Retail health clinics could play an important role in expanding access to health care in New York State, according to a new study by the Manhattan Institute’s Center for Medical Progress. But first, the state needs to break down its existing regulatory barriers to opening such clinics in settings such as pharmacies, grocery stores and even general retail outlets.

The study by Paul Howard, a Manhattan Institute senior fellow, sums up his findings as follows:

Published research and interviews we conducted suggest that retail clinics have the skills and organization to serve as convenient and cost-effective providers of basic health-care services, provided that certain troublesome and unnecessary regulatory barriers are lowered or removed. In particular, research suggests that:

• Retail clinics offer readily accessible, high-quality care for a relatively limited set of basic health-care ailments ranging from minor skin infections to sore throats and earaches. For the services they offer, quality appears to be at least equal to—and, in some cases, superior to—that offered by other types of providers.
• Total costs (to insurers and patients) of care at retail clinics appear to be significantly lower than those incurred by other types of providers such as physicians’ offices, urgent-care centers, and emergency rooms. Much of the lower cost can be attributed to the lower overhead associated with their retail location and widespread use of less expensive “mid-level” practitioners such as nurse-practitioners to provide care.
• A significant percentage of emergency-room visits could be safely and effectively redirected to retail clinics, saving millions of dollars annually.
• Patients are seeking care at retail clinics for appropriate conditions, and the availability of retail clinics does not seem to be increasing the utilization of such clinics for unnecessary care.

Howard presented his study this week at an Albany conference where the panel of responders included Assemblyman Richard Gottfriend, chairman of the Assembly Health Committee, who noted that a bill allowing for establishment of “convenient care clinics” has been reintroduced in the Assembly (sponsored by Assemblywoman Amy Paulin) this year.

Among other things, Howard points out, retail clinics can play a role in reducing unnecessary visits to emergency rooms. A 2010 study by Excellus Blue Cross/Blue Shield found that there were more than 640,000 unnecessary ER visits in 2008 in the forty-three counties constituting upstate New York—or 44 percent of all ER visits in that region. This included more than 20,000 visits for sore throat and more than 22,000 visits for ear infections, two ailments that retail clinics routinely treat. Excellus estimates that shifting even a small percentage of inappropriate ER visits to physicians’ offices would save millions of dollars annually.

New York currently ranks 49th in the number of retail health clinics relative to population, sandwiched between #48 Mississippi and #50 Alabama, Howard notes. The remedy he recommends is to “level the playing field”:

As their counterparts did in Massachusetts, New York regulators could recognize that the existing regulatory structure for traditional retail clinics is ill-fitting, expensive, and burdensome; in its place, they could clear a specially designated regulatory pathway for this new type of clinic. At the same time, they could lift restrictions on nurse-practitioners’ independence. Regulatory reforms would involve leveling the playing field for different clinic models. Meanwhile, the Department of Health could integrate retail clinics into existing public programs, including Medicaid … This path—fair competition and participation in emerging models of care—could win the support of incumbent providers, which say that they are concerned about the impact of retail clinics on continuity and comprehensiveness of care.