The geographic distribution, ownership, prices, and scope of practice at retail clinics

Abstract

Background: Retail clinics are clinics within a retail store that provide simple acute and preventive care services for a fixed price without an appointment.

Objective: To describe characteristics of retail clinics, including their location, scope of practice, prices, acceptance of insurance, and ownership, and to estimate the proportion of the U.S. population that lives within a short driving distance of such a clinic.

Design: Cross-sectional descriptive study.

Setting: United States.

Participants: All 982 retail clinics operating as of August 2008.

Measurements: Population living within a 5- and 10-minute driving distance of a retail clinic.

Results: In August 2008, 42 operators ran 982 clinics in 33 states; 88.4% were located in urban areas. Nearly half (44%) of all clinics were located in 5 states (Florida, California, Texas, Minnesota, and Illinois). All offered sore throat treatment (average price, $78) and more than 95% offered treatment of skin conditions, immunizations, pregnancy testing, and lipid or diabetes screening. Almost all (97%) accepted private insurance and Medicare fee-for-service (93%). Among 42 clinic operators, 25 are existing health care companies that operate 11% of the clinics, and 3 are for-profit retail chains that operate 73% of the clinics. An estimated 10.6% of the total U.S. and 13.4% of the urban U.S. population lives within a 5-minute driving distance of a retail clinic, whereas 28.7% (total) and 35.8% (urban) live within a 10-minute driving distance.

Limitation: Our inventory of clinics stopped in August 2008 and estimates of proximity are based on 2000 census data.

Conclusion: Retail clinics are positioned to provide immunizations and care for simple acute conditions for a substantial segment of the urban U.S. population.

Primary funding source: California Healthcare Foundation.

Figure 1. Location of the Retail Clinics in the United States

Footnote: Each circle represents a Combined Statistical Area (CSA) or Metropolitan Statistical Area (MSA) as defined by the US Office of Management and Budget (http://www.whitehouse.gov/omb/fedreg/metroareas122700.pdf). The size of the circle is proportional to the number of retail clinics in the CSA or MSA. The 30 CSA or MSAs with the largest number of clinics are labeled. The circle is mapped at the geographic centroid of the CSA or MSA (e.g. Los Angeles is not directly on the coast). CSAs and MSAs frequently include more than one city (e.g. San Jose and San Francisco and Oakland California are in one CSA). To ease legibility of the map, we only listed the largest city in the CSA or MSA (e.g. San Jose) as the label. Clinics not located in a CSA or MSA (rural clinics) are shown at their actual locations as a small dot.