For healthcare consumers, cost is often king. About half of Americans report having difficulty affording medical care and four in ten say they’ve avoided or delayed care because of cost, according to Kaiser Family Foundation. About the same proportion (44%) in another survey reported avoiding care because of uncertainty about cost.
But research released last month from the Deloitte Center for Health Solutions suggests that another factor is also extremely important to consumers: convenience.
Alternative sites of care—which include retail clinics, telehealth, at-home care, or mobile care units in communities, among others—have the potential to expand access and reduce health inequalities, according to the Advancing Health Through Alternate Sites of Care report, based on a nationally representative sample of more than 4,500 consumers and online focus groups with more than 450 consumers of color.
“Alternate care sites can provide more access points in convenient places that consumers are already ‘living, playing, and shopping,’” said Dr. Jay Bhatt, executive director of the Deloitte Center for Health Solutions and the Deloitte Health Equity Institute, and one of the report’s authors. “We understand that there is a premium in meeting patients where they are in their health journey, and alternative care sites are part of a continuum of care that can help reduce friction, lower costs, and address the last mile.”
But the report shows a disconnect between those who actually uses alternative sites of care and those who say they would use them. This disconnect was especially clear in data on retail clinic usage. Just one in ten respondents said they have used a retail clinic in the past year, but 55% said they were likely to or might use a retail clinic for preventive care. Nearly half (47%) said the same for mental healthcare.
Some groups were more likely to say they would use retail clinics than others. Urban respondents were both more likely to have used retail clinics than people in rural areas (15% compared to 8%, respectively) and to say they would visit a retail clinic in the future. Two-thirds (65%) of urban consumers said they would use retail clinics for preventive care and 57% said they would use retail sites for mental healthcare. In contrast, about half of both suburban (51%) and rural (47%) respondents said they would use retail clinics for preventive care and 37% of each group said the same for mental healthcare.
Though similar percentages of consumers by race or ethnicity reported using retail clinics in the past year (between 8% and 12%), respondents of color were more likely than white respondents to express openness to retail clinics. Two-thirds (66%) of Asian consumers said they were likely to use retail clinics for preventive care compared with 63% of Hispanic and 59% of Black respondents. In contrast, just 52% of white consumers said they would use retail sites for preventive care in the future.
The differences were narrower in mental health. About half of Asian (48%), Hispanic (51%), and Black (51%) respondents said they’d consider seeking mental health services at a retail clinic compared with 41% of white respondents.
The report also analyzed telehealth usage. Overall use of virtual care has increased dramatically since 2018, aided by the pandemic conditions that made virtual care essential. By 2022, Deloitte’s data show that overall, 42% of consumers had had a virtual visit in the past year. Though younger consumers were more likely to have used virtual care than older consumers—including 56% of Millennials and 44% of Generation X compared to 32% of Baby Boomers and 24% of Seniors—increases in telehealth usage were consistent across age groups. Regardless of age, 84% of people who had had a virtual visit would have another.
The data showed that consumers are increasingly using virtual care for preventive and mental health services, not just urgent care.
Nearly two-thirds of consumers across racial and ethnic groups said they would use digital health for preventive services. A similar percentage (65%) of urban consumers would use virtual visits for preventive care, even with easier access to retail clinics. On the other hand, only about half of suburban (53%) and rural (51%) consumers said they’d use telehealth for preventive care, despite having less access to other convenient alternatives such as retail clinics.
The survey also revealed interest in telehealth for mental healthcare among certain subgroups. Nearly three-quarters of consumers on Medicaid (74%) and Health Insurance Marketplace plans (73%) said they would use digital health apps or virtual visits for mental health.
According to Bhatt, alternative sites of care could have a particularly big impact on access to mental healthcare.
“Alternative care sites can provide opportunities to receive care in places and circumstances that reduce stigma associated with care delivered in traditional settings,” he said. “This can be really important to patients seeking mental health services.”
More broadly, Bhatt said that alternative care sites can reach more people.
“Our healthcare system doesn’t work for everyone because it wasn’t built for everyone,” he said. “Alternative care sites could be helpful in reaching and caring for segments of the population that feel stigmatized or fear traditional care settings.”
According to Bhatt, removing barriers to care for these groups could help reduce the cost of health inequities, which Deloitte previously estimated costs the United States $320 billion in unnecessary spending every year.
As healthcare providers and consumers get more comfortable with alternate care sites, Bhatt said they offer convenient, high-quality, affordable care options.
For consumers, Bhatt issued this guidance: “If you’re not getting the experience you want or access to the providers you want, there are other options to get connected to clinicians who you trust, who you can build a better rapport with, or provide a quality experience that you aren’t getting now.”