09
Jul 12

The Dark Matter of Walk-In Health Care

Invisible in this nifty retail clinics growth chart from Tom Charland’s Merchant Medicine by way of a 6/27/12 Wall Street Journal article is the ‘force’ (forces, maybe) that helps explain why retail clinics appear to have bumped into a stubborn ceiling:

Have you guessed it? No?

It’s urgent care clinics. For extra credit, it’s urgent care clinics plus community health centers.

There are over 10,000 urgent care clinics; there are approximately 1,200 community health centers. Both deliver a lot of routine non-emergency health care to people in the US. Neither populate the graph of retail clinics above.


22
Mar 12

Mobile + Retail = Convenient Care Future?

While we’re not completely convinced that we’ll soon see evidence its conclusions are timely, we are big fans of MobiHealth News’ recent report on the intersection of mobile health devices and applications and retail clinics (Mobile health at the clinic, Brian Dolan, MobiHealthNews, March 22, 2012).

….As new entrants like Walmart step up to build out retail clinics that provide primary care services, large employers continue to roll out on-site clinics, and existing retail clinic chains ink deals with local hospital groups to form collaborative care systems, mobile health services will have an increasing presence at the clinic….

For our money, Brian Dolan is the Nate Silver of mobile health, and mobile health is as convenient a bellwether of health innovation as you’re going to find.

What’s that you say? You haven’t read the report yet, even though it’s free? What on earth are you waiting for?


11
Nov 11

11 Things You Must Know About Walmart’s Latest Health Care Business Moves

Yes, the title’s a gimmick – sue me.

Walmart’s October distribution of a health and wellness services & products Request for Information was a highlight of Wednesday’s health news stream. Many of the stories, blog posts, tweets, etc got a lot of the story right. Some got some of it wrong. Here are the eleven things you MUST know to keep the story straight:

1. News of Walmart’s (WMT’s) moves generated plenty of media attention We circulated a meaty collection of them yesterday afternoon.

2. Despite WMT US Health & Welfare President Dr. Agwunobi’s Wednesday afternoon “correction”, WMT’s RFI in fact seems carefully designed to equip WMT to provide “national…low-cost primary care health care platform”

3. Integration of primary care services would seem to be a prime opportunity for WMT – yet WMT’s correction suggests they’re not going there. Our examination of the 14-page RFI suggests that of the objectives it identifies, this may be the only one that they are NOT in fact pursuing as assertively as they could.

4. Their 14 page health and wellness RFI is reported to have been sent to “dozens” of potential service and product providers Oh to be a fly on the wall of the response planning meetings of the recipient enterprises….

5. WMT’s persistence in pursuing a health care business niche, rather than its successes or failures, is the thing to pay attention to in all of this Some of the news headlines to the contrary, health care is not a new infatuation for Walmart. The history of their actions, together with last Wednesday’s news, suggest they’re in it and after it for the long haul.

6. They’ve had retail clinics for years Some reports, and internet commentary on the news, give the impression that Walmart is new to the clinics business. Not so..

7. Walmart is the 3rd largest operator of clinics

8. They began offering clinical professionals commercial EHR software and services in 2009

9. There’s little value in linking their new business moves to the changes they made in employee benefit plans for their own employees Several news stories reference Walmart’s recently-announced redesign of health benefits for their employee populations, implying that their foray into providing health and welfare services and products is intended to deflect, offset, or otherwise “cover” for their health benefit changes for their employees.

To those who sincerely believe there is a direct connection I can only say “Oh, please”.

10. WMT will find some opportunity in diminishing unit costs of specific primary care services – but more in Walmart brand loyalty/’stickiness’ (‘sickiness’?) Along with opportunity there are brand risks as well; health care is not hand soap.

11. Extra reading on the latest expert analyses of retail clinic usage (free subscription required) and broader trends in the re-invention of primary care shed a lot of light on the import of Walmart’s new initiative . A lot.*

12. There are probably more than 11 things to know about WMT’s latest health care business moves, so stay tuned to further installments – especially when there are signs of information about responses to the RFI….

*(UPDATE: California Healthcare Foundation has posted the revised Health Care Everywhere report


10
Nov 11

Everybody’s Talking About Walmart’s Wild Wednesday News Day

We arose today with ambitious plans to compose our thoughts about the National Public Radio story, and ensuing news stream, on the Health and Wellness Request For Information reportedly circulated by Walmart in late October to an as-yet-unidentified cadre of “dozens” (according to the New York Times) of potential providers of primary health care products and services presumably to be offered under the Walmart brand. Our observations are naturally many, varied, and each one profound.

Alas, we have gotten no further than compiling our certain-to-be-incomplete collection of news sources on the intriguing story, in which NPR’s 4-minute morning story about Walmart’s solicitation of proposals to provide services quite narrowly defined in the RFI provoked considerable discussion among health care business and policy analysts, and ultimately a terse afternoon “correction” via press release from Dr. John Agwunobi, Senior Vice President & President of Walmart U.S. Health & Wellness, reproduced here in its entirety:

Walmart Statement in Response to Health & Wellness Request for Information

BENTONVILLE, Ark., Nov. 9, 2011 /PRNewswire via COMTEX/ — “The RFI statement of intent is overwritten and incorrect. We are not building a national, integrated, low-cost primary care health care platform.”

For now we’ll only say that while the document in question slights its devotion to the matter of “integration”, in most courts of opinion it would serve quite well as Exhibit A for Walmart’s intent to construct a national, low-cost primary care health care platform.

That’s curious to us, for we feel integration is the chief strength Walmart would bring to the assembly of such a platform. But we’ll elaborate on that when we complete our summary masterwork on this news.

For now we hope you will be pleased to peruse a collection of the various “Walmart’s new health initiative” stories more conventional news sources released yesterday and today (most displayed in chronological order):

Wal-Mart Plans Ambitious Expansion Into Medical Care (Julie Appleby, Sarah Varney, National Public Radio, 11/9/11)

Request for Information: Walmart Health & Wellness (Walmart, distributed 10/21/11)

Walmart Wants To Be Nation’s Biggest Primary Care Provider (Kaiser Health News, 11/9/11)

Walmart denies plan to build major health platform (Reuters, 11/9/11)

Walmart Clarifies, Sort Of (Kaiser Health News, 11/10/11)

**What About Walmart’s Plans to Add Health Clinics? (Kaiser Health News, 11/10/11) This is a collection of links to, with thumbnails of, stories released by WSJ, LA Times, USA Today, Reuters, and ABC

Walmart wants to be your MD (MSNBC, 11/10/11)

Retail Health Care Competition Heats Up (Bruce Japsen, New York Times, Prescriptions: The Business of Health Care blog, 11/10/11)


08
Mar 11

Next Up for NextDoor…?

We had not really zoomed in on NextDoor Health, which apparently devotes itself to operating retail clinics in Walmart locations in states.

By our count (which is from their website’s list of clinics already opened). they are currently operating 7 Clinic at Walmarts.

But they plan to be running threefold that number by May. With additional clinics apparently in the works .

Yeah, we’ll be watching them like a nosy next door neighbor….

NextDoor’s role, as operator of clinics which frequently are branded by a local hospital as well as with Walmart’s own formidable ensign, makes for a most complex thicket of brands surrounding their clinic “product”. That becomes a special management challenge.


02
Sep 10

Green Shoots, The Sequel (vol 3)

Clinic operators continue to shift their mix of locations, closing here, opening there, changing operating hours elsewhere. Target’s announcement of plans to open five new Chicago-area clinics (Chicago Breaking Business, 9/2/10; immediate access) is just the latest sign of retail clinics’ continued evolution.

UPDATE: WalMart has also recently opened a new clinic in Palmyra, ME – it’s 100th retail clinic, according to available news stories.

Target has made few changes in its clinics mix in the past few years. The five new Chicago clinics will bring their total to 36 – a large move percentagewise, but not one that will vault Target into the ranks of the leading clinic operators, CVS (MinuteClinic), Walgreens (Take Care Health), Kroger (The Little Clinic), or WalMart.


04
Jun 10

Target Plans More Clinics

While there’s been a ripple of new-clinic-opening activity by Walmart and regional hospitals over the past several months, the “majors” (outside of The Little Clinic) have been fairly quiet, tweaking hours and service offerings here & there. (We think of the majors as MinuteClinic, Take Care Health, The Little Clinic, RediClinic, Walmart, and Target – major in terms of their pre-established retail presence and/or the fanfare with which they entered the retail clinics business.)

So it’s of some note that Target announced in yesterday’s Chain Drug Review that they would open eight new clinics in September 2010. CDR’s Russell Redman announced that Target would open three stores in Palm Beach FL and five in Chicago.