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May 8, 2018

Can Retail Clinics Transform Health Care?

Author Affiliations
  • 1Formerly with National Quality Forum, Washington, DC
JAMA. 2018;319(18):1855-1856. doi:10.1001/jama.2018.2172

The landscape of the US health care system continues to undergo change. As market forces are invoked to drive lower cost, better access, and improved quality, the entities in the health care market continue to diversify. For instance, Apple (with personal electronic health records), Amazon/JPMorgan and Chase/Buffett (with the promise of an affordable nonprofit employer health care system), CVS/Aetna (combining a health plan with retail clinics), emerging Walgreens-ExpressScripts-Cigna relationships, and Walmart (in discussion to acquire Humana) represent major relatively recent developments. CVS/Aetna is the most well-developed of these changes. Nearly 6 years ago, the growth of retail clinics was described as a potentially positive disruptor, especially in the expansion of access and convenience.1 Many clinicians were concerned about lack of continuity and delegation of care to nonphysicians, yet these clinics seemed to offer a more accessible and less costly point of care compared with emergency department visits or even physicians’ office visits. If retail clinics could overcome the limits of legacy electronic health records to connect to other components of patients’ care, this model could even create a virtual comprehensive “system” as a point of connectivity and care coordination.