title: Retail Clinic Visits For Low-Acuity Conditions Increase Utilization And Spending.
abstract: Retail clinics have been viewed by policy makers and insurers as a mechanism to decrease health care spending, by substituting less expensive clinic visits for more expensive emergency department or physician office visits. However, retail clinics may actually increase spending if they drive new health care utilization. To assess whether retail clinic visits represent new utilization or a substitute for more expensive care, we used insurance claims data from Aetna for the period 2010-12 to track utilization and spending for eleven low-acuity conditions. We found that 58 percent of retail clinic visits for low-acuity conditions represented new utilization and that retail clinic use was associated with a modest increase in spending, of $14 per person per year. These findings do not support the idea that retail clinics decrease health care spending.
authors.affiliation: J. Scott Ashwood is an associate policy researcher at RAND in Santa Monica, California.
authors.forename: J Scott
authors.initials: JS
authors.lastname: Ashwood
authors.affiliation: Martin Gaynor is the E. J. Barone Professor of Economics and Health Policy and chair of the Governing Board of the Health Care Cost Institute, both at Carnegie Mellon University, in Pittsburgh, Pennsylvania.
authors.forename: Martin
authors.initials: M
authors.lastname: Gaynor
authors.affiliation: Claude M. Setodji is a senior statistician at RAND in Pittsburgh.
authors.forename: Claude M
authors.initials: CM
authors.lastname: Setodji
authors.affiliation: Rachel O. Reid is a medical resident in the Department of Medicine, Brigham and Women's Hospital, in Boston, Massachusetts.
authors.forename: Rachel O
authors.initials: RO
authors.lastname: Reid
authors.affiliation: Ellerie Weber is an assistant professor of management, policy, and community health at the University of Texas School of Public Health, in Houston.
authors.forename: Ellerie
authors.initials: E
authors.lastname: Weber
authors.affiliation: Ateev Mehrotra (Mehrotra@hcp.med.harvard.edu) is an associate professor of health care policy at Harvard Medical School, in Boston.
authors.forename: Ateev
authors.initials: A
authors.lastname: Mehrotra
mesh_terms: D000208:Acute Disease; D000554:Ambulatory Care Facilities / Q000191:economics* / Q000706:statistics & numerical data*; D017046:Cost Savings; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007344:Insurance Claim Reporting; D008297:Male; D008389:Marketing of Health Services / Q000191:economics* / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D014481:United States
keywords: Cost of Health Care; Health Spending; Organization and Delivery of Care