More Americans find insurance pays for visits to retail clinics

A recent poll finds that the proportion of Americans using retail-based clinics hasn't changed appreciably, but the percentage of patients using insurance to pay for those visits has. The poll also showed that while most visitors to retail clinics were satisfied with their experience, a large -- but declining -- majority of respondents still have qualms about the quality of care they might receive.

The Harris Interactive poll of 4,937 Americans found that 7% were treated at a retail clinic -- the same proportion as in 2005. About 90% of those treated said they were very or somewhat satisfied with the service while 94% said they were satisfied with the convenience, up from 83% in 2007.

The Harris study, conducted for The Wall Street Journal's Online Health Industry Edition, found that the percentage of retail clinic visitors who said that all or part of the visit was covered by insurance rose from 42% in 2007 to 62% in 2008.

The study's authors say, and experts agree, this reflects the trend of more insurance plans covering services offered at retail clinics.

Mary Kate Scott, principal of the Marina del Rey, Calif., consulting firm Scott & Co., said it's probable that the ratio of uninsured to insured hasn't change, but that insured patients previously had paid cash during their visits.

The AMA, as well as the American Academy of Family Physicians, have expressed concern that some insurers were placing primary care practices at a competitive disadvantage by waiving the co-pays for patients who sought care at the retail-based clinics. At its 2007 Annual Meeting, the AMA passed policy urging lawmakers to look into the practice of insurers waiving co-pays.

According to a September 2007 study published by the California HealthCare Foundation, there were 62 clinics in January 2006 and more than 500 by the time the study was published. There are now about 1,000, and 1,500 are expected to be opened by the end of the year.

The CHCF study, which was authored by Scott, stated, "Thus far, clinic operators rarely choose to compete with one another in the same market, opting instead to position themselves as the best alternative to waiting a few hours in a doctor's office, urgent care clinic or emergency room." Retail clinics are located inside grocery stores, pharmacies or general retailers, and usually are staffed by nurse practitioners or physician assistants.

Scott called the 7% usage number from Harris low. However, some clinics have shut down because of a lack of use. Also, the Harris poll found that 65% had concerns about qualifications of staff providing care in a clinic not run by medical doctors. The same percentage worried that serious medical problems might not be accurately diagnosed in an onsite clinic in a retail store or pharmacy.

About 90% of poll respondents believe retail clinics offer convenient hours and a price that makes them accessible to those who otherwise could not afford care -- two major selling points the clinics have pushed.