The use of retail medical clinics located in pharmacies and other retail settings increased 10-fold between 2007 and 2009 according to a 2011 RAND study. The determining factors in choosing a retail medical clinic over a physician’s office were age, health status, income and proximity to the clinic.
The strongest predictor of retail clinic use was proximity. Retail chain operators proposed that the new clinics would improve access to medical care among uninsured or underserved populations. However, these clinics have been opened more often in higher-income areas that are less likely to be classified as medically underserved, according to a new study from the University of Pennsylvania School of Medicine published in the May 25 issue of Archives of Internal Medicine.
“There has been a rapid rise in the number of retail clinics across the United States, but this growth is not evenly distributed across communities,” says Craig E. Pollack, MD, MHS, an internist and Robert Wood Johnson Clinical Scholar at Penn. He added that “poorer neighborhoods are less likely to have access to these clinics.” “We know that people living in poorer areas are less likely to have health insurance, less likely to have a regular source of medical care, and may have transportation problems that keep them from getting to the doctor,” Pollack says. “By tending to locate in richer neighborhoods, retail clinics may not be meeting their full potential to help address these problems.”
Retail chains trying to attract Hispanic shoppers should be encouraged, but they should also be very concerned. They should be encouraged because the concept of walk-in pay for service clinics is a norm in Latin America. So in the U.S., it is very culturally relevant for Hispanics to seek out neighborhood clinics in their communities that provide health services in a similar manner because neighborhood clinics are often a cost-efficient and convenient solution among foreign-born Hispanics, who upon first arriving often do not have jobs where health care coverage is an option for them. Indeed, according to the Department of Human Health and Services three in ten individuals of Hispanic origin (30.7%) were uninsured in 2010 compared to 11.7% for non-Hispanic whites.
Retailers such as Wal-Mart, Walgreens, CVS, Duane Reade and H-E-B have opened hundreds of these retail clinics. However, studies clearly indicate that access should be of great concern to retailers interested in attracting and gaining loyalty among Hispanic shoppers. Beyond location, it is also important that these retail clinics are staffed with Spanish-speaking nursing staff members to avoid the risk that symptoms and treatment could be misunderstood and/or inappropriate treatment or medication provided or prescribed.
Retail walk-in clinics are a natural fit for Hispanics, but retailers can only maximize this fit when they start expanding access in areas where the market is concentrated and unless they staff and are able to provide quality and culturally relevant care.
Here are six steps you can take immediately to assess your chain’s existing retail clinic coverage and quality delivery in underserved Hispanic communities:
- Run a geo-demographic and acculturation analysis on all your store trading areas including those the stores where your clinics are located to assess Hispanic market density and reach within the store’s trading area
- Create clusters of stores in terms of High Hispanic, Medium and Low Hispanic density – typically 50% or >, 20-50% and 20% or less are standard thresholds.
- Run an acculturation and socio economic segment analysis on each cluster to profile Hispanics in each cluster – this will help you understand language and other culture stage differences and the implied health care / staffing requirements. You will see that low acculturation profiles will be stronger in areas where Hispanic density is highest and vice versa.
- Take a count of how many clinics are in each cluster category and identify your coverage gaps and service delivery requirements.
- Do the same for your competition and focus on addressing coverage gaps where your competition has the strongest presence in trade areas where the least acculturated Hispanics are most concentrated.
- As an immediate step, strengthen your health care delivery in existing stores located in low acculturation trade area locations even as you plan for increasing retail clinics in underserved locations.