Checking Up on Retail-Based Health Clinics: Is the Boom Ending?

Originally published as a Commonwealth Fund Issue Brief by the Center for Studying Health System Change (HSC). The article examined the growth and potential leveling off of retail-based health clinics in pharmacies and other retail settings. HSC was a nonpartisan policy research organization funded principally by the Robert Wood Johnson Foundation.

Checking Up on Retail-Based Health Clinics: Is the Boom Ending?

Retail-based health clinics -- walk-in facilities located in pharmacies, grocery stores, and big-box retailers staffed primarily by nurse practitioners and physician assistants -- had grown rapidly in the mid-2000s, raising questions about their role in the broader health care delivery system. This issue brief, published by the Commonwealth Fund, examined whether the retail clinic boom was sustainable or had begun to plateau.

The Rise and Potential Limits of Retail Clinics

Retail clinics had carved out a niche by offering convenient, low-cost treatment for a limited range of common conditions -- sore throats, ear infections, flu shots, and basic screenings. Their appeal rested on extended hours, no-appointment-necessary access, and transparent, posted prices that were typically lower than urgent care centers or physician offices. Several large chains, including MinuteClinic (CVS) and Take Care Health Systems (Walgreens), had expanded aggressively, opening hundreds of locations across the country.

However, the analysis found signs that the retail clinic growth curve was flattening. Some operators had closed underperforming locations, and the pace of new openings had slowed. The business model faced several challenges: narrow profit margins on the limited services offered, competition from urgent care centers that could handle a broader range of conditions, resistance from organized medicine concerned about care fragmentation, and the difficulty of building patient volume sufficient to sustain operations in some markets. The brief explored whether retail clinics might evolve beyond their initial model by expanding their service offerings, forming partnerships with health systems, or serving as access points within larger integrated networks.

Implications for Primary Care Access

The policy discussion around retail clinics centered on their potential role in addressing primary care access gaps. With a growing shortage of primary care physicians, particularly in underserved areas, retail clinics offered a partial solution by handling routine care that might otherwise require a physician office visit. Proponents argued that retail clinics freed up physician time for more complex patients and reduced unnecessary emergency department visits. Critics worried that retail clinics fragmented care by treating patients outside the context of an ongoing physician relationship, potentially missing important medical history and failing to coordinate with patients' regular providers. The brief concluded that retail clinics were likely to remain a part of the health care landscape but would need to integrate more effectively with the broader delivery system to maximize their value.

Sources and Further Reading

This Issue Brief was published by the Commonwealth Fund. The research drew on data from HSC's Community Tracking Study site visits, industry reports on retail clinic operations, and interviews with retail clinic operators, health system executives, and policy experts.