In California, Kaiser Permanente (KP) operates 35 clinics inside Target retail stores, which seems like an unusual partnership on the surface. But in practice, the model helps KP open up capacity for office-based primary care physicians to handle chronic conditions and realize greater value for the system, according to Alan A. Ayers, MBA, MAcc, President of Urgent Care Consultants and Senior Editor of The Journal of Urgent Care Medicine. Ayers also believes the KP Target Clinics are a demonstration of how the retail model can work to address value-based care metrics. KP’s structure is unique in that its health plan members are generally limited to accessing care exclusively from KP’s own integrated provider network. And all of its providers have access to all the members’ medical records, which helps coordinate care across sites. “The Target Clinics use scheduled appointments but accept walk-ins until the day’s schedule is full, so the assumption is that these are built more for KP members who leverage their member portal to schedule in advance, while filling excess capacity with the general public,” says Ayers. The Target Clinics are open to anyone who seeks care but with limited acceptance of non-KP coverage.
You’re overdue: Unlike most retail clinic operators, Target Clinics employ both nurse practitioners and licensed practical nurses (LPNs) with the LPNs capturing care gaps and making referrals for follow-up visits. By remedying care gaps—such as overdue vaccines or cancer screenings—KP may be able to avoid downstream higher costs. “Value-based care is the most important point and the not-so-obvious business case for these clinics,” says Ayers. “This translates to a business case for KP that generally doesn’t exist outside of fully integrated ‘payvider’ systems.”