Convenient Care Bringing Accessible, Affordable, High-Quality Healthcare to Patients

Transcription

1 Convenient Care Bringing Accessible, Affordable, High-Quality Healthcare to Patients Healthcare Remains in Crisis Limited access to care Skyrocketing costs of care Primary-care physician shortage Gaps in health insurance Crisis! Consumers pressed for time & convenience 1

2 Disrupting the Status Quo Convenient Care has been termed a disruptive innovation for the impact it has had on thinking about healthcare and healthcare delivery. What Are Retail Clinics? Healthcare facilities located in high-traffic retail outlets like retail pharmacies, grocery stores and big box retailers Staffed primarily by NPs and PAs Treat minor and acute illnesses and chronic disease conditions Offer many wellness services 2

3 Services Provided at Retail Clinics Services include: Evaluation, treatment, & education of patients from 18 months through 65+ Acute care Immunizations Wellness/preventive services School, camp and sports physicals DOT physicals EpiPen Instruction and Prescription Medication reconciliation Minor office procedures Chronic disease care Prescribe medications as necessary Expansion of Services Clinic services are expanding to include chronic disease care (screening, education, management) for conditions such as: Diabetes Hypertension Hyperlipidemia Asthma/COPD 3

4 Retail Clinics Focus on Wellness Education and wellness services include: Smoking Cessation Weight Management Lifestyle Modification & Coaching i.e. The Little Clinic staffs Registered Dieticians Convenient Care The Value & Solution 4

5 Intro to CCA & Where We Started At our founding ~150 clinics open. Concept was very novel. Clinics were mostly cash-only, offered a very limited scope of services, and were nearly all operated or owned by corporations. Many questioned the viability and legitimacy of the model. Early opposition tried to beat industry back. Our Role Founded in 2006, we are the national trade organization representing the convenient care industry. CCA membership is diverse, representing many companies, health systems, and others around the country. CCA works to enhance and sustain the growth of convenient care through: Sharing best practices & common standards of operations in primary care Serving as voice for clinics, providers & patients Building partnerships within the medical community Advocacy for policy work advancing the cause of convenient care to expand access to high-quality & affordable healthcare 5

6 # of Clinics 11/28/2016 The Industry Today Year More than 2,300 retail clinics in over 43 states and D.C. Greater acceptance publicly and support for an emphasis on patient-centered care. Operators include: hospitals/health systems and corporations The majority of individual clinics still operated by 4 non-hospital companies Significant growth in affiliations between non-hospital operators and major health systems. Clinical Affiliations Examples CVS Caremark/MinuteClinic UCLA Health System, Sharp HealthCare, Dignity Health, Cleveland Clinic FL, Emory Healthcare Walgreens/Healthcare Clinic at select Walgreens Johns Hopkins Medicine, The Valley Health System, Memorial Health, LSU Healthcare Network The Little Clinic The Ohio State University Wexner Medical Center, University of Louisville Physicians RediClinic Memorial Hermann Healthcare System, Methodist Healthcare System, St. David's HealthCare FastCare Bellin Health, Anne Arundel Medical Center 6

7 Partnerships with Hospitals and Health Systems Over 110 health systems are actively affiliated with retail clinics which benefit consumers: Increased Access to Care Improved Quality and Continuity of Care Expansion of Services Partnerships with Hospitals and Health Systems Retail clinic partnership opportunities and benefits to hospitals/health systems include (but not limited): Data Sharing to improve patient outcomes & continuum of care Diverting patients from crowded ERs Connecting patients with specialty services 7

8 Research Shows That Clinics Improve access. Lower cost. Are high-quality. Retail Clinics Improve Access to Care Fill Primary Care void: Nearly 50-60% of clinic patients report not having a PCP.¹ Create Point of Entry: Some hospital systems report their retail clinics are an entry point into system. Clinical affiliations between non-hospital operators & health systems include referral process. Reduce ED Traffic: 12 to 14% of all ED visits can be seen at convenient care clinics.² Convenience: Nearly 30% of the U.S. population lives within 10 minutes of a clinic.³ ¹ Mehrotra, Ateev, and Judith R. Lave. Visits to Retail Clinics Grew Fourfold From 2007 To 2009, Although Their Share of Overall Outpatient Visits Remain Low. Health Affairs, 31, No. 9, (2012). ² Weinick, Robin M., Rachel M. Burns, Ateev Mehrotra. (2010) Many Emergency Department Visits Could be Handled at Urgent Care Centers and Retail Clinics. Health Affairs, 29, No. 9 (2010): ³ Rudavsky, R, Craig Evan Pollock, Ateev Mehrotra. The Geographic Distribution, Ownership, Prices, and Scope of Practice at Retail Clinics. Annals of Internal Medicine, 151, No. 5 (2009):

9 Retail Clinics Improve Access to Care Retail clinics offer a quick, affordable alternative for patients with pressing, non-emergency medical needs. CCCs prominently display their healthcare services and pricing, so patients know costs up-front. CCCs may reduce health care costs by providing preventive care (e.g., flu shots) and facilitating earlier access to care. CCCs demonstrate significant cost savings for both consumers and third-party payers. Retail clinics reduced ER use and costs for pediatric population, and reduced admissions and outpatient costs for patients with chronic illnesses. 4 Blue Cross and Blue Shield of Minnesota eliminated copays for enrollees who used a clinic, citing $1.2 million in cost savings. 5 4 Parente, Stephen T., Retail Clinics as Key Performers for Successful Bipartisan Health Reform (Presentation), May BlueCross BlueShield Association, July 29, 2008 Retail Clinics Lower Costs Costs of care at a convenient care clinic are significantly lower than those at an urgent care center, primary care office, or emergency department. 6 Provider Average costs for treatment: Cost Emergency Department $ Physician Office $ Urgent Care $ Retail Clinic $70.00 ⁶ Thygeson, Marcus, Krista A. Van Vorst, Michael V. Maciosek, and Leif Solberg. Use and Costs of Care In Retail Clinics Versus Traditional Care Sites. Health Affairs, 27 No. 5 (2008): Sussman, Andrew, Dunham, Lisette, et. al. Retail Clinic Utilization Associated with Lower Total Cost of Care.: Am J Manag Care. 2013; 19(4): e148-e157. 9

10 High-Quality Standards CCA member retail clinics use electronic health records (EHRs), and at the patient s request, these can be shared with a patient s primary care provider in order to facilitate continuity of care. The use of EHRs in the clinics monitor evidence-based practice performance. CCA s Quality and Safety Standards were developed with input from leading nursing, medical and quality organizations and are more stringent than those recommended by the American Medical Association, American Academy of Family Practitioners and American Academy of Pediatrics. High-Quality Standards CCA members follow OSHA, CLIA, HIPAA, ADA and CDC requirements and guidelines. CCA members are committed to monitoring quality and safety on an ongoing basis including: Collaboration Certification & Accreditation Patient Satisfaction Data 10

11 Retail Clinic Growth & Opportunity Visits grew four-fold between the years 2007 and Accenture Research projects health clinics to grow 25% to 30% annually and clinics have already surpassed 2,100. MinuteClinic to open new clinics each year, for next five years ( ). Growing numbers of affiliations from 60 in 2014 to 100+ at end of Retail clinics significantly help to address capacity constraints at hospitals and PCP offices. 8 7 Mehrotra, Ateev, and Judith R. Lave. Visits to Retail Clinics Grew Fourfold From 2007 To 2009, Although Their Share of Overall Outpatient Visits Remain Low. Health Affairs, 31, No. 9, (2012). 8 Accenture Report, June Role in Increasing Healthcare Workforce For NPs, PAs, NP/PA students and NP/PA faculty, retail clinics offer: Clinical training sites (with access to most illness/conditions seen in primary care offices). Autonomous advanced practice provider operated clinical experience. Exposure to a career path that includes leadership opportunities. Opportunity to provide care in an evidenced-based practice environment. Exposure to a patient-centric model with advance practice leadership. Opportunities for research, project, and DNP Capstone. Opportunity to collaborate with interprofessional care teams. 11

12 Thank you! Questions? Contact: Tine Hansen-Turton, MGA, JD, FCPP, FAAN