A new INQRI-funded study shows that retail clinics can reduce costs when Nurse Practioners (NPs) are allowed to practice independently, potentially by nearly $472 million or more in 2015.
Retail clinics are an increasingly popular option for people who need diagnosis and treatment for common, non-life-threatening conditions. NPs are the primary care providers in these clinics, which are located in a range of settings, including pharmacies, grocery stores and “big box” stores. First established in 2000, there are now more than 1,200 retail clinics nationwide.
The research team for the study was led by Joanne Spetz, professor at the Institute for Health Policy Studies and associate director for Research Strategy at the Center for the Health Professions at the University of California, San Francisco, and Stephen Parente, director of the Medical Industry Leadership Institute at the Carlson School of Business, University of Minnesota. The team compared claims data over a two-week period for 9,503 patients who visited retail and non-retail clinics from 2004 to 2007. Researchers compared costs in states that require NPs to be supervised by or collaborate with physicians, states that allow NPs to practice independently but not prescribe, and states in which NPs are allowed to practice and prescribe independently. The study is in the November issue of Health Affairs.
The researchers found that insurance claims over a two-week period were lower following retail clinic patient visits than after visits to other settings, such as doctor’s offices and emergency departments, for the same conditions. Insurance expenditures for retail patient visits were even lower in states that allow NPs to practice independently. Payments for prescriptions were slightly higher in states where NPs are allowed to prescribe, but that increase in cost was mitigated by the lower cost of an NP practicing independently.
Adjusted to 2013 dollars, the average two-week cost for non-retail clinic visits was $704, for retail clinic visits in states with no NP independence it was $543, and for retail clinic visits in states where NPs have independence in practice, it was $484. The average cost for retail clinic visits in states where NPs had independence in practice and prescribing was $509.
Retail clinics are projected to account for about 10 percent of outpatient primary care visits by 2015. The study’s authors projected that the cost savings realized from using retail clinics at that level would be $2.2 million. The savings would be increased by $810 million if all states allowed NPs to practice independently and by $472 million if NPs were allowed to practice and prescribe independently.
Read the study.
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