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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Medical Home: Usual Source of Sick Care.

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Strategy. Retail Clinics

Approach. Support retail clinics to increase opportunities for regular sick care of children.

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Overview. Retail clinics offer rapid access to basic healthcare services for minor illnesses such as sore throats or skin conditions, along with immunizations, pregnancy testing, and preventive care like routine lab tests, including cholesterol and diabetes screenings.[1] Some retail clinics also offer behavioral health screenings and chronic disease management.[2] Services are usually provided by non-physician providers such as nurse practitioners. (NPs) or physicians assistants. (PAs)[3], and care prices are posted and available before patients see the provider.[4] Retail clinics are usually open for longer hours than physician practices, including evenings and weekends, offering on-demand appointments in reachable locations.[3] Clinics are generally found in more affluent metro and suburban areas, and are located within retail stores such as CVS, Target, and Walgreens. Clinics may be owned by the retailer or associated with local physician practices or healthcare systems. Retail clinics are also known as retail pharmacy, walk-in, or convenient care clinics.[5]

Evidence. Expert Opinion. Strategies with this rating are recommended by credible, impartial experts...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Retail clinic appointment availability and after-hours access data
  • Patient and parent/caregiver satisfaction surveys
  • Clinic staff training and competency records

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Direct Care (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of retail clinics partnered with Title V established or expanded to provide sick care services for children. (Shows the availability and usability of the approach)
  • Number of non-physician providers (e.g., nurse practitioners, physician assistants) recruited and trained to deliver pediatric sick care services in retail clinics supported by Title V. (Indicates the workforce capacity to support the approach)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of non-physician providers in retail clinics partnered with Title V who demonstrate proficiency in pediatric assessment, diagnosis, and treatment through ongoing competency evaluations. (Shows the quality and effectiveness of the workforce delivering the approach)
  • Percent of pediatric sick care visits at retail clinics supported by Title V that include comprehensive, age-appropriate care (e.g., physical exams, diagnostic testing, patient education) per clinical guidelines. (Indicates the thoroughness and appropriateness of the care provided)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Retail clinics offer rapid access to basic healthcare services for minor illnesses such as sore throats or skin conditions, along with immunizations, pregnancy testing, and preventive care like routine lab tests, including cholesterol and diabetes screenings.[1] Some retail clinics also offer behavioral health screenings and chronic disease management.[2] Services are usually provided by non-physician providers such as nurse practitioners. (NPs) or physicians assistants. (PAs)[3], and care prices are posted and available before patients see the provider.[4] Retail clinics are usually open for longer hours than physician practices, including evenings and weekends, offering on-demand appointments in reachable locations.[3] Clinics are generally found in more affluent metro and suburban areas, and are located within retail stores such as CVS, Target, and Walgreens. Clinics may be owned by the retailer or associated with local physician practices or healthcare systems. Retail clinics are also known as retail pharmacy, walk-in, or convenient care clinics.[5]

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of retail clinics partnered with Title V providing pediatric sick care that are located in medically under resourced areas or health professional shortage areas as identified by Title V. (Shows the approach's reach and focus on addressing access challenges)
  • Percent of retail clinic staff partnered with Title V providing pediatric sick care who reflect the makeup of the communities served. (Indicates the responsiveness and representativeness of the workforce delivering the approach)
  • Percent of families who use retail clinics for their child's sick care and report a strengthened medical home relationship and continuity with their primary care provider. (Shows the approach's success in complementing, rather than fragmenting, the medical home model)
  • Percent of pediatric healthcare partners (e.g., payers, policymakers, professional associations) who recognize and support the role of retail clinics in providing usable, high-quality sick care for children as part of a coordinated healthcare system as a result of educational outreach conducted by Title V. (Indicates the approach's influence on shaping healthcare system norms and policies)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Win 2016 - Win AZ. The changing face of pharmacies in America: Retail clinics. Perspectives in Public Health. 2016;136(3):130-131.

2 Chang 2015a - Chang JE, Brundage SC, Chokshi DA. Convenient ambulatory care — Promise, pitfalls, and policy. The New England Journal of Medicine. 2015;373:382-388.

3 Hoff 2019 - Hoff T, Prout K. Comparing retail clinics with other sites of care: A systematic review of cost, quality, and patient satisfaction. Medical Care. 2019;57(9):734-741.

4 Alexander 2019 - Alexander D, Currie J, Schnell M. Check up before you check out: Retail clinics and emergency room use. Journal of Public Economics. 2019;178.

5 RAND-Retail clinics 2016 - RAND Corporation. The evolving role of retail clinics. Santa Monica: RAND Corporation; 2016.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.