Where Does Convenient Care Fit?
A new study published in August by RAND Corporation tackled the policy implications of convenient care (see the 94-page report here). There are a combined total of, I estimate, 4,500 NPs and PAs working for convenient care clinics, so it's important for NPs and PAs to know whether this care model will be part of a healthcare "cure" as we move forward with reform. The RAND study has a lot of "no surprise there" information, but there are some interesting points worth mentioning.
In the "duh" column, we have the following:
- Convenient care clinics aren't serving the underserved, they're serving insured families with kids
- Convenient care provides a limited scope of services
- Patients cite convenience as their main reason for visiting
- Patients are satisfied
- Care is appropriate (i.e., prescribing rates are similar to a physician's office)
- Profitability is always a challenge
- Many emergency department visits (13.7 percent, actually) could be taken care of in convenient care clinics.
That last point does have an interesting twist, according to study coauthor Ateev Mehrotra: "We've known for a long time that many people go the emergency
department with problems that could be addressed elsewhere, but this is
the first time we have been able to quantify how many of those visits
could be addressed at these alternative locations."
Also in the "interesting" column, we have this:
- There are conflicting opinions on whether convenient care will boost or chip away at primary care practices
- Convenient care clinics may not actually reduce healthcare spending, because it may increase the total number of patients seeking care
- CMS recently developed a code for convenient care clinics so that it can track usage by Medicare patients.
The report makes some interesting suggestions about how convenient care could fit into the healthcare arena: could they be Federally Qualified Health Centers? Could they be affected by demonstration projects? Will newly insured patients end up in convenient care clinics? The authors recommend that policymakers look at ways to integrate the industry into future healthcare plans. They also suggest that policymakers take a page from the convenient care book, focusing on customer service and convenience as they consider the future of healthcare. And here's a breath of fresh air: "ensure that retail clinics are treated in the same manner as other healthcare providers."
Read the RAND news release.