The recent proliferation of retail clinics — more than 1,000 sites in 37 states — provides many consumers with an alternative source for certain types of care. These clinics, usually located in urban and suburban retail facilities and staffed primarily by nurse practitioners rather than physicians, offer fast access to evidence-based care at lower cost.

Retail clinics also pose challenges and opportunities for state policymakers and regulatory agencies. These include:

• Insufficient state regulation or physician oversight may lead to inappropriate care delivery or coordination;
• Clinic payment structures may exclude underserved populations;
• Care at retail clinics may interfere with the continuity of care a patient receives through a medical home, and retail clinics may reduce the viability of safety-net clinics;
• Retail clinics may present conflicts of interest, influencing patients to buy medications and other items at the facility where the clinic is located; and
• Corporate practice of medicine laws may deter some retail clinic systems from operating in a given state.

This issue brief explores how regulation and licensing in six states — California, Florida, Illinois, Massachusetts, New Jersey, and Texas — promote, structure, or limit retail clinics. The states' approaches to the clinics vary, as do interpretations of how existing regulations fit the retail clinic model. Only one state, Massachusetts, has written new regulations expressly for retail clinics.

The project's researchers interviewed stakeholders about each state's regulation of health services in retail settings. These included state Medicaid, licensing, and certification agencies; retail clinics; organizations that represent health care providers; and state legislators and their staff. Interview protocols were tailored for each stakeholder group.

This issue brief addresses some common themes that emerged concerning regulation of retail clinics, as well as each of the six states' unique responses to the emergence of retail clinics.

The full text of the issue brief is available under Document Downloads. A more detailed version of the project's findings can be found on the Web site of the National Academy for State Health Policy via the External Link.