The Geographic Distribution, Ownership, Prices, and Scope of Practice at Retail Clinics

Published in: Annals of Internal Medicine, v. 151, no. 5, Sep. 1, 2009, p. 315-320, W-103-W-108

Posted on RAND.org on January 01, 2009

by Rena Rudavsky, Craig Pollack, Ateev Mehrotra

BACKGROUND: Retail clinics are clinics within a retail store that provide simple acute and preventive care services for a fixed price without an appointment. OBJECTIVE: To describe characteristics of retail clinics, including their location, scope of practice, prices, acceptance of insurance, and ownership, and to estimate the proportion of the U.S. population that lives within a short driving distance of such a clinic. DESIGN: Cross-sectional descriptive study. SETTING: United States. PARTICIPANTS: All 982 retail clinics operating as of August 2008. MEASUREMENTS: Population living within a 5- and 10-minute driving distance of a retail clinic. RESULTS: In August 2008, 42 operators ran 982 clinics in 33 states; 88.4% were located in urban areas. Nearly half (44%) of all clinics were located in 5 states (Florida, California, Texas, Minnesota, and Illinois). All offered sore throat treatment (average price, $78) and more than 95% offered treatment of skin conditions, immunizations, pregnancy testing, and lipid or diabetes screening. Almost all (97%) accepted private insurance and Medicare fee-for-service (93%). Among 42 clinic operators, 25 are existing health care companies that operate 11% of the clinics, and 3 are for-profit retail chains that operate 73% of the clinics. An estimated 10.6% of the total U.S. and 13.4% of the urban U.S. population lives within a 5-minute driving distance of a retail clinic, whereas 28.7% (total) and 35.8% (urban) live within a 10-minute driving distance. LIMITATION: Our inventory of clinics stopped in August 2008 and estimates of proximity are based on 2000 census data. CONCLUSION: Retail clinics are positioned to provide immunizations and care for simple acute conditions for a substantial segment of the urban U.S. population.

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