Allina and MinuteClinic to join forces

In a marriage of giants, Allina Hospitals and Clinics is teaming up with MinuteClinic to coordinate care for patients and expand medical services down the road.

Allina is the biggest hospital and clinic group in the Twin Cities, with 11 hospitals and 90 clinics. MinuteClinic, the pioneer of bare-bones retail kiosks staffed by nurse practitioners, has 24 locations in the Twin Cities and 500 nationwide.

The deal announced Thursday is a sign of how far retail clinics have come, from being viewed with fear and suspicion by doctors to being essentially partners with the medical establishment.

"By coordinating care between the retail clinic setting and our clinics and hospitals, patients can feel confident that they will be well taken care of, whether they have a minor illness or something more serious," Kenneth Paulus, Allina's chief executive, said in a statement.

This is the second such partnership for MinuteClinic, coming after a similar deal with the Cleveland Clinic in Ohio. Though it started in Minneapolis, MinuteClinic is now owned by CVS Caremark, based in Woonsocket, R.I.

Mutual backup

Allina doctors will offer medical oversight to MinuteClinic nurse practitioners in Minnesota, and the two organizations will share electronic medical records. An Allina patient who visits a MinuteClinic, for example, will get that visit recorded in her Allina record.

Likewise, MinuteClinic may refer patients who need services beyond its limited scope to an Allina primary care doctor. "These are serious referrals that Allina is interested in," said Tom Charland, who runs a retail clinic consultancy, Merchant Medicine, in Shoreview. "The good news is they get some downstream referrals without the investment."

Other Minnesota clinic groups have experimented with opening their own retail clinics. HealthPartners has three, and Fairview Health Services has four. "To the extent that MinuteClinic and Allina are working together to coordinate care, that is a good thing," said HealthPartners spokesman Joe Dangor.

The Allina/MinuteClinic deal comes at a time of uncertainty in health care. Health care legislation in Congress contemplates ways to both cut payments and shift from paying for procedures to paying for outcomes.

That would pressure medical providers to be more efficient -- for example, patients with less serious conditions may be seen by nurse practitioners instead of doctors, at lower cost. That is already happening in some areas, with retail clinics the most obvious example.

"We anticipate payment reform, and having a cost-effective and efficient front-end like MinuteClinic makes sense," said Dr. Bob Wieland, an executive vice president who oversees Allina clinics.