FAQContact usTerms of servicePrivacy Policy

No More Waiting Game for NPs

Monday May 5, 2008
Printer Icon
line
Select Text Size: Zoom In Zoom Out
line
Comment
Share this Nurse.com Article
rss feed
An NP-run convenient care clinic (CCC) is coming to a major retail outlet near you. The CCC industry, which began in 2000 in Minnesota, has taken flight nationally and is soaring into Washington, Maryland, and Virginia.

CCC NPs offer affordable, accessible, quality care and augment an overburdened healthcare system. They generally provide quick, walk-in care for patients 18 months and older with uncomplicated minor conditions, such as ear infections, urinary tract infections, bronchitis, and sinus infections. Located within convenient retail locations, CCCs generally are open seven days a week and holidays and accept most insurance plans, including Medicare and sometimes Medicaid. Services such as flu shots are offered daily.

“It’s an NP-driven model that promotes the role of NPs and the contributions they make to health care,” says Karen Frye, RN, FNP, manager of the Richmond, Va., districts for RediClinic, a CCC chain that includes nine clinics in the greater Richmond area in Wal-Mart Supercenters.

MinuteClinic, a CCC chain located within CVS/pharmacy stores, includes 17 clinics in Richmond and Northern Virginia and 27 in the Baltimore and Maryland Beltway areas. MinuteClinic says it anticipates expanding in the region this year. There are also five Target Clinics, located in Target stores in Maryland. My Healthy Access Inc. has one CCC location in Frederick, Md.

“These are wonderful places for this type of access, convenience, and affordability, because people in these areas often commute for long hours and are very busy,” says Anne Pohnert, RN, MSN, FNP, manger of operations for MinuteClinic in Northern Virginia and Washington.

Resistance and benefits
Resistance to the competitive CCC industry has included a demand from some members of the American Medical Association for a complete ban on CCCs and a call for investigation into perceived conflicts of interest, such as requiring or encouraging patients to fill prescriptions at on-site pharmacies. There also have been concerns about quality and fragmentation of care. The CCC industry is confident of its integrity, quality of care, and the benefits it offers the healthcare system.

Spokespersons for RediClinic and MinuteClinic say patients are encouraged to fill prescriptions at any pharmacy they choose, and CCCs provide patients with minor complaints a less expensive, alternate site to overcrowded EDs. The basic visit fee for a local RediClinic or MinuteClinic is $59.

“Even if we are not in-network with a particular insurance company, the choice is there for a $59 out-of-pocket expense compared to a co-pay of $75 to $100 for an ED visit, where you may have to wait for hours to be seen for an ear infection,” says Pohnert.

In addition, CCC pricing is standardized and transparent pricing for visits is an advantage for patients.

“For individuals with incomes that are fixed or who do not have insurance, that’s a huge advantage,” says Frye.

A major goal of the CCC industry is to work within the existing medical system to help people establish a medical home and reduce fragmentation of care. All patients seen at RediClinic and MinuteClinic who do not have a primary care provider receive a referral to someone in their area who accepts new patients and their form of payment or insurance. About 30% of patients seen nationally at MinuteClinic do not have a medical home, according to Donna Haugland, RN, MSN, CNP, director of practitioner services for MinuteClinic.

High profile NPs
The success of convenient care clinics is increasing visibility of NPs and their skills while presenting an opportunity for them to play a driving role in developing a new dimension in health care. In addition to staffing clinics, NPs fill roles as managers and directors of operations who are responsible for local and regional management of CCCs.

“NPs are very well known for teaching and preventative care, and our company incorporates that into the way we give care,” says Frye. This includes the development of programs for smoking cessation and screenings for high cholesterol, diabetes, heart disease, liver and kidney function, thyroid disease, allergies, prostatic specific antigen (PSA), and osteoporosis.

“This is an excellent opportunity for NPs to do all those things they do so well,” says Frye. “It’s a unique place for NPs to stretch their wings.”

Catherine Spader, RN, is a contributing writer for Nursing Spectrum.

To comment, e-mail editorDC@nursingspectrum.com.