CHICAGO — There’s a new front door to the U.S. health care system, and it’s not your hospital’s emergency department or doctors' offices.
A new report, released Wednesday by Oliver Wyman, says it’s actually retail health clinics, located down the street at places like Walgreens and CVS. While some docs may believe that there’s no comparison between the two types of visits, interviews with 2,000 individuals show that consumers feel differently.
Nearly 80 percent of those polled said the experience was the same or better than that of a traditional doctor’s office, and about 30 percent of consumers said the experience was “better” or “much better.” Consumer interest in retail health clinics is clearly on the upswing, with one-quarter of patients polled saying they’ve used one, an 11 percent increase from the previous survey in 2013.
“Consumers have spoken; the new front door is here,” Graegar Smith, principal in Oliver Wyman’s Health & Life Sciences practice, said in a press release. “Now it’s up to health care providers, insurers and retailers to build it in a way that has meaning, impact and value.”
During a presentation Thursday at the American College of Healthcare Executives 2016 Congress, Andrew Sussman, M.D., executive vice president and associate chief medical officer of CVS Health, told hospital leaders how the company plans to do so. The nation’s largest retail clinic chain, with more than 1,135 locations in 33 states, has been in rapid expansion mode in recent years. And they’re not providing care in a silo by any means, as they’ve formed 70 partnerships with health systems across the country and implemented the use of Epic electronic health record systems to coordinate care with those organizations.
Thanks to a cornucopia of different factors — a primary care shortage, aging baby boomers in need of care, a rising epidemic of chronic disease and obesity, and patients spilling into the system because of the Affordable Care Act — the health care system is getting taxed. CVS wants to be there to help with access, with more than 50 percent of the U.S. population living within 10 miles of a MinuteClinic, staffed by nurse practitioners and physician assistants. They offer everything from routine lab tests to minor wound treatment, vaccinations and the ability to diagnose and treat common family illnesses. Sussman said they’re not planning on performing open-heart surgery anytime soon, which makes such partnerships with hospitals critical.
“Nobody is going to get an appendectomy in the greeting card section of a CVS. That’s not going to happen,” he said.
The increasingly consumer-minded patient is also fueling growth for the Woonsocket, R.I., retail chain. With patients being asked to take on a larger share of the health care dollar, they’re shopping around more carefully for the most affordable experience. More often than not, they’re ending up at CVS’s doors. Upward of 50 percent of MinuteClinic patients do not have a primary care physician, and 50 percent of visits come in during evenings and weekends when doc offices are often closed. Sussman pointed to studies showing that patients can save 80 percent on the price of care compared with higher-cost settings.
Hospital leaders must be vigilant of this shop-for-care trend and find ways to address it. Patients are treating their care similar to a visit to an auto mechanic and just getting the overdue oil change while ignoring the air conditioning filter and wiper blades that also need replacement.
“In a bygone era, most everything was covered,” Sussman said. “But now, when it’s your money or you feel like it’s your money, you’re making decisions that might not always be in your best interests, particularly as it relates to preventive services. ‘Hey, I feel well. Should I really spend money on this?’ ”
Telehealth is one growth area that CVS is warming to as a way to provide low-cost services, and consumers are, too. Oliver Wyman’s study estimates that 57 percent of consumers are now familiar with the concept of a health and wellness visit conducted remotely via voice or video chat. Some 95 percent of CVS customers said they thought a telehealth visit was “just as good” or “better” than the traditional model, Sussman added.
CVS has partnered with three players in the telehealth space — Doctor on Demand, American Well and Teladoc — aiming to build out its capabilities. Pilots tied to those partnerships include making telehealth services available through the CVS app, having one company beam its doctors into CVS telehealth clinics to look at rashes and other superficial ailments or sending patients from a telehealth provider’s app into MinuteClinic if further in-person consultation is required.
Sussman believes telehealth certainly has the potential to turn health care on its head.
“It is absolutely going to be disruptive to the larger health care world, because it creates a link between supply and demand that’s very disruptive to bricks and mortar assets,” he said. “Let me just say that again: The supply and demand linkage is very disruptive to bricks and mortar assets, because now that cardiologist doesn’t have to be in the building to see that patient on the other side of the state.”
Oliver Wyman certainly agrees with Sussman’s statement. Here’s that and four more implications for providers taken from the company’s report:
- There are tremendous implications for systems’ ambulatory footprints. Some existing assets, such as a market-blanketing primary care footprint, no longer may be needed; and some systems will identify asset gaps. The new front door may provide an efficient vehicle to increase a provider’s number of attributable and managed lives, so getting the footprint right will become increasingly important as more providers transition to value.
- Physicians and care teams must be ready to receive/operate in this environment. Performance metrics, compensation and incentives will need to shift.
- Coordinating care is easy to say, hard to do. Systems have to get it right — connecting with and transferring information among the various new front-door access points to create a truly integrated experience. Traditional health system thinking will be an encumbrance here; systems must start with consumer needs and hassles in mind.
- To capitalize on that legacy-brand position, providers must move quickly and determine how they will monetize the brand plus quality plus trust advantage. As they do, they must recognize they are now operating in an arena driven by consumer expectations; what might have passed for customer service in the traditional arena won’t fly in the new, consumer-centric front door.
- Introducing this in a manner that (a) meets with consumer/patient readiness, and (b) that can be effectively resourced (staffed) will be key to creating traction toward a magnetic and impactful experience.