Over the years, various non-traditional models of health care delivery have sprung up and, more often than not, disappeared a short while later. 

Sometimes market forces bring about changes in traditional healthcare settings, such as same-day appointments in medical practices.  Sometimes they create new settings. One of the most powerful market forces in this field at present is consumer-directed healthcare (CDH), and one product of this force (and others) is the retail-based clinic.  In the main, these clinics are staffed by nurse practitioners and offer routine care in 15-minute encounters. 

Anybody who wasn’t paying attention to this phenomenon before this week certainly is now.  Business Week reports: 

On July 13, CVS Corp., the largest drugstore chain in the country, acquired Minneapolis-based MinuteClinic, the pioneer and largest provider of . . . retail-based health clinics in the U.S. "We’ve seen success by offering simple health-care solutions in the pathway of consumers," says Michael Howe, chief executive officer of MinuteClinic, which has grown from 19 clinics in two states to 83 in 10 states in just one year. The company plans to triple in size to 250 by the end of the year. The financial terms of the agreement were not disclosed.

Wal-Mart, Rite Aid, Osco and Walgreens all have arrangements with companies that have brought clinics into some of their stores as well.

This week, the California Healthcare Foundation published a timely report (pdf) on this phenomenon (summarized here), noting that these clinics are likely to take hold even in states with more stringent physician supervision requirements — such as California or my home state, Massachusetts.

CDH continues to be a very powerful idea, and the retail-based clinic is but one more arena in which this concept continues to be tested. It remains to be seen whether entrenched forces such as organized medicine and state regulators will act to slow or stop the retail-based clinics’ ability to make the leap from test markets to a nationwide presence, or whether they, together with payors, will work collaboratively to ensure that there is a rational framework within which these clinics can operate.

— David Harlow