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Opportunities in Delivery of Preventive Services in Retail Settings

Recommended clinical preventive services are not being delivered despite well-documented benefits. Here we show that transferring simple and repetitive preventive services to nurse-staffed retail clinics provides an opportunity for dramatically improving their delivery. For each of 35 high-benefit, cost-effective preventive services, we identify required training, number of repetitions, and time and cost for full coverage in the US. We determine that full delivery through physician-based practices would require an unrealistic 400,000 full-time personnel. We estimate the efficiency gains from implementation at nurse-staffed clinics at retail locations for 28 services. Widespread adoption would result in a five-fold reduction in variable costs and three-fold reduction in personnel. By elevating the benefit-to-cost ratio, retail implementation can expedite widespread prevention coverage and help transform US healthcare.