How Surprise Bills and Retail Clinics are Influencing Healthcare Purchasing Patterns

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Written By Online Figure

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Frustrated by the lack of medical billing transparency, as well as pricey and time-consuming visits to the emergency room, customers are turning their attention – and money – towards retail clinics.

Recent consumer surveys show a radical change in behaviors in healthcare customers.

A poll by HealthSparq, for instance, found that 40 percent of interviewees would rather skip a routine check-up, physical, or other preventive screening than go to a hospital and risk getting an unexpected bill.

Their worries are well founded. In the past year alone, more than half of survey respondents said they received a surprise health bill. What’s more, 60 percent of them said they initially thought the services they were charged for were covered by insurance plans. As a result, 39 percent have avoided care when they or a family member were sick or injured.

Puzzled by the billing system, customers started migrating towards retail-style healthcare options such as retail clinics. Today, there are five times more ‘quick care’ sites than in 2010, according to a new report by Civis Analytics.

Customers are flocking to clinics like CVS Health’s MinuteClinic, Walgreens’ Healthcare Clinic, and Walmart’s Care Clinic not only because they are more convenient, but also because they are more affordable.

The up-front billing for out-of-pocket payments and the fact that there’s no need for appointments make clinics a fierce competitor for hospitals.

“Patients want good medical care, but they also value convenience and want healthcare to meet them where they are, rather than cause disruption to their daily lives,” said Crystal Son, Healthcare Analytics Lead at Civis Analytics.

The survey found that the bulk of clinic customers consists of younger people, who are in good health and need “one-and-done” primary care services. Around 40 percent of them seek care for minor illnesses or injuries, while over 30 percent of patients come for vaccinations.

The retail clinics industry is expected to expand even more by 2025, when experts predict it will reach $7.3 billion based on analysis of healthcare trends.

This upward trend can be best observed in Illinois where residents started going to clinics for minor conditions like flu and general aches. Blue Cross and Blue Shield of Illinois saw an 11.7 percent increase in the rate of retail clinic visits by patients with insurance through their employers between 2014 and 2015, shows a the 2017 Health of America Report.

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