Retail Clinic Visits For Low-Acuity Conditions Increase Utilization And Spending

Health Aff (Millwood). 2016 Mar;35(3):449-55. doi: 10.1377/hlthaff.2015.0995.


Retail clinics have been viewed by policy makers and insurers as a mechanism to decrease health care spending, by substituting less expensive clinic visits for more expensive emergency department or physician office visits. However, retail clinics may actually increase spending if they drive new health care utilization. To assess whether retail clinic visits represent new utilization or a substitute for more expensive care, we used insurance claims data from Aetna for the period 2010-12 to track utilization and spending for eleven low-acuity conditions. We found that 58 percent of retail clinic visits for low-acuity conditions represented new utilization and that retail clinic use was associated with a modest increase in spending, of $14 per person per year. These findings do not support the idea that retail clinics decrease health care spending.

Keywords: Cost of Health Care; Health Spending; Organization and Delivery of Care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Ambulatory Care Facilities / economics*
  • Ambulatory Care Facilities / statistics & numerical data*
  • Cost Savings*
  • Cross-Sectional Studies
  • Female
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Insurance Claim Reporting
  • Male
  • Marketing of Health Services / economics*
  • Marketing of Health Services / statistics & numerical data
  • Severity of Illness Index
  • United States