By 2014, it is estimated that 30 million citizens will gain access to health insurance through the Affordable Care Act. According to a recent article in Minneapolis Star Tribune, this could lead to an influx of customers for retail medical clinics. The clinics are already popular with the uninsured as well busy moms and ill workers. But as more people gain health coverage will they continue to visit retail clinics or go to already crowded doctor’s offices and in the wake of a predicted physician shortage. Since retail clinics are cheaper than traditional office visits and emergency room trips, simple lab work, vaccinations and minor ailments are easily treated without an appointment and are a natural extension of the pharmacy.
Pharmacies deal with insurance companies regularly as they reconcile the payments through PBMs. Retail clinic visits often fall under medical benefit, and with increased use, pharmacies will have a new insurance payment stream to monitor and reconcile.
As clinics become savvier, and begin to monitor chronic ailments such as asthma and diabetes, the role of community pharmacy could rise and give opportunities for collaboration between pharmacy and in store clinic to enhance disease management. In addition as new Specialty Pharmacy therapies require administration by a Healthcare professional, in store clinics can create a more affordable and convenient site of administration of these drugs. Because many of these new Specialty medications are not self administered, many are covered by medical benefit. This is a natural extension of the clinic services already being provided.
As an easily accessible health care professional, pharmacists in conjunction with in-store clinics have the opportunity to better improve transitional care and adherence by coordinating with the hospital discharging the patient. With chronic and elderly patients, this could help reduce readmissions and misuse of medicine. This face to face communication and collaboration with health systems, gives community pharmacies a competitive edge over mail order pharmacies.
In the backroom of the pharmacy, this will lead to a great deal of questions for retailers with returns management of pharmaceuticals as well as handling and destruction of expired pharmaceuticals. With an increase of vaccinations and injections, there is a new layer of hazardous materials for retailers that must be managed.
While retail clinics are not the best solution for all illnesses, usage could increase as more people take advantage of their new insurance coverage and look for fast and accessible health care. In addition, as retail clinics continue to evolve into more preventative medicine and not just focus on acute episodic care, the opportunities for retailers to be a more integrated part of improving healthcare and patient outcomes along with their convenient presence in the community this could permanently change the way pharmacies grow their business.
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