Health insurers now cover most retail clinic visits

In the past, patients often paid out-of-pocket to visit retail health clinics, but many can now use their insurance coverage to pay for services. In fact, more than four in five visits to retail clinics operated by CVS and Walgreens are covered by insurance.

CVS said 84 percent of its MinuteClinic visits were covered by insurance as in-network providers. And Walgreens confirmed that more than 80 percent of its clinic visits are now covered by a health plan, Forbes reported.

The increase in coverage could be because insurers see retail clinics providing higher quality and lower cost services. Plus, more retail clinics have hired nurse practitioners and physician assistants.

By covering members' visits to retail clinics, insurers can save more than $200,000 each year due to fewer ER visits and hospital admissions, FierceHealthPayer previously reported. And research has shown that ER visits could be diverted to less-expensive retail sites. For example, an insurer could pay $518 to treat a member with strep throat at an ER, $85 at an urgent-care clinic or $35 at a retail clinic like Walgreens.

"The business case for providing those services can be compelling, especially when they are aligned with incentives from payers," said the authors of a report from the Robert Wood Johnson Foundation.

That report, which was conducted by consultants Manatt Health, said a retail clinic's cost of care is about $110 for commercially insured consumers, while care at a doctor's office costs almost $170.

To learn more:
- read the Forbes article
- here's the RWJF report

 

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