Published January 26, 2017

When a parent's day starts with a sick child with a sore throat, they usually have two options. Option one includes deciding who will take time away from work, coordinate the doctor’s appointment, spend time in the waiting room, wait for results or diagnosis, and finally – if possible – return to work. Or, in option two: take the child to a retail clinic on the way to work and be done in 30 minutes or less.

As the number of retail health clinics continues to rise, consumers are increasingly choosing them as cost-effective and convenient options to seek care for earaches, sore throats and other common health conditions. But not everyone is taking full advantage.

In a new report the Blue Cross Blue Shield Association (BCBSA) finds that while retail clinic visits nearly doubled from 2011 to 2015, the rate at which people with individual insurance visit retail clinics lags behind people with employer-based insurance. This is especially true of the newly insured.

Emergency room visits, meanwhile, spiked during the last three years among the individually insured, despite these visits sometimes costing 10 times as much for treatment of the same condition.

These costs add up quickly for consumers. For example, a member’s average out-of-pocket costs for visiting a retail clinic for upper respiratory conditions is $35. Going to the ER for that same issue can cost hundreds of dollars, and according to the report, nearly a third of ER visits could have been treated in a retail health clinic setting.

OOP Costs

 

The report also sheds some additional light on who is using retail clinics and when. Women and young adults make the greatest use of retail clinics, with women making up 72 percent of clinic visitors. Young adults are three times as likely to visit clinics compared to older patients. Of course, as cold and flu season hits, visits to retail clinics surge. Nearly 42 percent of clinic foot traffic occurs during the winter months.

While there over 2,000 retail clinics nationwide, they still represent a relatively small portion of outpatient options. However, such facilities, walk-in appointments and evening and weekend hours, might be the best choice for those seeking treatment for sore throats or other minor aches. For the parent of a sick child, or the college student on a budget, the convenience and affordability of retail clinics beats other outpatient options time and time again.

The Blue Cross Blue Shield Association is an association of 36 independent, locally operated Blue Cross and/or Blue Shield companies.