Table of Contents
1: Executive Summary
Scope and Methodology
The U.S. Healthcare Market
The Emergence of Retail Clinics
2: Introduction
The U.S. Healthcare System Today
Overview
The Need for Alternatives
High Cost of Care
Inconsistent Quality of Care
Delays to Treatment
Insufficient Focus on Wellness and Prevention
Healthcare Reform
Medical Tourism
The History of Retail Clinics
Retail Clinics Today
Business Model
Consumer Response
Growth Drivers
Challenges
Kalorama Survey on Consumer Retail Clinic Feedback
Establishing a Retail Clinic
Demographics and Location
Choice of Outlet
Systems and Scheduling
Funding and Expansion
Alliances
3: Out-of-pocket Expenditures: The Market in 2016
Types of Expenditures
Insurance Co-Payments
Direct Payments
Premiums and Plan Fees
Payment Methods
Cash or Check
Credit Cards
Loans and Lines of Credit
Flexible Spending Accounts
Health Savings Accounts
Medical Financing
Amount Financed
Elective Procedures
Non-Elective Procedures and Prescription Drugs
Non-Elective Procedures and Prescription Drugs
Consumers Who Pay Out-Of-Pocket
The Uninsured and Underinsured
Medicaid Recipients
The Disabled
Senior Citizens
The Mentally Ill
The Obese
Persons with Alcohol and Drug Addictions
Persons with Chronic Conditions
4: Out-of-Pocket Expenditures: The Market in 2015 – 2020
Trends
Out-of-Pocket Expenditure Growth Drivers
Out-of-Pocket Expenditure Growth Constraints
Forecasts
Expenditures by Type
Payment Methods
Amount Financed
Types of Expenses Financed
Consumers Who Pay Out-of-Pocket
5: Retail Clinic Service Providers
The Industry
Convenience Clinic Sales Forecasts
The Market
Competitive Positions of Key Players
6: Retail Clinic Suppliers
Point of Care Tests
The Industry
Competitive Positions of Key Players
Convenience Clinic Sales Forecasts
Clinical Chemistry and Immunoassays
The Industry
Competitive Positions of Key Players
Convenience Clinic Sales Forecasts
Vaccines
The Industry
Competitive Positions of Key Players
Convenience Clinic Sales Forecasts
7: Outlets for Retail Clinics
Drug Stores
The Industry
Competitive Positions of Key Players
Other Medical Care
Convenience Clinic Sales Forecasts
Food Stores
The Industry
Competitive Positions of Key Players
Other Medical Care
Convenience Clinic Sales Forecasts
Mass Merchandisers
The Industry
Competitive Positions of Key Players
Other Medical Care
Convenience Clinic Sales Forecasts
8: Total Market
Kalorama Retail Clinic Survey
9: Issues and Trends
Health Care Reform
Physician Shortages
Public Awareness
Competition with Primary Care Providers
Regulation
Overview
Regulation of Convenience Clinics
Pending Legislation
Development of Standards
Streamlining of Services
Labor Shortages
10: Company Profiles
Aurora Quick Care
History and Lines of Business
Financial Information
Convenience Clinics
Bellin Health Fastcare
History and Lines of Business
Financial Information
Convenience Clinics
Capitol One Healthcare Finance
History and Lines of Business
Financial Information
Patient Financing
CareCredit
History and Lines of Business
Financial Information
Patient Financing
CareSpot
History and Lines of Business
Financial Information
Convenience Clinics
Clear Balance
History and Lines of Business
Financial Information
Patient Financing
Credit Medical
History and Lines of Business
Financial Information
Patient Financing
E-Financing Solutions
History and Lines of Business
Financial Information
Patient Financing
MedChoice Financial
History and Lines of Business
Financial Information
Patient Financing
MinuteClinic
History and Lines of Business
Financial Information
Convenience Clinics
RediClinic
History and Lines of Business
Financial Information
Convenience Clinics
Reliance Medical Finance
History and Lines of Business
Financial Information
Patient Financing
The Little Clinic
History and Lines of Business
Financial Information
Convenience Clinics
Walgreens Boots Alliance
History and Lines of Business
Financial Information
Convenience Clinics
List of Exhibits
2: Introduction
Figure 2-1: Distribution of Health Plan Enrollment for Covered Workers by Plan Type, 1988 – 2015
Figure 2-2: National Health Expenditures (NHE) and NHE as a Percent of GDP,1980 – 2015
Figure 2-3: Average Annual Health Insurance Premiums and Worker Contributions for Family Coverage, 2005 – 2015
Figure 2-4: Unnecessary Deaths Resulting From Variations in Health Care Quality, by Condition
Table 2-1: U.S. Health Care Coverage of the Non Elderly, 2014
Table 2-2: Cost Savings From Medical Tourism For Various Procedures, 2016
Table 2-3: Scope of Practice Laws for Non-Physician Medical Practitioners
Table 2-4: Estimated Number of U.S. Convenience Clinics, 2009 – 2020
Table 2-5: Characteristics of Retail Outlets, 2016
Table 2-6: Benefits and Drawbacks of Convenience Clinic Funding Approaches,2016
3: Out-of-pocket Expenditures: The Market in 2016
Figure 3-1: Premium Increases vs. Increases in Workers Earnings and Prices,2000 – 2015
Figure 3-2: Consumer Out-of-pocket Health Care Expenditures, 2015
Figure 3-3: Consumer Out-of-pocket Health Care Expenditures by Payment Type, 2015
Table 3-1: Main Business Activities of Selected Medical Financing Companies,2016
Figure 3-4: Average Out-of-Pocket Payment by U.S. Residents with Health Care Spending by Percentile of Total Health Spending, 2015
Figure 3-5: Methods of Financing Elective Procedures, 2015
Figure 3-6: Average Share Paid Out-of-Pocket by U.S. Residents with Health Care Spending by Type of Service, 2015
Figure 3-7: Average Share Paid Out-of-pocket by U.S. Residents with Health Care Spending by Percentile of Total Health Spending and Type of Service, 2015
Figure 3-8: Distribution of Out-of-pocket Spending on Non-Elective Procedures for the Average Person, 2015
Figure 3-9: Distribution of Out-of-pocket Spending for the Average Person, by Spending Level, 2015
Figure 3-10: Drug Cost Coverage by Payor Type (Public, Private, Cash), 1965,1986, 2000, 2005, 2010, 2015
Table 3-2: Obesity in the United States, 1980 – 2019
Figure 3-11: National Overdose Death Rates, Number of Deaths from Prescription Drugs, 2001 – 2014
Figure 3-12: National Overdose Death Rates, Number of Deaths from Heroin,2001 – 2014
Figure 3-13: Proportion of Adults Under Age 65 with Chronic Conditions, 2015
4: Out-of-Pocket Expenditures: The Market in 2015 – 2020
Table 4-1: Selected Rx-to-OTC Switches in the United States, 1990 – 2015
Table 4-2: Consumer Out-of-Pocket Expenditures per Worker, 2010–2020
Table 4-3: Consumer Out-of-pocket Expenditures by Type, 2010–2020
Figure 4-1: Proportion of Consumer Out-of-pocket Spending by Type of Health Care Expenditure, 2010, 2015, 2020
Table 4-4: Consumer Out-of-pocket Expenditures by Type, 2010–2020
Figure 4-2: Proportion of Consumer Out-of-pocket Spending by Payment Type,2010, 2015, 2020
Table 4-5: Amount of Consumer Out-of-pocket Expenditures for Elective Procedures That Are Financed, 2010–2020
Table 4-6: Amount of Consumer Out-of-pocket Expenditures for Non-Elective Procedures That Are Financed, 2010–2020
Figure 4-3: Proportion of Consumer Out-of-Pocket Spending for Elective Procedures That Are Financed (All Methods), 2015 – 2020
Figure 4-4: Distribution of Out-of-Pocket Spending on Non-Elective Procedures for the Average Person, 2015, 2020
Figure 4-5: Proportion of Consumer Out-of-pocket Spending for Non-Elective Procedures That Are Financed (All Methods), 2015 – 2020
Table 4-7: Size of High Risk Groups for High Out-of-Pocket Health Care Expenditures, 2010–2020 (Millions of Persons)
5: Retail Clinic Service Providers
Table 5-1: The U.S. Market for Retail Clinic Services, 2010–2020
Figure 5-1: Growth of U.S. Retail Clinic Services, 2010–2020
Table 5-2: Leading Service Providers’ Revenues and Market Share, U.S. Market for Convenience Clinics, 2015
Figure 5-2: Market Shares of Leading Retail Clinic Service Providers, 2015
6: Retail Clinic Suppliers
Table 6-1: Sales to Retail Clinics by Supplier Segment, 2010–2020
Figure 6-1: Growth of Retail Clinic Supplier Sales by Type of Supplier,2010–2020
Table 6-2: U.S. Professional POC Test Sales, 2010–2020
Table 6-3: Leading POC Test Makers’ U.S. Revenues and Market Share, 2015
Table 6-4: U.S. Professional POC Test Sales to Retail Clinics, 2010–2020
Table 6-5: U.S. Professional POC Test Sales to Retail Clinics by Segment,2010–2020 (Cholesterol Tests; Diabetes Tests; Strep, Influenza &
Pneumonia Tests; Pregnancy; Other Tests; Total POC Tests)
Table 6-6: U.S. Clinical Chemistry and Immunoassay Sales, 2010–2020
Table 6-7: Leading Clinical Chemistry and Immunoassay Suppliers’ Revenues and Market Share, 2015 (Clinical Chemistry, Immunoassays, Total)
Table 6-8: U.S. Clinical Chemistry and Immunoassay Sales to Convenience Clinics, 2010–2020
Table 6-9: U.S. Clinical Chemistry and Immunoassay Sales to Convenience Clinics, by Segment, 2010–2020 (Tests for Strep, Tests for TB, Other Tests,Total Tests)
Table 6-10: Diseases for Which Vaccines Are Available in the U.S., 2016
Table 6-11: U.S. Market for Preventative Vaccines, 2010–2020 (Adult Vaccines,Pediatric Vaccines, Total)
Table 6-12: Leading Vaccine Manufacturers’ U.S. Revenues and Market Share,2015
Table 6-13: U.S. Vaccine Sales to Convenience Clinics, 2010–2020
Table 6-14: U.S. Vaccine Sales to Convenience Clinics, by Segment, 2010–2020(Vaccine for Flu, Vaccine for HPV, Vaccine for MMR, Vaccine for Pneumonia,Vaccine for Td/Tdap/Dtap, Other Vaccines, Total Vaccines)
7: Outlets for Retail Clinics
Table 7-1: Number of Retail Clinics by Type of Retail Outlet, 2010–2020(Drug Stores, Supermarkets, Mass Outlets, Total)
Figure 7-1: Proportion of Retail Clinics by Type of Retail Outlet, 2010–2020(Drug Stores, Food Stores, Mass Outlets)
Table 7-2: Rents Collected from Retail Clinics by Type of Retail Outlet,2010–2020 (Drug Stores, Supermarkets, Mass Outlets, Total)
Figure 7-2: Proportion of Rents Collected from Retail Clinics by Type of Retail Outlet, 2010–2020 (Drug Stores, Food Stores, Mass Outlets)
Table 7-3: Indirect Income Generated by Retail Clinics by Type of Retail Outlet,2010–2020 (Drug Stores, Supermarkets, Mass Outlets, Total)
Figure 7-3: Proportion of Indirect Income Generated by Retail Clinics by Type of Retail Outlet, 2010–2020 (Drug Stores, Food Stores, Mass Outlets)
Table 7-4: Selected Retail Outlet Relationships with Convenience Clinics, 2016
Table 7-5: U.S. Drug Store Sales, 2010–2020
Table 7-6: Leading U.S. Drug Stores’ Revenues and Market Share, 2015
Table 7-7: U.S. Drug Store Direct Retail Clinic Revenues in the Form of Rents,2010–2020 (Number Stores, Square Footage, Cost per Square Foot, Total Rents) .. 163
Table 7-8: U.S. Drug Store Indirect Retail Clinic Revenues, 2010–2020 (Number of Clinics, Patients/ Clinic/Day, Incremental Sales per Patient, Total Indirect Revenue)
Figure 7-4: Direct vs. Indirect Revenues to Drug Stores from Retail Clinics,2010–2020 (Total Indirect Revenue, Total Rents)
Table 7-9: U.S. Food Store Sales, 2010–2020
Table 7-10: Leading Food Stores Revenues and Market Share, 2015
Table 7-11: U.S. Food Stores Direct Retail Clinic Revenues, 2010–2020 (Number of Stores, Square Foot/Store, Cost/Square Foot, Total Rents)
Table 7-12: U.S. Food Store Indirect Retail Clinic Revenues, 2010–2020 (Number of Clinics, Patients/ Clinic/Day, Incremental Sales per Patient, Total Indirect Revenue)
Figure 7-5: Direct vs. Indirect Revenues to Food Stores From Retail Clinics,2010–2020 (Total Indirect Revenue, Total Rents)
Table 7-13: U.S. Mass Merchandiser Retail Sales, 2010–2020
Table 7-14: Leading U.S. Mass Merchandisers Retail Revenues and Market Share, 2015
Table 7-15: U.S. Mass Merchandiser Direct Retail Clinic Revenues, 2010–2020(Number of Stores, Square Foot/Store, Cost/Square Foot, Total Rents)
Table 7-16: U.S. Mass Merchandiser Indirect Retail Clinic Revenues, 2010–2020(Number of Clinics, Patients/ Clinic/Day, Incremental Sales per Patient,Total Indirect Revenue)
Figure 7-6: Direct vs. Indirect Revenues to Mass Merchandisers from Retail Clinics, 2010–2020 (Total Indirect Revenue, Total Rents)
8: Total Market
Table 8-1: Retail Clinic Service Revenues, 2010–2020
Table 8-2: Sales to Retail Clinics by Suppliers, 2010–2020
Table 8-3: Revenues to Retailers from In-Store Clinics, 2010–2020
Figure 8-1: Revenues to Retailers from In-Store Clinics, 2010–2020 (Indirect Income, Direct Income)
9: Issues and Trends
Table 9-1: Selected U.S. Federal and State Health Care Oversight Bodies, 2016
Table 9-2: Retail Clinic Legislation by State, 2016
