Use of retail medical clinics located in pharmacies and other retail settings increased 10-fold between 2007 and 2009, according to a new RAND Corporation study.
Researchers accessed a database of commercial insurance claims from a population of 13.3 million patients in 22 markets from 2007 to 2009. Among 3.8 million enrollees who made at least one retail clinic visit, the monthly utilization rate increased from 0.6 visits per 1,000 in January 2007 to 6.5 visits per 1,000 in December 2009. Proximity was the strongest predictor of retail clinic selection: Patients living within one mile of a retail clinic were 7.5 percent more likely to use one than those living 10 to 20 miles away. Other key predictors of retail clinic use included:
- gender: females are more likely to visit retail clinics than males;
- age: retail clinic patients tended to be between the ages of 18 and 44 (patients over 65 were excluded from the study);
- higher income: patients from zip codes with median incomes of more than $59,000 were more likely to use retail clinics than lower income groups;
- health status: patients with a chronic health complaint were less likely to use a retail clinic than those in good health.
“We identified 11 simple acute conditions that can be easily managed at a retail clinic,” said J. Scott Ashwood, a senior programmer/analyst at RAND and the study’s lead author. “These conditions, which include upper respiratory infection, bronchitis, ear infection, flu and conjunctivitis, were the most common seen at retail clinics.”
The researchers did not find a correlation between retail clinic use and the number of primary care physicians in the community.
Care initiated at retail clinics is 30 to 40 percent less expensive than similar care provided at a physician’s office and 80 percent less expensive than similar care provided in a hospital emergency room. However, it is not clear how increasing use of retail clinics will affect healthcare costs. “If the growth in retail clinic visits that we noted represents substitution for other sources of care, then the increase in retail clinic use could lead to lower costs,” Mr. Ashwood said. “However, if these visits represent new utilization or induced demand—in other words, patients are seeking care when they would have otherwise stayed home—then costs could increase. Answering these questions requires additional study.”
Source: RAND Health, a division of the RAND Corporation, www.rand.org/health
Urgent Care Clinic Growth Urgent care clinics in the United States treat an estimated 3 million patients per week, according to the Urgent Care Association of America.
To meet increased demand, the number of facilities has steadily increased from 8,000 in 2008 to more than 9,200, including about 600 centers opened in 2011, and continued growth is expected, Kaiser Health News reported. Economy Affects Insurance Industry
The National Council on Compensation Insurance examines the current state of the economy and the implications for workers’ compensation insurers in its December 2011 Gauging the Economy newsletter.
Among the findings:
Medical Inflation:
According to Moody’s Analytics, general inflationary pressure is expected to ease in 2012 but medical inflation is expected to remain strong and will negatively influence medical severity. Medical price inflation will continue to outpace general inflation in the economy in the foreseeable future.
Employment Growth:
Continued weakness in the economy is projected to produce slow growth in private-sector employment. Slower job growth indicates that there will be limited pressure on claim frequency and exposure.
Wage Growth:
Changes in average weekly wages are a key factor in determining indemnity severity. The projected weakness in the labor market suggests that pressure on indemnity severity due to wage inflation should increase only slowly.
Interest Rates:
Downward pressure on investment income for the property/casualty industry will likely continue primarily due to actions by the Federal
Reserve to keep interest rates very low for an extended period.
In another NCCI study, medical services were shown to comprise nearly 60 percent of workers’ compensation claim costs, up from about 40 percent in the early 1980s. The study examines variations associated with severity, service group and claim size. Among the findings:
- Office visits and emergency services dominate the service mix for smaller claims.
- Surgery and anesthesia represent a larger share of services for mid-range ($5,000 to $100,000) claims than for other claim sizes.
- Hospital services and prescription drugs comprise more than 40 percent of the cost of claims that are greater than $100,000. To learn more, visit www.ncci.com. Flu Vaccine Recommended
For all Health Care Workers The Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices (ACIP), and the Healthcare Infection Control
Practices Advisory Committee (HICPAC) recommend that all U.S. health care workers get vaccinated annually against influenza. During the 2010-2011 flu season, coverage for influenza vaccination among all health care workers was estimated at 63.5 percent, compared to 98 percent among health care workers who had an employer requirement for vaccination. In the absence of requirements, increased vaccination coverage was associated with employers offering vaccination onsite, free of charge, for multiple days. During the 2009-2010 influenza season, an estimated 62 percent of healthcare workers received seasonal influenza vaccine.
