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Like it or not (and debate certainly exists), mid-level providers are playing an increasing role in the primary care arena of the healthcare system.  In a recent study which examined data from greater than 300 retail clinics operated by such giants as Wal-Mart, Walgreens and CVS, utilization studies found that:

  1. The vast majority of visits were for simple treatments such as ear infections, immunizations, and blood pressure checks.
  2. Insurance was billed (and paid) for most of the visits.
  3. Most of the patients that used the retail service didn’t have an established primary care provider.

This is relevant information for private practices because it helps us understand how people are using this more accessable (albeit, more fragmented) type of care environment.  By understanding this, we can begin to conceptualize ways that these mid-level provider practices should structure themselves and function in order to best care for their patients.

One suggestion that is evident is that mid-level provider practices should (1) address the “urgent care” needs of their market because that is how utilization currently happens, and (2) work on the development of comprehensive disease management tracts in order to properly prevent and maintain disease conditions for those that otherwise don’t (and likely won’t) have an established primary care relationship to keep them healthy.

Here’s a link to an article on the topic at the WSJ Blog.

Most of the patients said they didn’t have a primary care provider. One concern about the clinics is that they would lead to further fragmentation of care, by disrupting the patient-doctor relationship. “We found that three-fifths of patients did not report having a PCP, so for these patients there is no relationship to disrupt,” the authors write.