title: Retail clinic utilization associated with lower total cost of care.
abstract: OBJECTIVE
  To better understand the impact of retail clinic use on a patient's annual total cost of care.
  
  
  METHODS
  A propensity score matched-pair, cohort design was used to analyze healthcare spending patterns among CVS Caremark employees in the year following a visit to a MinuteClinic, the retail clinics inside CVS pharmacies.
  
  
  METHODS
  De-identified medical and pharmacy claims for CVS Caremark employees and their dependents who received care at a retail clinic between June 1, 2009, and May 31, 2010, were matched to those of subjects who received care elsewhere. High-dimensional propensity score and greedy matching techniques were used to create a 1-to-1 matched cohort that was analyzed using generalized linear regression models.
  
  
  RESULTS
  Individuals using a retail clinic had a lower total cost of care (-$262; 95% confidence interval, -$510 to -$31; P = .025) in the year following their clinic visit than individuals who received care in other settings. This savings was primarily due to lower medical expenses at physicians' offices ($77 savings, P = .008) and hospital inpatient care ($121 savings, P = .049). The 6022 retail clinic users also had 142 (12%) fewer emergency department visits (P = .01), though this was not related to significant cost savings.
  
  
  CONCLUSIONS
  This study found that retail clinic use was associated with lower overall total cost of care compared with that at alternative sites. Savings may extend beyond the retail clinic visit itself to other types of medical utilization.
authors.affiliation: CVS Caremark, Northbrook, IL, USA. ASussman@cvs.com
authors.forename: Andrew
authors.initials: A
authors.lastname: Sussman
authors.forename: Lisette
authors.initials: L
authors.lastname: Dunham
authors.forename: Kristen
authors.initials: K
authors.lastname: Snower
authors.forename: Min
authors.initials: M
authors.lastname: Hu
authors.forename: Olga S
authors.initials: OS
authors.lastname: Matlin
authors.forename: William H
authors.initials: WH
authors.lastname: Shrank
authors.forename: Niteesh K
authors.initials: NK
authors.lastname: Choudhry
authors.forename: Troyen
authors.initials: T
authors.lastname: Brennan
mesh_terms: D000554:Ambulatory Care Facilities / Q000191:economics*; D015331:Cohort Studies; D003132:Commerce; D003365:Costs and Cost Analysis; D005102:Health Expenditures; D006297:Health Services Accessibility; D006801:Humans; D016555:Matched-Pair Analysis; D011320:Primary Health Care; D057216:Propensity Score; D014481:United States