How Big-Box Retailers Can Revitalize Rural Health Care

Telemedicine Growth User Reluctance
ASSOCIATED PRESS

There's a surefire, and perhaps unlikely, way to bolster access to health care for underserved Americans—at the shopping mall.

Millions of Americans struggle to get affordable, timely medical care. Roughly one-quarter of rural Americans haven't been able to get needed care at some point in recent years, according to a May 2019 poll conducted by NPR, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health.

The main reasons? Affordability. Trouble scheduling an appointment. Having to travel a long distance.

Retailers can help overcome these barriers. In many rural communities, the local Walmart or CVS is not just an economic anchor but a civic institution. It's a gathering place for far-flung residents. And it may be the most convenient place for historically underserved populations to seek health care.

Adding telehealth capabilities to our existing retail infrastructure could significantly expand access to top-notch care—and reduce costs for patients and the healthcare system.

Retail health clinics—low-cost health providers capable of treating minor ailments like fevers, colds, rashes, strep throat, and the like—have proliferated across the country. From 2006 to 2017, the number of clinics jumped from just 350 to 2,800.

It's easy to see why. For one, they're less expensive than conventional healthcare facilities. A retail clinic visit is about 30% to 40% cheaper than a trip to the doctor, according to research conducted by a professor at Harvard. It's 80% less expensive than going to the emergency room.

Consider those savings in real dollars. In Massachusetts, an average visit to a retail health clinic costs just $69—about $830 less than the average ER visit.

What's more, retail clinics typically publish their prices upfront. So patients can shop around. And they won't be hit with surprise medical bills.

Retail clinics are convenient, too. They tend to be near where people conduct routine errands. They certainly offer longer hours than the typical doctor's office. Most don't require appointments. Indeed, about half of people cited "hours were more convenient," "no need to make appointment," and "location was more convenient" as major reasons they chose a retail health clinic in a recent survey from the Robert Wood Johnson Foundation.

There's still a tremendous potential market for retail clinics. Consider the sheer number of potential locations. Kroger has more than 4,000 stores nationwide. Walmart has nearly 5,000. CVS Health has about 10,000.

Yet Walmart currently runs clinics in just three states. CVS's MinuteClinic brand operates in about 1,100 locations.

If even a fraction of these stores added health clinics, millions of Americans would be able to access care more easily. After all, 90% of the country lives within a 15 minute drive of a Walmart.

The need for more healthcare infrastructure is certainly acute. Nearly 80 million people live in federally designated Health Professional Shortage Areas. Many of those areas are rural.

Adding telehealth capabilities to a more robust network of retail clinics would maximize their impact. Previously isolated patients could head to their local big-box retailer to connect with top-flight specialists miles away via videoconference. Clinics could even outfit patients with devices to monitor vital signs remotely—and then transmit the data back to their distant specialists.

Fortunately, retail clinics are starting to incorporate telehealth in their offerings. Rite Aid, for example, is installing kiosks in its clinics that connect patients with remote care. With the help of a medical assistant, the kiosk records patients' vital signs and answers to a medical survey. Then, the patient is connected to a remote physician, who develops a treatment strategy.

CVS is enabling patients to get treatment for minor illnesses, injuries, or skin conditions from their homes. Using the CVS Pharmacy app, patients can connect to a provider in their state via video at any time of the day.

Deploying the latest telehealth technology across our existing retail infrastructure could cost-effectively address the healthcare gaps that afflict rural and other underserved communities.

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There's a surefire, and perhaps unlikely, way to bolster access to health care for underserved Americans—at the shopping mall.

Millions of Americans struggle to get affordable, timely medical care. Roughly one-quarter of rural Americans haven't been able to get needed care at some point in recent years, according to a May 2019 poll conducted by NPR, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health.

The main reasons? Affordability. Trouble scheduling an appointment. Having to travel a long distance.

Retailers can help overcome these barriers. In many rural communities, the local Walmart or CVS is not just an economic anchor but a civic institution. It's a gathering place for far-flung residents. And it may be the most convenient place for historically underserved populations to seek health care.

Adding telehealth capabilities to our existing retail infrastructure could significantly expand access to top-notch care—and reduce costs for patients and the healthcare system.

Retail health clinics—low-cost health providers capable of treating minor ailments like fevers, colds, rashes, strep throat, and the like—have proliferated across the country. From 2006 to 2017, the number of clinics jumped from just 350 to 2,800.

It's easy to see why. For one, they're less expensive than conventional healthcare facilities. A retail clinic visit is about 30% to 40% cheaper than a trip to the doctor, according to research conducted by a professor at Harvard. It's 80% less expensive than going to the emergency room.

Consider those savings in real dollars. In Massachusetts, an average visit to a retail health clinic costs just $69—about $830 less than the average ER visit.

What's more, retail clinics typically publish their prices upfront. So patients can shop around. And they won't be hit with surprise medical bills.

Retail clinics are convenient, too. They tend to be near where people conduct routine errands. They certainly offer longer hours than the typical doctor's office. Most don't require appointments. Indeed, about half of people cited "hours were more convenient," "no need to make appointment," and "location was more convenient" as major reasons they chose a retail health clinic in a recent survey from the Robert Wood Johnson Foundation.

There's still a tremendous potential market for retail clinics. Consider the sheer number of potential locations. Kroger has more than 4,000 stores nationwide. Walmart has nearly 5,000. CVS Health has about 10,000.

Yet Walmart currently runs clinics in just three states. CVS's MinuteClinic brand operates in about 1,100 locations.

If even a fraction of these stores added health clinics, millions of Americans would be able to access care more easily. After all, 90% of the country lives within a 15 minute drive of a Walmart.

The need for more healthcare infrastructure is certainly acute. Nearly 80 million people live in federally designated Health Professional Shortage Areas. Many of those areas are rural.

Adding telehealth capabilities to a more robust network of retail clinics would maximize their impact. Previously isolated patients could head to their local big-box retailer to connect with top-flight specialists miles away via videoconference. Clinics could even outfit patients with devices to monitor vital signs remotely—and then transmit the data back to their distant specialists.

Fortunately, retail clinics are starting to incorporate telehealth in their offerings. Rite Aid, for example, is installing kiosks in its clinics that connect patients with remote care. With the help of a medical assistant, the kiosk records patients' vital signs and answers to a medical survey. Then, the patient is connected to a remote physician, who develops a treatment strategy.

CVS is enabling patients to get treatment for minor illnesses, injuries, or skin conditions from their homes. Using the CVS Pharmacy app, patients can connect to a provider in their state via video at any time of the day.

Deploying the latest telehealth technology across our existing retail infrastructure could cost-effectively address the healthcare gaps that afflict rural and other underserved communities.

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Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her next book -- False Premise, False Promi...