Retail clinics win victory in Mass., but Boston remains hurdle
BOSTON —The convenient care industry celebrated a victory in Massachusetts in January as state health officials approved regulations allowing for limited-service medical clinics, but hit a snag within the city of Boston as the mayor looks to limit—if not ban—such clinics. The question is what impact, if any, will the city’s move have on providing convenient access to health care?
As previously reported online at drugstorenews.com, on Jan. 9, the state Public Health Council approved rules for limited-service medical clinics. The regulations, which took effect immediately, marked the end of a long review process that included two public hearings and the submission of hundreds of pages of testimony regarding the regulations.
Sparking the move to create specialized regulations for these clinics was CVS’ application to open a MinuteClinic in one of its stores in Weymouth. According to the council, early in the application review process it became clear that Department of Public Health regulations governing medical clinics did not address the operation of medical clinics with limited scope of services. Rather than consider applications requiring numerous waivers from full-service clinic regulations, the department decided to create a specialized set of rules.
Many industry sources, including MinuteClinic executives and the Convenient Care Association, applauded the effort, but soon faced yet another hurdle as Boston Mayor Thomas Menino objected to the council’s move, claiming that clinics “jeopardize patient safety.”
“Allowing retailers to make money off of sick people is wrong. People need continuous care, and this type of for-profit facility is ignoring the standards and measures needed for quality care,” Menino stated.
| States to Watch | Reason Why |
| Tennessee | The Tennessee Medical Association is proposing regulations that would significantly restrict NP and PA practice. The state legislature has proposed a bill that restricts the operation of clinics by prohibiting healthcare delivery (but not pharmacy operations) in stores that also sell tobacco products. CCA expects this to be an issue in other states, as well. |
| Oklahoma | State legislators are pushing bills that would impose strict ratio requirements and would require physician ownership of convenient care clinics. |
| Connecticut | The Connecticut State Medical Society seeks to work with regulators and state legislators to address issues that store-based clinics “will likely cause the healthcare system in Connecticut.” One concern cited by CSMS: In some states, health insurers have reportedly waived certain co-payments and deductibles to encourage clinic use—something Connecticut state law prohibits. |
| Illinois | Rep. Mike McAuliffe, R-Chicago, introduced the Retail Health Care Facility Permit Act, which would charge the Illinois Department of Public Health with regulating healthcare services provided in a retail store or pharmacy. The proposed law failed to pass, but will be reintroduced this year. Backing the legislation is the Illinois State Medical Society. |
According to a spokesperson for the Boston Public Health Commission board, the commission has since asked its attorneys to gather additional information on in-store clinics, such as the experiences of other clinics within other states. Attorneys also were asked to investigate what could be done legally—if anything—to limit, if not ban, clinics from opening in the city.
The next monthly board meeting is scheduled for Feb. 14, but it was unclear as of press time if attorneys would be ready to report findings at that meeting.
In response to Menino’s actions, MinuteClinic has stated, “We at MinuteClinic are committed to providing convenient, affordable access to quality health care.” The company also stated that it “would be happy to talk to Mayor Menino about any of his concerns.”
Defending its decision to allow clinics to operate, the state Public Health Council issued a statement that read: “The members of the Public Health Council were deliberative and thoughtful in their review of the limited-service clinic regulation. We believe these types of clinics, operated either as part of a retail operation or in a nonprofit setting, can provide the public access to safe, convenient, and quality care for minor health issues.”
While it is unclear, how the situation will play out within the city’s limits, if the city did in fact ban such clinics, the effect on the vast majority of Massachusetts residents would be minimal.
According to U.S. Census Bureau data, the city of Boston accounts for about 9 percent of the state’s population of 6.44 million people. The state is 7,840 square-miles, with Boston accounting for 48 square-miles.
The numbers suggest that, as with many larger cities, many people may work within the city limits but reside outside the city. Given the extended evening and weekend hours of retail-based clinics, it would likely be easy for a commuter to visit a walk-in clinic on their way to or from the city, or during the weekend.