In the post-Affordable Care Act era, patients are becoming empowered consumers that have a much bigger say in how and where their healthcare dollars are being spent. In the new world of retail healthcare, providers such as Walmart are getting it right.

They have a better understanding of what patients really desire rather than what traditional healthcare providers want patients to want.

Retail clinics understand this growing shift in consumer preferences and have responded by lowering the cost of care. They’ve also taken steps to make care more convenient, such as extending hours of operation, offering visits without appointments, and opening locations on practically every corner.

Retailers have also customized services, offering face to face consultations as well as virtual consultations via webcam or phone.

Walmart, the provider of $4 generic pharmaceuticals, now provides $4 clinical visits covering a range of services, from diagnosis and treatment of basic medical conditions to management of chronic disease.

So how do retailers keep costs low? Certified nurse practitioners, who are fully licensed, credentialed, and experienced to provide primary healthcare, are the main reason behind such low costs of care. Additionally, the sheer volume of their business also helps to drive costs down—combined, CVS, Walgreens, and Walmart see more than 50 million visits a day.

So what does this mean for emergency departments and primary care facilities? Here are a few thoughts:

  • Hospitals should see a decline in the lower acuity “fast track” visits in their EDs, allowing them to focus on higher-acuity patients and true emergency cases.
  • EDs might explore creating larger exam rooms to accommodate the needs of more serious cases and increase the number and types of equipment available.
  • The decreased patient volume will also allow hospitals to dedicate resources to improving the patient experience in the ED, even borrowing design cues from retail competitors. For example, convenient parking should be located near the front door, while waiting should be decreased or eliminated altogether, improving throughput and getting patients in and out in a timely manner.
  • Primary care physicians’ offices are also likely to see fewer wellness visits and a decrease in low-acuity patients. To recapture these patients, it will be important to pursue locations in high-traffic areas with convenient access, all with the operational efficiencies retail competitors are boasting, too.
  • Hospitals and primary care physician offices don’t have to worry about losing their entire market share yet, though, as they still have an advantage over the retail providers in the relationships they’ve built with patients and the medical expertise they possess.

Jim Atkinson, AIA, EDAC, LEED AP, is vice president and director of healthcare design and planning for HDR Architecture. He can be reached at Follow him on Twitter at @jimatkinsonhdr.