Family Medicine Coalition Makes Deal With CVS MinuteClinics

November 23, 2015 - As retail clinic growth increases sharply, a coalition of associations representing family medicine has struck a deal with CVS Health, which operates the MinuteClinic chain, to reinforce the role of primary care practices and patient-centered medical homes.

Family Medicine for America's Health (FMAHealth), which includes the American Academy of Family Physicians, the American Board of Family Medicine, and six other associations, said in a news release that the collaboration with CVS Health "will advocate for patient access to coordinated, continuous care and help to ensure that all consumers have access to a primary care provider."

The Health Is Primary communications campaign of the year-old coalition will work with CVS Health, the press release said, "to disseminate patient materials that provide a roadmap for understanding the various resources available through the medical neighborhood while helping [patients] know when and where to access these services."

Nurse practitioners at CVS' MinuteClinics already ask their patients whether they have a primary care provider, noted FMAHealth President and Board Chair Glen Stream, MD, in an interview with Medscape Medical News. If a patient does not have a primary care physician, the clinic offers that person a list of local practices that are accepting new patients, he added.

"About half of the people that MinuteClinics see don't have a regular primary care physician," he noted. "So MinuteClinics make an effort to refer these patients to doctors in the community who are accepting new patients."

FMAHealth decided to collaborate with CVS, he said, because, unlike some other retail clinics, the MinuteClinics have a policy of collaborating with, rather than trying to replace, primary care practices. Although its nurse practitioners monitor chronic conditions in addition to treating minor acute illnesses, they do so in cooperation with the patient's primary care physician, Dr Stream pointed out.

The MinuteClinics chain, which operates more than 1000 outlets in 33 states and the District of Columbia, has collaborative agreements with more than 60 provider organizations, according to a recent Accenture report. It is the largest retail clinic operation by far and has aggressive expansion plans. Overall, Accenture noted, the number of retail clinics in the United States is expected to grow to 2800 by 2020.

"Within the Right Guidelines"

Asked whether primary care physicians are concerned about the competition from retail clinics, Dr Stream said it depends on how many of those outlets are in their area, and on how much demand there is for primary care.

"There are areas that struggle with having enough capacity to deliver enough primary care services, and physicians and other primary care providers are overwhelmed by the demand for their services," he observed. "That's an opportunity where retail clinics, within the right guidelines, can be a useful contributor to the medical home concept."

One guideline is that retail clinics should focus mainly on care for minor acute illnesses, especially when primary care practices are not open, Dr Stream said. Any treatment of patients in retail clinics should be coordinated with "their usual source of primary care," he added.

In that respect, Dr Stream said, MinuteClinics have been good partners. "Even when they see patients with an existing doctor, they make every effort to communicate back and forth, so they can be an extension, rather than a replacement, for that practice." Some practices, he noted, send patients with minor problems to the retail clinics after hours.

Regarding other kinds of care, Dr Stream said, "Chronic illness care for conditions such as diabetes and hypertension should not primarily be managed in retail clinics. But if they collaborate with my practice, and patients go to the retail clinic to have their blood pressure checked when they can't get in to see me conveniently, there could be true collaboration."

MinuteClinics, which use the Epic electronic health record, can exchange health information online with practices that use Epic and can also participate in health information exchanges, he noted. In a pinch, they can send faxes back and forth with practices. Although that is not ideal, Dr Stream pointed out that interoperability is not great between primary care practices and other healthcare providers, either.

By: Ken Terry
Posted on Medscape.

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