Retail health clinics have evolved over the years. Once a small space in the corner of a supermarket or drug store, where a shopper could get a flu shot, the clinic has transformed into a high-tech, consumer-centric health hub that provides primary care. Store chains are increasing their investments in these entities, and making sure consumers know that these in-store clinics do much more than administer vaccines or perform routine diagnostic tests.
When the convenient care industry, as the Convenient Care Association, or CCA, refers to it, debuted more than two decades ago, the establishments provided limited, affordable healthcare services for a small number of illnesses. The clinics provided an alternative to visiting a hospital emergency department for non-emergent care. If people would visit a clinic in the same place where they were shopping and getting their prescriptions filled, that would help to mitigate issues ranging from long ER wait times to the ballooning costs of health care.
Although they have advanced degrees, NPs and PAs are considered mid-level providers, which points to another issue. “The biggest challenge is getting nurse practitioners and physician assistants paid at the top of their license,” said Meggen Brown, chief nursing officer at Kroger Health/The Little Clinic. In Medicare, third-party payors and insurance companies, there is a reimbursement gap. The amount that NPs can bill for a service is 85% of the amount a physician can bill for that service.
On the bright side, some insurance companies are more advanced on how they view NPs and PAs because these insurers understand the long-term savings. “We save them millions of dollars a year,” Brown said. “Instead of someone going to the ER for a runny nose, they are coming to us.” Kroger has 226 The Little Clinics in the U.S.
The pandemic helped people realize that they can visit The Little Clinic for more than a runny nose. Kroger administered 11.4 million COVID-19 vaccines, which helped millions of consumers become familiar with the supermarket chain’s healthcare services. Many have returned for everything from diabetes management to anxiety. “It’s not just vaccines, not just sports physicals,” Brown said. “If you can get it done at primary care you can get it done at retail.”
It helps that Kroger’s The Little Clinic received Joint Commission accreditation. “People didn’t think you could get quality health care inside a grocery store,” Brown said. “People are taken aback because it looks like a doctor’s office.” The clinics are part of Kroger’s larger goal of being healthcare destinations. The retailer also has its Food as Medicine platform, which includes nutrition education with Kroger Health registered dietitians.
Diagnostic tests are also in demand, not just for COVID-19 but for routine maladies. Jonathan C. Overbey, head of corporate alliances and channel management at Sekisui Diagnostics, said the biggest markets right now are related to strep throat and flu. “Most of the testing now is for respiratory,” he said. “Kids are back playing sports, and people are getting on airplanes. We’re getting back to what it was to some degree pre-COVID.”
Challenges such as supply chain constraints are affecting businesses everywhere, including diagnostic companies. For a while, Overbey said, raw materials shortages made it difficult to get swabs and plastic tubes. “Our suppliers have gotten better, and they ramped up production,” he said. “It takes time to build a plant.”
Amid all the challenges, clinic expansion will continue. “The thing with retail is it is uniquely driven by consumer demand,” Bronstein said. “As they ask for new things, you see these things arise.”
Johnson & Johnson Consumer Health has a portfolio of brands that offer solutions for many retail clinic visits. During the height of the pandemic, the company worked closely with its retail partners to provide resources that clinicians could reference to help educate new and recurring patients. It produced educational materials on its products and the health needs they address, including allergy therapy and management, wound care, photosensitivity/sun protection, oral care and atopic dermatitis.
“Additionally, we have worked with the CCA to provide peer-to-peer education for hundreds of clinic healthcare providers who can use the materials to increase their knowledge of the science behind the health conditions they are likely to encounter frequently,” Johnson & Johnson Consumer Health said by email.