How will retail clinics be affected by potential ACA changes?

NEW YORK — With both the White House and congressional leadership pushing for changes to the Affordable Care Act and Medicaid funding, retail clinics are in a position to see potential opportunities and challenges from such changes. That’s the argument of market analyst Michelle La Vone Richardson, of Decision Resources Group, who examined the issue in a blog post for the company. 

Richardson notes that lack of coverage could drive many people covered under the ACA who were previously uninsured toward retail clinics in a search for affordable and accessible care. And potential changes to Medicaid proposed by President Donald Trump in the form of blocking grants could also increase retail clinic utilization, as states with limited funding would seek the least expensive options. 

“Some states, like Tennessee, long ago indicated their interest in using retail clinics to drive down unnecessary emergency visits,” Richardson wrote. “Telemedicine, alongside retail clinic utilization, is likely to help address patients with low-acuity needs.”

When it comes to potential challenges, though, Richardson notes that Blue Cross Blue Shield recently found retail clinic utilization over the past five years was largely driven by those insured under their employer, rather than under marketplace plans. She notes that if Trump does indeed repeal the ACA mandate requiring employers with 50 or more workers to provide health care, retail clinics could be negatively impacted. 

It could still be too soon to tell, though, and retail clinics continue to move forward. 

“To be sure, retail clinic utilization is not on the downswing and will not be anytime soon,” Richardson wrote. “What we could see is the continued outsourcing of existing clinic space to hospitals and health systems who want to expand their footprints and improve population health.”