26
May 10

Primary Care Visits: A Field Test of Value

http://blogs.wsj.com/health/2010/05/24/how-much-would-you-pay-for-a-primary-care-visit/tab/comments/

How do you find out what value people place on a primary care physician visit? You could try asking them, as a small group of Missouri physicians recently did.

….On the day of the events, no insurance was accepted. Care was provided only to the uninsured, who were asked to pay what they could afford. Laboratory tests were provided at cost, and patients who needed additional services were referred to various public resources….most valued it enough to pay something…

….None of the participating physicians collected enough money to make the concept financially viable over the long term, mainly because payments didn’t match a typical day’s collections from insurance and co-pays. Yet most say they want to do it again and enjoyed having one day free from insurance paperwork.

“I couldn’t afford to do it every day and feed my family, but I will probably try and do it once a year,” said [one Maine physician]…

Frankly we’re not convinced the pay what you can docs really looked carefully enough at how close what they made was to their net from treatment of insured patients. Did they, for example, discount for the costs they avoided for
a) collecting patient payment data
b) reviewing, confirming, and transmitting that data for payment
c) reconciling payments on receipt with submitted charges, etc?

Anyway, the Wall Street Journal Health Blog picked the story up (5/24; paid subscription required)


26
May 10

Unnecessary ER Visits – And Results of Efforts to Cut Down On Them

A new report on potentially unnecessary emergency room visits in upstate NY, released 5/25 by Rochester, NY-based Excellus Blue Cross Blue Shield, notes that close to half of all such visits may be unnecessary, and that reducing the number of such visits by as little as five percent could save between $6 & $9 million.

The report notes

The Indianapolis Medical Society Foundation’s Project Health18 provides care and service free of charge to low income, uninsured adults. Members must “make all reasonable attempts to avoid using the ER for non-urgent care.” Unnecessary ER visits among members dropped from 77 percent to less than 1 percent.[Our emphasis]

(Story in the Rochester Democrat-Chronicle)


20
May 10

NACDS Embraces Brokaw Embracing Convenient Care

We noted yesterday the pragmatic Washington Post guest editorial by San Francisco emergency room physician Dr. Jennifer Brokaw.

It appears the National Association of Chain Drug Stores (NACDS) was proudly proclaiming Dr. Brokaw a “Pharmacy Great Communicator” at about the same time.

NACDS’s presser notes

NACDS designates a “Pharmacy Great Communicator” when opinion leaders inject into the public debate the positive story of pharmacy’s role as the face of neighborhood health care.


19
May 10

Docs Embracing The Convenient Care Concept

Judging, that is, from two items freshly available on the internet.

First this from a May 18 posting in Postgraduate Medicine: Embracing The Convenient Care Concept.

The five Drexel clinicians (three are physicians, at least one is a registered nurse) who authored this piece address the controversial status of retail clinics among physicians this way:

This new trend in delivering health care has been mostly, if not totally, ignored by the medical school practice plans, with the exception of the Mayo Clinic in Minnesota, which has developed several “express care” clinics as stand-alone facilities. As a medical school practice plan and a division of general internal medicine, we could continue to keep a blind eye toward this new trend in primary care medicine or embrace the concept. We aim to develop a new convenient care model integrating our College of Medicine practice plan in partnership with our College of Nursing graduate nursing program to form a stand-alone clinic within a bustling business district in downtown Philadelphia….

….Although organizations such as the American Medical Association and the American Academy of Pediatrics initially voiced concerns over quality of care and disruption to the continuity of care, … retail clinics have exceeded expectations and proved that they can perform well, both in terms of patient satisfaction and in quality measures….

The second is a Washington Post guest editorial written by San Francisco-based emergency room physician Jennifer Brokaw:

Keeping routine medical care out of hospital emergency rooms (5/18/10; free registration may be required).

….[N]on-emergency care delivered in the ER costs almost five times more than in a doctor’s office or clinic.

There are four ways we can steer minor emergencies away from the ER.

First, establish more offices and clinics that are not based in hospitals (and do not carry hospital overhead). The recent trend toward low-cost, retail- and pharmacy-based clinics has been a relative success for what these facilities offer: quick evaluation and treatment for simple problems. They have been found to cost less than one-fifth of what an ER costs for the same complaint….


11
May 10

Free Clinics Win Internet?

We feel the tools for locating free clinics are better than almost all of those available for locating retail clinics, or urgent care clinics. But don’t take our word for it. Go ahead – you be the judge:

Here’s the locator provided by the National Association of Free Clinics (of course there is one).

Here’s the locator provided by the Convenient Care Association (we love CCA – their locator, not so much).

Here’s the locator provided by the Urgent Care Association of America.


11
May 10

Consensus on Retail Clinics’ Future: More of Them

That’s the takeaway from this May 10, 2010 American Medical News story:

Retail clinics look to health reform to boost business

The article notes that Merchant Medicine CEO Tom Charland “thinks reform will help the retail clinic industry somewhat, but he doesn’t think it will be as big of a boon as some in the industry think.”

We’re with Tom.

EDIT: Kaiser Health News picked up this story, & paired it with a story about free health clinics under the title Free Health Clinics Still Drawing Large Crowds In Cities Across U.S.


11
May 10

Bayer Diabetes Care Sponsors Free A1c Tests At MinuteClinics Thru June 12

As they say in the retail business, “while supplies last”….

Free A1c Tests Available at MinuteClinic to Help Diabetes Patients Monitor Blood Sugar Levels


11
May 10

Take Care Health Co-Founder Departs

We’re never quite sure what to make of the news like this – the departure of a relatively low-profile cofounder – especially when his next act is billed merely as a “new entrepreneurial venture”. What obvious thing are we missing here?

Retail clinic pioneer Peter Miller to leave Take Care Health Systems.


10
May 10

Retail Clinics and Mobile Health

Without any extant models that we know of to point to, we’re nonetheless convinced that there is a useful nexus of retail clinics/convenient care and mobile health out there somewhere.

We are quite sure that Solantic’s 5/7/10 announcement of its mobile phones application is not it – but on a slow news day, an example is an example….


10
May 10

Giant Eagle Adds Clinics

Large midwest regional grocer Giant Eagle opened a retail clinic in Lyndhurst, Ohio last Thursday, reports the Cleveland Plain Dealer:

Giant Eagle adds walk-in clinics staffed by University Hospital nurse practitioners (5/5/10)

University Hospitals’ first FastCare clinic, opening inside the Legacy Village Giant Eagle on Thursday morning, will be staffed with UH nurse practitioners who can diagnose and treat basic ailments ranging from strep throat to bladder infections.

Congrats to Giant Eagle and to University Hospitals, but we feel obliged to note that while they have done a nice job with their media releases, neither has backed their clinic opening with easy-to-locate information about WHERE the clinic actually IS, WHEN it is open, or HOW to contact them.

Here’s the address of the University’s page for the clinic: http://www.uhhospitals.org/LocateaUHFacility/tabid/848/Default.aspx

As of 5/6/10, Giant Eagle does not have a page with the clinic’s location info.

Giant Eagle is host to another clinic, in Morgantown West Virginia. Here’s their page for that location: http://www.gianteagle.com/Article.aspx?cntid=207224

{sigh}

Allow us to hook you up:

Mon General FastCare