Clinics a key part of health reform
MASSACHUSETTS boasts a long tradition of pioneering innovations in public health, from the nation's first local board of health - chaired by none other than Paul Revere - to Columbia Point Health Center in Dorchester, the first nonprofit community health center in the United States, to the first-in-the-nation law ensuring access to healthcare for all. That ethic of innovative leadership is evident again, as the state's public health leaders develop a regulatory context for a promising new model of healthcare delivery called "limited-service clinics."
These conveniently located clinics - at which nurse practitioners treat common ailments seven days a week, at a much lower cost and shorter waiting times than emergency rooms - are already blossoming around the nation. MinuteClinic, for example, has provided routine healthcare through more than 1 million patient visits at more than 250 locations in 22 states.
Limited-service clinics can make an important contribution to the process of healthcare reform. The nation's discussion on health reform, as in Massachusetts, has focused on four imperatives for medical care: access, quality, affordability, and continuity of care. Limited-service clinics can help on each front.
In addition to being conveniently accessible seven days a week, limited-service clinics can expand access to high-quality care by helping people who do not have insurance, or who lack a primary-care physician, to find both. MinuteClinic creates collaborative relationships with providers, and regularly helps patients to find an ongoing "medical home."
Often uninsured patients slip through the cracks, unseen until they emerge sick or injured at the healthcare system's most expensive points. Because they are among those patients who may visit a limited-service clinic, the providers can treat them and then help steer them toward affordable options under Massachusetts' health reform law for ongoing primary care.
MinuteClinic, accredited by The Joint Commission, contributes to healthcare quality because it practices evidence-based medicine. A recent study showed, for example, that patients who sought care at MinuteClinic for sore throats received best-practice treatment 99 percent of the time, compared with 55 percent for the medical community nationwide.
Meanwhile, by treating routine conditions, these clinics can also improve the capacity of the state's healthcare system by freeing emergency rooms to focus on genuine emergencies and enabling physicians to spend more time providing comprehensive support for their patients' complex and chronic conditions. Currently, MinuteClinic provides care only for persons 18 months and older.
Limited-service clinics across the country are helping to lower healthcare costs. A typical MinuteClinic visit costs $59 - and most insurers will cover it - compared with $350 for a trip to the emergency room. What's more, a patient in the emergency room is often forced to wait for hours, while limited-service clinics can see patients in minutes.
Finally, MinuteClinic uses the latest technology to ensure the quality and continuity of care. For example, it uses secure and rapid technology to transmit patients' visitation summaries to their primary-care provider after each visit.
Of course, Massachusetts knows better than anyone that healthcare reform is complicated. No one model will decide its success or failure. What limited-service clinics can do is to help meet an important need: expanding the state's capacity for delivering quality, affordable, and accessible care for acute, common family ailments. In doing that, they can help healthcare reform succeed. And Massachusetts' long tradition in healthcare - a tradition marked by innovation and excellence - can be the guide.
Michael Howe is the chief executive of MinuteClinic.
