MinuteClinic has been growing rapidly, with 49 percent growth in 2009 and 22 percent growth in last year alone. FierceHealthcare recently checked in with Dr. Andrew Sussman (pictured), president of MinuteClinic and senior vice president/associate chief medical officer of CVS Caremark, to learn more about what’s behind MinuteClinic’s current growth and where it's headed as the national debate about healthcare reform heats up again.
FH: How many patients a day does the busiest MinuteClinic see?
Sussman: We can’t get into that level of detail, but I can tell you that we've seen almost 9 million patients since MinuteClinic started 10 years ago. Since 2007, we've seen almost 8 million of those patients. The rate of growth has really increased dramatically.
FH: What's driving that growth?
Sussman: I think people feel like they get high quality care at MinuteClinic. Ninety-five percent of people are highly satisfied. It's accessible seven days a week without appointment. And it's affordable. Our visits start at $79.
A recent RAND Institute study found that care at MinuteClinic was 40 to 80 percent less expensive than the alternatives, a physician's office, urgent care center, or an emergency room. It also found that the quality of care on 14 objective measures of quality was at least as good as those other settings. That combination of highly accessible care in an environment where there's a shortage of primary care which is affordable and accessible is very valuable.
FH: Who are MinuteClinic's patients?
Sussman: About 80 percent of our patients use their health insurance. From their standpoint, it's their usual copay. For the 20 percent who are uninsured, having transparent prices really helps them.
What's interesting about our practices is that about half the patients who come to see us don't have a primary-care physician. We talk a lot about the medical home, but there's actually a lot of "medical homelessness." So we think that we can play a role there. And we keep lists of physicians in the area who are taking new patients that we can refer patients to for follow up.
FH: How do you plan to expand your portfolio of services in coming years?
Sussman: We're always looking and seeing what our patient's needs are and collaborating with health systems. I do see opportunities on the wellness front, for example, in the future helping with problems like obesity.
In addition to adding services, we have begun to develop relationships with major health systems. So we now have, actually for over a year, we've had a formal affiliation with the Cleveland Clinic. We have a similar relationship with Allina up in Minnesota and Wisconsin, and with Catholic HealthCare West out in Arizona and Nevada, as well as St. Vincent's Hospital in Florida. And we are talking to many other health systems about similar relationships where we share medical directors with those systems.
We work together on clinical programs and we work to integrate electronic records so we can send notes from our electronic record to the physician's record in the health system and vice-versa. That allows us to make sure that all of the clinical information circles back to the physicians who might be taking care of those patients when we're not seeing them.
FH: Do you see a role for MinuteClinic in some of the health reform's newer developments?
Sussman: While the regulations are still being written for those accountable care organizations, it's clear that one of the goals will be to provide care in an accessible and affordable way. We think MinuteClinic is quite well positioned for that.
We have early ACOs now asking us about opportunities to work together to help take care of patients and share information, working together as part of a team. That's really the role we think we can play in an ACO in various areas around the country.
FH: A few years ago, some doctors were jumpy about the existence of retail clinics. Do they have anything to be afraid of?
Sussman: Our goal is to work as part of a larger healthcare system and integrate what we're doing with the rest of the providers taking care of a patient. I think many physicians recognize that at the moment, we have a shortage of primary care in the United States.
Look at Massachusetts, a state with universal access; that is some of the basis for the national direction we're heading. One of the effects of universal access was to exacerbate the shortage of primary care in Massachusetts. Actually, MinuteClinic is growing quite rapidly in Massachusetts because there is a profound shortage of primary care.
Now think about what's going to happen in a state like Texas. There are more uninsured people in Texas than there are people in Massachusetts. We're going to need access to primary care if we're going to provide care to everybody. MinuteClinic can fill an important role.
Many physicians recognize there's a shortage. We have physicians sending us patients now, because they can't get a patient in for say a sore throat or ear infection. We have seen in general a growing acceptance of what we're doing. Our goal is to work with medical groups and hospitals in a complementary way as part of the medical neighborhood.
FH: What is your reaction to the Florida judge's ruling that the entire healthcare reform is unconstitutional? Does that affect MinuteClinic’s future plans?
Sussman: It really doesn't. There's a lot to be played out in exactly what the final legislation is. The important thing is that what we're providing--accessible, affordable, high-quality care--is going to be needed with whatever comes next. However we decide to move ahead in American healthcare, we think that there is tremendous value in the service that we're providing. That's the direction that our system has to go.
This interview has been condensed and edited.