Despite Rapid Growth, Retail Clinic Use Remains Modest

Despite rapid growth in the number of retail clinics operating within pharmacies and retail stores across the United States, actual patient use of these facilities remained modest, according to research from the Center for Studying Health System Change (HSC). Retail clinics, staffed primarily by nurse practitioners, offered a limited menu of services for common acute conditions and preventive care at lower prices and with greater convenience than traditional physician offices or emergency departments. Yet their share of overall ambulatory care visits stayed small.

Rapid Growth in Clinic Numbers

The number of retail clinics expanded dramatically, from a handful of locations in the early 2000s to more than 1,200 sites by the time of the study. Major pharmacy chains including CVS (MinuteClinic), Walgreens (Take Care Clinic), and Walmart drove the expansion. The clinics typically operated during extended hours, including evenings and weekends, and did not require appointments -- appealing to patients seeking convenient, accessible care for minor health issues.

Retail clinics positioned themselves as a lower-cost alternative for conditions like strep throat, ear infections, minor skin conditions, and routine vaccinations. Prices were typically posted transparently, and visit costs were generally well below what patients would pay at a physician's office or urgent care center -- and dramatically less than an emergency department visit. Health plans increasingly included retail clinics in their provider networks and some waived or reduced copayments for retail clinic visits.

Modest Utilization Despite Rapid Expansion

Despite the growing number of locations, retail clinic visits accounted for a small fraction of total ambulatory care. Most Americans continued to rely on traditional physician offices and hospital outpatient departments for their primary care needs. Several factors contributed to the relatively low utilization: limited geographic availability concentrated in urban and suburban areas, consumer uncertainty about the scope and quality of care available at retail clinics, and many patients' preference for ongoing relationships with established physicians who knew their medical history.

The physician community had initially responded to retail clinics with skepticism and in some cases opposition, raising concerns about care fragmentation, inappropriate prescribing, and the lack of medical records integration with patients' primary care providers. Over time, some of these concerns were addressed as retail clinics adopted electronic health records and worked to share visit information with patients' physicians. Some health systems partnered with retail clinic operators, incorporating them into broader care networks.

Implications for the Health Care System

Retail clinics represented an important experiment in making health care more accessible and affordable for routine services. Their price transparency, convenient locations, and extended hours addressed real gaps in the traditional care delivery system. However, their limited scope of services and modest utilization rates suggested they would complement rather than replace physician-based primary care. The long-term impact of retail clinics on the health care system would depend on their ability to integrate effectively with other providers, expand their service offerings, and demonstrate consistent quality.

Sources and Further Reading

HSC research on retail clinic growth and utilization, based on analysis of national claims data and community-level interviews.