A new study from Accenture released this week at America’s Health Insurance Plans (AHIP) Institute shows that retail health clinics are projected to double over the next few years to meet the demand of newly insured patients under health reform. Those clinics are expected to save $800m annually in health care costs by 2015.
The report shows that the growing number of retail health clinics walk-in medical facilities located in pharmacies and retail chains will add capacity for 10.8 million patient visits per year, compared to 5.1 million in 2011. The number of patient visits at retail clinics is projected to account for 10 percent of non-primary care outpatient visits by the end of 2015. Many of these retail clinics are currently in larger cities, at the back of stores like Walgreens or Duane Reade. However, they are growing rapidly, and offering more than just standard blood pressure checks. Often, these clinics have referral networks set up with local hospitals, and serve as a low-cost screening mechanism.
Historically, retail clinics experienced a five-year trend of rapid growth from 2003-2008, ranging from 50-92% annually during that time. However, growth in the sector stalled, falling to just 2 percent per year from 2008-2012. The number of retail clinics is expected to increase 20-25% per year between now and 2015 and double from 1,418 to 2,868 clinics in that time period.
These clinics can also be a half step in improving the vast primary care physician shortage throughout the United States. Because of the Affordable Care Act (ACA), many more patients will be seeking primary care, however, primary care or general practitioner medical care has been steadily decreasing.
According to researchers at the George Washington University School of Public Health and Health Services (SPHHS), less than 25% of newly minted doctors go into this field and only a tiny fraction, 4.8%, set up shop in rural areas. The study which will be in the new issue of Academic Medicine shows that the graduate medical education system (GME) in the United States relies on public funding including nearly $10 billion in funds from the Medicare program and another $3 billion from Medicaid. Despite the large infusion of cash, experts have said that the federal government does not hold residency programs accountable for producing physicians trained to serve in rural or underserved parts of the country. Even though Medicare and Medicaid represent the largest public investment in the U.S. health workforce, there are still serious shortfalls in the number of primary care physicians in some geographical regions and in other high need specialties like general surgery.
The study looked at the career paths of 8,977 physicians who had graduated from 759 medical residency sites from 2006 to 2008. Researchers found that 198 out of 759 institutions produced no rural physicians at all during the study period. And 283 institutions graduated no doctors practicing in Federally Qualified Health Centers, clinics that provide care to low-income patients and others–often in remote or struggling urban areas.
About 66 million people in the United States live in rural areas or urban neighborhoods that have too few primary care physicians or access to primary care in clinics.
“If residency programs do not ramp up the training of these physicians the shortage in primary care, especially in remote areas, will get worse,” said lead study author Candice Chen, MD, MPH, an Assistant Research Professor of Health Policy at SPHHS. “The study’s findings raise questions about whether federally funded graduate medical education institutions are meeting the nation’s need for more primary care physicians.”
This week, Senators Roy Blunt (R-MO) and Jack Reed (D-RI) introduced the “Building a Health Care Workforce for the Future Act” (S. 1152). The Senators say the measure aims to make it easier for individuals to pursue careers in health care. The bill has an emphasis on primary care physicians.
According to the Association of American Medical Colleges, by 2020, there will be a nationwide shortage of 91,000 physicians. Approximately half of the shortage, 45,000, will be in primary care.
“Our nation faces a longstanding shortage of health care providers. In particular, the demand for primary care doctors is growing, but the supply is not keeping pace. This is a problem that is only going to get worse unless Congress acts,” said Senator Reed. “The Reed-Blunt plan would give our medical workforce a booster shot and ultimately expand and improve access to health care.”
The bill includes provisions for state scholarship and mentoring programs, new core competencies, and changes to documentation for medical professionals that is meant to streamline Medicare documentation. So far the bill is supported by the Alliance of Specialty Medicine; the American Association of College of Osteopathic Medicine; the American College of Physicians; the American Osteopathic Association; the Association of Academic Health Centers; the Association of American Medical Colleges; and the Society of General Internal Medicine.