Sick? More Illinois residents heading to store clinics for treatment

Jan. 20--Illinois residents with tender throats and agonizing earaches are increasingly heading to store clinics -- not just their doctors -- for treatment.

Nationally, the rate of visits to retail clinics among people with Blue Cross and Blue Shield insurance almost doubled over the last five years, according to the Blue Cross Blue Shield Association. That's despite concerns from some physicians and policymakers that patients may receive better care from doctors familiar with their needs and medical histories.

People with insurance through their employers drove that increase. Blue Cross and Blue Shield of Illinois -- the state's largest health insurer -- saw an 11.7 percent increase in the rate of retail clinic visits by patients with insurance through their employers between 2014 and 2015. The rate of visits by people with individual insurance grew much more slowly nationally -- and in Illinois declined by 4.5 percent between 2014 and 2015, according to the data.

Store clinics often are found in pharmacies such as Walgreens and CVS, and also can be in grocers and big-box stores like Target and Wal-Mart. Nurse practitioners often staff them, treating conditions such as bronchitis and the flu.

More people are using the clinics because they're so convenient, said Dr. Stephanie Vomvouras, vice president and chief medical officer at Blue Cross and Blue Shield of Illinois. They're often open on weekends and evenings and accept walk-in appointments.

"The out-of-pocket cost is lower and they're just sort of an easy way to get seen for minor conditions like flu, earache, minor things of that nature," Vomvouras said.

On average, a patient will pay $35 out of pocket for a visit to a retail clinic for an upper respiratory condition, compared with $37 for a doctor's office and $377 for a visit to the emergency room for the same condition, according to the report.

Dr. Kaveh Safavi, head of the health practice at consulting firm Accenture, said more people are flocking to retail clinics for the same reasons they're also turning to workplace clinics and telemedicine: People are looking for the least expensive way to get care close to home and work.

But in 2014, the American Academy of Pediatrics advised parents against taking their children to retail clinics, saying in a news release they "do not provide children with the high-quality, regular preventative health care children need." The academy said if parents must use retail clinics, they should consider only using clinics that have relationships with their children's pediatricians.

Some physicians and policymakers say people are better off going to their doctors who know their histories and what they might need in the future.

"For example, a child who presents to their (primary care physician) with an earache, could also receive a needed immunization, and an adult who sees their (primary care physician) because of a cough could also have their diabetes medication adjusted," according to a 2010 article published in the journal Health Affairs. "These ancillary but important services may be missed if a patient presents to a retail clinic."

The Health Affairs article also noted that some worry the growth of retail clinics will take business from primary care doctors, undermining them financially.

A 2015 report by Accenture predicted more than 2,800 retail clinics would dot the country by this year -- an increase of 47 percent since 2014.

CVS Health has more than 1,100 retail clinics across the country, including 56 in Illinois -- and it's still expanding. CVS Health hopes ultimately to grow to 1,500 clinics, said spokeswoman Amy Lanctot. Deerfield-based Walgreens has about 400 retail clinics nationally, including 56 in the Chicago area owned and operated by Advocate Health Care.

Accenture's Safavi said doctors realize that to compete with retail clinics and other health care services, they have to make their services more convenient. He said he expects retail clinics likely will evolve as well, eventually replacing nurse practitioners with medical assistants who will work with patients and convey information to doctors working remotely.

Vomvouras, of Blue Cross, said she's taken her own kids to retail clinics for minor conditions because they're often open when her regular doctor's office is not.

"They're not the end-all-be-all, and they don't meet every need and they don't replace a physician's office," Vomvouras said. "They're just another venue that people can get certain limited types of care in a time when they need it. It extends access."

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