J, et al. The costs and quality of care for three common illnesses at retail clinics as compared to other medical settings. Annals of Internal Medicine. 2009;151(5):321–8.
13 Reid 2012 - Reid RO, Ashwood JS, Friedberg MW, et al. Retail clinic visits and receipt of primary care. Journal of General Internal Medicine. 2013;28(4):504–12.
14 Feder 2011 - Feder JL. Charting a life-and-health cycle and expanded primary care options for patients in Wisconsin. Health Affairs. 2011;30(3):387–9.
15 Rohrer 2013 - Rohrer JE, Angstman KB, Garrison GM, Maxson JA, Furst JW. Family medicine patients who use retail clinics have lower continuity of care. Journal of Primary Care and Community Health. 2013;4(2):150-153.
16 Patwardhan 2012 - Patwardhan A, Davis J, Murphy P, Ryan SF. After-hours access of convenient care clinics and cost savings associated with avoidance of higher-cost sites of care. Journal of Primary Care & Community Health. 2012;3(4):243–5.
17 Wang 2010 - Wang MC, Ryan G, McGlynn EA, Mehrotra A. Why do patients seek care at retail clinics and what alternatives did they consider. American Journal of Medical Quality. 2010;25(2):128–34.
18 Duncan 2016 - Duncan I, Clark K, Wang S. Cost and utilization of retail clinics vs. other providers for treatment of pediatric acute otitis media. Population Health Management. 2016;19(5):341-348.
19 Spetz 2013 - Spetz J, Parente ST, Town RJ, Bazarko D. Scope-of-practice laws for nurse practitioners limit cost savings that can be achieved in retail clinics. Health Affairs. 2013;32(11):1977–84.
20 AHRQ HCIE-Patterson - Patterson A, Smith KL. Retail walk-in clinics provide easy access to low-cost primary care services. Rockville: AHRQ Health Care Innovations Exchange.
21 Wong 2017 - Wong CA, Bain A, Polsky D, et al. The use and out-of-pocket cost of urgent care clinics and retail-based clinics by adolescents and young adults compared with children. Journal of Adolescent Health. 2017;60(1):107-112.
22 Carthon 2017 - Carthon JMB, Sammarco T, Pancir D, Chittams J, Wiltse Nicely K. Growth in retail-based clinics after nurse practitioner scope of practice reform. Nursing Outlook. 2017;65(2):195-201.
23 RAND-Weinick 2010 - Weinick RM, Pollack CE, Fisher MP, Gillen EM, Mehrotra A. Policy implications of the use of retail clinics. Santa Monica: RAND Corporation; 2010:Technical Report 810.
24 Ashwood 2016 - Ashwood JS, Gaynor M, Setodji CM, et al. Retail clinic visits for low-acuity conditions increase utilization and spending. Health Affairs. 2016;35(3):449-455.
25 Martsolf 2017 - Martsolf G, Fingar KR, Coffey R, et al. Association between the opening of retail clinics and low-acuity emergency department visits. Annals of Emergency Medicine. 2017;69(4):397-403.
26 Mukamel 2019 - Mukamel DB, Ladd H, Amin A, Sorkin DH. Patients’ preferences over care settings for minor illnesses and injuries. Health Services Research. 2019;54(4):827-838.
27 Abara 2019 - Ogechi Abara N, Huang N, Raji MA, Kuo YF. Effect of retail clinic use on continuity of care among Medicare beneficiaries. Journal of the American Board of Family Medicine. 2019;32(4):531-538.
28 Rudavsky 2010 - Rudavsky R, Mehrotra A. Sociodemographic characteristics of communities served by retail clinics. Journal of the American Board of Family Medicine. 2010;23(1):42-48.
29 Pollack 2009 - Pollack CE, Armstrong K. The geographic accessibility of retail clinics for underserved populations. Archives of Internal Medicine. 2009;169(10):945–9.
30 Ashwood 2011 - Ashwood JS, Reid RO, Setodji CM, et al. Trends in retail clinic use among the commercially insured. American Journal of Managed Care. 2011;17(11):e443–8.
31 CCA - Convenient Care Association (CCA). About CCA: The national trade association of companies and healthcare systems that provide consumers with accessible, affordable, quality healthcare in retail-based locations.
32 CVS MinuteClinic - CVS MinuteClinic. Our convenient services and experienced practitioners make health care easier. CVS Health.
33 Target-Clinic - Target. Clinic: Ready to serve.
34 Walmart-Care Clinic - Walmart. Care Clinic services.
35 Walgreens-Find Care - Walgreens. Find care: Local health system operators.
36 Heath 2020 - Heath S. COVID-19 lights the way for retail health clinics, consumer health. PatientEngagementHIT; May 2020.
37 CVS MinuteClinic-COVID-19 - CVS MinuteClinic. COVID-19 testing: More than 1,400 testing locations, no cost to you. CVS Health.
38 CDC-Health care facilities COVID-19 - Centers for Disease Control and Prevention (CDC). Coronavirus Disease 2019. Healthcare facilities: Managing operations during the COVID-19 pandemic; June 2020.
Related What Works for Health Strategies
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