This article is part of a series sponsored by HLTH highlighting topics that will be discussed at the HLTH conference November 13-16 in Las Vegas.
Retail pharmacy chains and Amazon are transforming themselves into omnichannel healthcare providers, developing primary care services and virtual tools through acquisitions, partnerships and investments. The goal is to not only adapt to the preferences of their own customers but to act on demographic shifts and perceived consumer needs to make healthcare more easily accessible through employer health plans.
The Covid-19 pandemic is a public health crisis that has tested the healthcare capabilities of these retailers. They have responded by delivering tests, vaccines, and masks and virtual primary care. The scale up of virtual healthcare during the height of the pandemic and the extension of the Covid-19 public health emergency means virtual health is here to stay and retailers are positioning their strategy accordingly.
Interestingly, not only are health tech companies aligning with retail partners, but primary care providers such as One Medical and Oak Street Health are aligning with health tech businesses to extend virtual health services to customers.
The 2021 Omnichannel Healthcare Experience report by Avtex surveying healthcare setting preferences by generation has some compelling findings. It noted that Millennials favored using walk-in retail clinics to address their primary care needs, in sharp contrast to Baby Boomers and Generation X who prefer going to a doctor’s office. Yet telehealth was used in significant numbers across generations.
CVS Health’s acquisition of Aetna, completed in 2018, offered a preview of the company’s healthcare ambitions. Although none of its rivals has successfully acquired a health insurance business, companies like Walmart and Walgreens are collaborating with self-insured employers to extend their consumer reach. Each of these retailers has also rolled out services to support people with chronic conditions.
As Alyssa Jaffee of 7Wire Ventures noted in an article earlier this year:
“Just like many retail players enhanced their online purchasing offerings over the past two years, there are vast opportunities for retail and pharmacy players to expand beyond in-person healthcare experiences. Partnerships with tech-enabled care delivery solutions can help bridge in-person, remote, and virtual care experiences.”
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Here’s a look at some of their strategies:
Walgreens
In its efforts to support consumerization, Walgreens relies on lab data to curate healthcare solutions that are personalized, impactful and affordable, according to Rina Shah, Group Vice President, Pharmacy of the Future and Healthcare Segments at Walgreens. It also worked closely with VillageMD to offer an integrated primary care and pharmacy service business model.
“Many of our recent investments and innovations are already helping us to expand and scale well-known services that communities have come to rely on pharmacists for throughout the pandemic – including testing, immunizations, medication adherence and medication therapy management,” Shah said in response to emailed questions.
She noted the retailer’s recent partnerships with specialty pharmacy care business Shields, home care company CareCentrix and primary care company VillageMD demonstrate how providers can leverage digital tools to sync clinical and pharmacy data and foster dialogue between care teams.
“In doing so, Walgreens can optimize treatment protocols and better track metrics such as medication reconciliation and treatment adherence to improve the patient’s whole health,” Shah said.
Shah also explained how she views the role of retail health providers like Walgreens compared with hospitals and payers, pointing out that the company is investing in transforming the operating model.
“Walgreens is laying the groundwork for pharmacists to play an expanded role in supporting care delivery. This requires a complete shift in how we fill and dispense medications. This gives us the autonomy to implement solutions that help drive health care services and lower the cost of care. This includes developing programs that allow pharmacists to test and treat routine illness, provide comprehensive care for chronic conditions and solve medication adherence barriers.”
Walgreens has also used pilots to identify ways to improve health equity. In several Florida pharmacies, Shah noted that the company tests and treats for upper respiratory conditions.
It also launched a pilot program with Ohio Buckeye (Centene) to support asthma and COPD patients as part of a multi-phased approach to create comprehensive expanded clinical services. Pharmacists counsel patients on how to use their inhalers, provide proactive outreach to non-adherent patients and use predictive modeling to reach out to people at high risk for becoming non-adherent, Shah said.
“This is the first expanded disease state management pilot for Asthma/COPD in partnership with a payer to include pediatric and adult Managed Medicaid, Medicare and Health Exchange patients.”
CVS Health
CVS Health boasts 45 million unique digital customers, according to the Q2 2022 earnings conference call transcript. Its MinuteClinic care teams have supported more than 2.8 million patient visits as of June 30. It has rolled out 936 Health HUBs as of August 11.
Four years ago, even before the company’s acquisition of Aetna was finalized, former CVS Health Chief Medical Officer Troyen Brennan shared a preview of the retailer’s healthcare transformation as part of a talk at the Wharton Healthcare conference at University of Pennsylvania. Minute Clinics would expand their primary care services to include support for five chronic conditions – asthma, COPD, depression, hypertension and diabetes. Although he observed that younger people tended to use its Minute Clinics the most, he made a point of sharing that remote patient monitoring to improve chronic disease management were areas of interest. He also noted that lab testing services would increase.
CVS Health’s insurance business Aetna formed a strategic partnership with virtual diabetes care startup Virta through a joint venture with Banner Health in February, according to a press release. The collaboration gives Aetna members access to Virta’s diabetes care management program combining remote monitoring with nutrition management. CVS Health has added other chronic conditions to its offering, such as sleep apnea.
It has also ramped up virtual health. In 2021 CVS Health delivered 19 million virtual visits, more than half of which (10 million) were for behavioral health. Although it offers behavioral health services at its Health HUBs, CVS Health also inked a deal with telemedicine provider AmWell for primary care and behavioral health support for its customers. It also launched a virtual-first primary care plan for self-insured employers last year.
Through an app, CVS provides post-Minute Clinic/Health HUB visit summaries and third party test results. It also enables members to check their prescription medication status.
A partnership with Microsoft is helping the company accelerate a data-driven, personalized customer experience. By aggregating customer data from different areas across the company, CVS Health seeks to enhance omnichannel pharmacy capabilities and deliver customized health recommendations.
In order to identify useful technologies for its business, CVS Health launched a $100 million venture fund focused on early stage investment in health tech.
As part of a push to provide home health services, CVS embarked on a collaboration with Cancer Centers of America to provide in-home chemotherapy to oncology patients. CVS Health also announced a deal to amplify its home health through the acquisition of Signify Health – a deal that could also boost its Medicare Advantage customers. Signify Health uses a network of clinicians for home-based visits to identify a patient’s clinical and social needs so they can be connected to follow-up care and community-based resources, according to a press release.
Walmart Health
Although Walmart is a dominant retail player, its moves into healthcare have been more modest than CVS and Walgreens. But that is beginning to change. A dominant theme of expanding retail health services among these companies has been to use acquisitions to supplement primary care, chronic condition management, behavioral healthcare and virtual care. Walmart’s acquisition of MeMed in 2021 added the virtual health component it needed. Walmart has since integrated MeMed into its Walmart Health Virtual Care brand.
As part of a collaboration with American Heart Association announced earlier this year, Walmart launched a virtual diabetes management service for payers and self-insured employers. The program blends personalized diabetes education with behavioral health awareness and counseling. Patients will also be able to receive necessary vaccinations, low-cost insulin and diabetes medications at more than 4,600 Walmart pharmacies nationwide.
“Our aim is to empower patients with the most up-to-date diabetes education and clinical care so they can take control of their health,” Dr. John Wigneswaran, Walmart’s Chief Medical Officer said in a press release. “Our program focuses on a patient’s physical and mental health, which also helps employers maintain healthier workforces and drive down overall healthcare costs.”
In 2020 Walmart acquired CareZone’s tech and IP to help people juggle multiple medications, in a similar strategic play as Amazon’s Pillpack business which paved the way for Amazon to add a mail order pharmacy business.
On the bricks and mortar front, it has opened a steady stream of primary care offices in Georgia, Arkansas, Illinois, and Florida.
Amazon
Amazon has been fighting to compete with CVS Health, Walgreens and Walmart through strategic acquisitions. Amazon acquired PillPack in 2018 to provide a mail-order pharmacy, which was later rebranded as Amazon Pharmacy. Its Amazon Care brand has served as the company’s virtual primary care and urgent care service geared to employers. But Amazon was missing a critical component – a bricks and mortar provider. More recently, it has sought to address this with the acquisition of One Medical, a primary care business with multiple locations. Although this acquisition will mean the dismantling of Amazon Care with in-person and virtual care more easily delivered by a healthcare focused subsidiary, media reports suggest this deal could be blocked by the FTC. In any case, Amazon’s healthcare journey continues.
The strategy by retail players to slowly add and diversify the healthcare services they offer has switched into overdrive since 2020. The realization that virtual care is here to stay and their ability to leverage the customer data they already have to guide their strategy has led to a steady stream of collaborations, investments and acquisitions to put in place the healthcare components they lack. Each of them is learning through trial and error the complexities of being a retail provider. As the stray drumbeat of hospital consolidation continues, retail health players have an important role to play in underserved communities. It will be interesting to see how these retail health models evolve and which ones will endure.
Photo: Walmart
