Feds Pay for Retail Medicine: Minute Clinic Chain to Accept Medicare

RediClinic now accepts Medicare

Houston Business Journal - Wednesday, June 13, 2007

"RediClinic LLC has formed a provider agreement with the Centers for Medicare and Medicaid Services to accept traditional Medicare in RediClinic's 46 locations nationwide" including:

  • 13 clinics in Wal-Mart stores
  • 17 clinics in H-E-B stores throughout Texas
  • 16 clinics in Atlanta-area Walgreens

"The Houston-based retail convenient care company said the Medicare coverage is in addition to the Medicare Advantage coverage already in place through existing contracts with Aetna, CIGNA, Humana and UnitedHealthcare."

They're not just lobbying payment providers like crazy.RediClinic is all over the news, building a series of partnership deals that break into mainstream retail spaces.

Will these clinics replace current ongoing relationships with primary care docs or community hospitals we consider our "medical home?" (see Dr. Larry Fields' description of the 'medical home' concept here).

Who knows? Most of us are waiting to see how these systems complement the current system, and how the growth and consolidation of regional chains will affect the marketplace.

The real question, however, is whether the retail/minute clinic model will succeed in reducing the strain on overburdened quickcare/urgent/fast track clinics and ERs.

In addition, how will payors deal with claims that include same-day visits to a retail clinic and a hospital (for referred FU care the clinic couldn't D&T)? Although many of the clinics operate under care-for-cash models, how often are consumers aware of what's really coming out of their wallets? They may end up triple-paying...once for the clinic fee, once for the copay at the ED or for other FU care, and once if the services related to that condition's D&T are not 100% covered by insurance. And of course this doesn't count the dollar drain they already experience paying for insurance coverage. If anyone can augment this post with experience on how HMOs, hospital billing offices, etc. handle these claims, I'd love to hear about it - please chime in with a comment.

When I worked as a patient advocate in a small community hospital ED, we often saw referrals from the local Urgent Care Clinic. Understandably, many of these patients were frustrated that they'd waited at the UCC, been told the UCC didn't have the facilities/equipment/staff on hand to diagnose/treat them, and now had to register and wait again in the ED.

It would be interesting to see results from a study detailing the percentage of patients from retail clinics referred to EDs for further treatment, including Xrays and other relatively common diagnostic procedures.

In other words, for patient populations of varying demographics, how often can the retail clinic model meet all of their needs without additional follow-up care? What number of patients are referred to other providers (ie hospitals) for 'immediate' or same-day follow-up care? 1 in 5? 1 in 50?

For the RediClinic opening in a Richmond, VA Wal-Mart Supercenter store, RediClinic offered "$39 sports and camp physicals and our 7 Vital Tests for Women package for just $15 so everyone can experience how easy and inexpensive healthcare can be.” - Web Golinkin, chief executive officer of RediClinic

RediClinics are open Monday through Friday 8 a.m. to 7 p.m., Saturday 9 a.m. to 5 p.m., and Sunday 10 a.m. to 5 p.m. Adults and children over age two are welcome, no appointments are necessary and a typical visit takes about 15 minutes (15 minutes?!! I may take a drive to Richmond to mystery shop this visit time). RediClinic charges a flat rate of $59 for Get Well services and preventive services start at $15.

If I could walk in to a RediClinic while on the road for work and pay 15 bucks for preventative services, would I consider that visit as an alternative to waiting 4-6 weeks for a slot on my PCPs schedule? Heck yes.

Talk about your competitive advantage...

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