Tabitha Smith spent just $70 at an urgent care clinic near her home in La Puente,… (Anne Cusack, Los Angeles…)
Tabitha Smith had been sick for about a week last November with what she thought was just a cold. When she didn't get better, her mom pushed her to see a doctor. "I told her I can't afford the doctor," says Smith, a 31-year-old social media manager who has been uninsured for five years.
"I've gone in the past," she says, "and it's just been so expensive without insurance."
Ultimately Smith decided that Mother knows best. She headed to an urgent care clinic near her home in La Puente. Last time she saw a doctor in private practice it cost her $200. At the urgent care center, she spent just $70, a fee that included the cost of the medication for what turned out to be a case of walking pneumonia.
"I'd go back," Smith says. "I liked that I didn't have to wait in line very long." Smith says she also appreciated that prices for the various services offered were clearly listed on the wall.
Nontraditional healthcare sites such as urgent care centers and retail clinics are gaining popularity with consumers looking to avoid the long waits and high prices of the doctor's office or emergency department. These sites, however, are not meant to replace a relationship with a primary care physician, and they're never a substitute for appropriate use of hospital emergency rooms.
Still, the trend is expected to continue as the Affordable Care Act's full implementation looms and concerns grow over a shortage of primary care physicians.
"There's such a shortfall of primary care physicians that as a nation we have to begin to look at how we meet the needs of the population. One way to address it is by sending people to these alternative resources for healthcare," says Nancy Finn, Boston-based author of "e-Patients Live Longer: The Complete Guide to Managing Health Care Using Technology."
Retail clinics are typically staffed by nurse practitioners and physician assistants who treat ailments such as strep throat, infections, minor wounds and joint sprains. They also offer vaccinations and physicals. Increasingly, Finn says, "people have begun to use the clinics to manage chronic conditions."
Their prevalence has exploded. Visits to the country's three largest retail clinics — CVS Caremark's MinuteClinic, Walgreen's Take Care Health and Kroger's Little Clinic — have skyrocketed in recent years.
Their popularity, a 2012 report by Rand Corp. found, is due to their convenience, accessible hours and low cost. The average cost of a visit is about $78.
Urgent care centers
Urgent care centers are usually staffed and often owned by physicians — and sometimes hospitals. Nationwide, there are roughly 9,000 such clinics in operation, with about 300 new centers opening each year, according to the industry trade group Urgent Care Assn. of America.
Urgent care clinics treat infections, lacerations and bone fractures, among other ailments, and conditions that require immediate medical attention but that don't pose a threat to life or limb.
"They are for people who are relatively healthy and have a single problem," says Dr. Alex Rosenau, president-elect of the American College of Emergency Physicians. He adds that if you feel faint, or have chest or severe belly pain, you should go to an emergency room.
Because of the convenience and lower cost compared with hospital emergency rooms (an average visit to an urgent care center is about $118) insurance companies are increasingly including urgent care centers in their provider networks. Employers have also begun providing incentives for workers to use them, says Don Weber, managing director with consulting firm PricewaterhouseCoopers' Health and Hospital practice.
Work site clinics
Almost one-third of employers with 500 or more workers offer health clinics onsite or close to the office, according to a recent survey by consulting firm Mercer.
They typically offer preventive tests and screenings, health coaching and treatment for minor ailments. Some monitor chronic health conditions, such as diabetes. For employees without a family doctor, work site clinics often provide a trusted healthcare advisor, Weber says.
"Navigating the healthcare system is very complex. These people are on your side to help you become a better consumer, to help you get through the system. Some will even coordinate care with a specialist," Weber says. In addition, he says, employers are very careful to comply with privacy laws and to keep employees' medical information confined within the clinic.
Often employers give discounts for care at worksite clinics or waive co-pays, Weber says. Many also offer prescriptions at significantly reduced rates.
Community health clinics
The services available at community health clinics vary, but generally include primary healthcare, dental, mental health and pharmacy services.
The clinics function as primary care for some people (often low-income), so they will have access to physicians, nurses and other ancillary healthcare providers.