  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.
