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If your child wakes up with a fever during the weekend and your family doctor isn't available until Monday, there are other ways to receive immediate medical care. A local shopping center may be an option.

A growing number of people visit roughly 1,200 retail-based clinics that operate in pharmacies, grocery stores and big-box outlets throughout the country.

Industry leaders say the clinics can improve access to health care as federal health care reform unfolds.

And because many regions suffer from a primary care physician shortage, making an appointment with a doctor is likely to get harder by 2014, when almost all Americans will be required to buy health insurance coverage.

Retail-based clinics aren't meant to replace primary care doctors. But they can fill a health care gap when patients need quick treatment, a screening for common ailments such as ear infections and strep throat, or vaccinations.

They are generally staffed by nurse practitioners and physician's assistants and offer walk-in appointments seven days a week -- including evenings. If a higher-level treatment is required, clinicians refer patients to physicians.

"Access to health care is key," says Gabriel Weissman, a spokesman for Take Care Health Systems, which operates 350 clinics inside Walgreens drugstore chains in 19 states. "Over 40% of our patients tell us that if it weren't for our clinics they would go to the emergency room, urgent care clinic or wouldn't seek treatment."

Retail-based clinics sprouted around the country about 10 years ago. MinuteClinic in CVS pharmacies and Take Care Health Systems in Walgreens now control roughly 77% of the market, according to a report by Deloitte Center for Health Solutions, "Retail Clinics: Update and Implications." Other retailers that offer walk-in clinics inside their stores include H-E-B stores, Target and Wal-Mart, which co-brands clinics and works with local health care systems to operate them.

Health insurance at retail clinics

Retail clinics originally targeted uninsured and underinsured patients who paid for most health care out of their own pockets. Today, most health insurance companies contract with retail clinics, and the vast majority of patients -- up to 80% of Take Care clients -- use insurance to pay for their visits.

Some insurers, such as Aetna, which has offered coverage for walk-in or retail clinics since 2005, pay claims no differently than for any other provider. Members typically pay the standard co-pay for a primary care physician or specialist visit, says Aetna spokeswoman Tammy Arnold.

But some health insurance plans, such as Blue Cross-Blue Shield and Health Partners, both in Minnesota, are dropping or reducing co-pays for retail clinic visits, which are generally less expensive than doctors' office visits. According to a 2009 report by Rand Health, an average visit to a retail clinic (excluding lab tests or prescriptions) costs about $66. Compare that to visiting a doctor's office ($106), an urgent care center ($103) or a hospital emergency room ($570).

Retail clinics experienced a rapid expansion in the mid-2000s, then growth slowed and the industry slimmed down, with about 150 retail clinic closings in 2008 and early 2009. RediClinic, for example, went from some 50 clinics to 20 in mid-2009, and Minute Clinic closed 104 underperforming clinics, reports Deloitte Center for Health Solutions.

More retail-based clinics on the horizon

Now the industry seems poised for another wave of growth. Merchant Medicine, which tracks retail clinics, projects that up to 4,000 clinics will be in operation by 2015.

"We're back on the growth path," declares RediClinic CEO Webster Golinkin, who is also president of the industry's trade group, the Convenient Care Association. "The landscape for retail clinics right now is quite positive. There's more support from the medical community and more awareness among consumers."