“Jiffy” health care clinics represent one of the fastest-growing sectors of the health care industry, providing quick, convenient, and affordable primary care services without the long waits and higher costs of traditional family practices.
In-and-out health clinics exist in states across the country and are often located inside pharmacies, such as CVS and Walgreens, as well as in grocery stores and large retail stores. Clinics are often led by a nurse practitioner or a single primary care physician. Staffs are kept low and facilities have limited testing capabilities and expensive machinery, keeping costs down.
The Philadelphia Inquirer reports the Convenient Care Association says there are more than 1,600 retail health clinics nationwide, with many more planned. In some states where costs and patient wait times are particularly high, retail clinics are growing at a rapid rate. There are more than 350 retail health clinics in Pennsylvania, many of which are in Philadelphia, where the average wait time to see a primary care doctor is roughly three weeks, according to the American Hospital Association.
The growing number of retail health clinics can be attributed in large part to expanding wait times and the growing number of Americans entering Medicaid, both of which have come as a result of the reforms mandated by the Affordable Care Act (ACA).
Since ACA-established health insurance marketplaces opened in 2014, patient wait times in numerous specialties, but especially in family health care, have increased in highly regulated markets, such as Massachusetts, according to a study by Merritt Hawkins and Associates.
Also, Medicaid enrollment has exploded under Obamacare. For example, In Colorado, 477,000 additional Americans were enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) from 2013 to 2015, an increase of 60 percent.
Even more problematic, the growing Medicaid population is having an increasingly more difficult time finding doctors who will take them on as patients, adding further to the number of people looking for alternative health care options.
Nationally, only 45 percent of doctors across a range of specialties now accept Medicaid, a decline of roughly 10 percentage points from 2009.
The combination of growing wait times for patients, a ballooning Medicaid population, and a shrinking number of doctors willing to accept Medicaid patients has created a perfect environment for economic growth for the retail health clinic industry. Now, more than ever, patients are looking for convenient and inexpensive ways to receive care, and the model utilized by in-and-out health facilities offers a seemingly perfect solution.
However, the framers of the ACA created the Obamacare system with a different model in mind, and virtually all of their projects, cost analyses, and programs failed to account for the possibility the retail health clinic market could take off.
Obamacare’s chief goal was to add the roughly 30 million Americans who were said to live without health insurance in 2009 to the health insurance marketplace, even though many of these people could not afford to pay for health insurance on their own. Some of the primary ways Obamacare’s designers sought to offset the increased costs that would come from adding millions of lower-income people to the marketplace were to mandate all people buy health insurance, including the many young health Americans who didn’t previously purchase health insurance; to heavily regulate the health insurance marketplace; and to establish policies that would push people into primary care facilities instead of emergency rooms.
The theory was that if more young people and lower-income people, demographics that haven’t traditionally seen primary care doctors on a regular basis, started frequently seeing a local family health care physician, primary care doctors would be able to offset the lower reimbursement rates received for Medicaid patients with new income from insured young people and families who used federal subsidies to purchase private insurance.
Further, health care costs would be reduced because people would theoretically be much healthier over time since they would now be under the regular care and guidance of a family physician. The expectation was that the prevalence of many preventative diseases, especially those related to obesity, could be reduced, saving the health insurance market billions.
Since Obamacare was first fully implemented, however, the market has reacted in a radically different way. Many young people have chosen to pay the health insurance fine (or is it a tax?) rather than buy expensive Obamacare health insurance; far more people than previously expected have enrolled in Medicaid rather than purchase subsidized Obamacare health insurance policies; family practitioners are turning away Medicaid patients in droves; and a growing number of Americans are heading to emergency rooms for care. All of this indicates the expected infusion of cash into the primary care marketplace has not occurred.
Additionally, the growing success of retail health care facilities means more patients are only seeing doctors when they are sick, which the American Academy of Family Physicians says will likely lead to more “missed [opportunities] to address more complex patient needs.”
If patients aren’t receiving consistent preventative care from primary care physicians, costs will continue to explode at rates Obamacare’s creators never anticipated, making the system even less sustainable in the future than it already appears to be today.