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 Michael D. Fine, MD, Rhode Island's Director of Health, Thursday approved the application of CVS MinuteClinics Diagnostics of Rhode Island, LLC to license seven healthcare facilities in Rhode Island, but with a number of significant conditions attached. In deciding to approve the license application of the CVS MinuteClinics' request to open seven MinuteClinic locations in Rhode Island, and in determining the conditions upon which that approval depends, the Department has carefully investigated and considered the effect these services will have on Rhode Islanders' access to primary care, and on the quality of patients' relationships with primary care providers within both the MinuteClinics and primary care practice settings. In assessing the expediency of conditions of licensure, the state agency addressed concerns regarding (1) potential conflicts and the appearance of conflicts of interest incident to the corporate structure and relationships between pharmacy and prescribers; (2) the potential fragmentation of primary care delivery and effect on the primary care business model; (3) the appropriateness of pediatric care in the MinuteClinic setting, and; (4) patient access for underserved communities.  "Primary care based delivery systems around the nation and around the world create the best population health outcomes at the lowest cost, "Dr. Fine said. "Primary care practices have been significantly challenged by the necessity of functioning as businesses in a world in which they have no effective market power, while obligated to meet regulated standards of professional practice, and by their own ethical commitments." Accordingly, serious consideration has been given to the issue of MinuteClinics' potential to erode the underpinnings of the primary care practice model. "CVS is a great Rhode Island company," Dr. Fine said. "A company whose character, commitment, competence, and standing in the community is well documented. It is likely that these facilities will provide safe and adequate treatment for individuals receiving MinuteClinic services." Approval of MinuteClinics' request for licensure is contingent upon MinuteClinics' acceptance of the Health Department conditions, which are intended to maintain a level playing field, to protect the health and safety of all Rhode Islanders, to provide access to health services for the traditionally underserved, to prevent conflicts of interest between MinuteClinic prescribers and CVS pharmacy dispensers, to develop a balanced healthcare system, and to ensure the seamless and confidential flow of personal health information to facilitate the best patient care.
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