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First Match Wal-Mart Revolutionizing Healthcare?

Wal-Mart may turn the primary-care industry on its ear with its new, convenient and highly accessible extended-care centers, where treatment will be provided to employees and consumers alike.

Wednesday, April 8, 2015
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About eight years ago, I was one of a half-dozen people attending a private, day-and-a-half-long meeting with a senior Wal-Mart executive. Our assignment was to brief the retail giant on everything there was to know about maintaining or improving employee health. I vaguely recall the key elements we presented; however, I remember in exquisite detail the story the Wal-Mart leader told during the meeting's welcoming session.

The United States Postal Service, he said, was one of the most vilified organizations in the country. Countless stories abounded about its inefficiencies, he recounted, including slow delivery times and misdirected mail. Yet, in his lifetime, he never experienced any of this. His theory was the postal service was an object of derision because it was an institution.

Wal-Mart, he believed, was also often criticized because the company transformed over a 50-year period from a single storefront in Rogers, Ark., to an institution with the capacity to influence prices on consumer goods, and to upend other industries-including healthcare.

This analogy influenced my thoughts four years ago, when I wrote: "Wal-Mart may turn out to be the ultimate outsider that changes the way healthcare services are delivered to employees and consumers alike."

Speculation turned into reality in early March when I toured a Wal-Mart care clinic housed in a supercenter in Carrollton, Ga. This 1,000-square-foot "expanded primary care" center is one of 17 clinics being piloted in Texas, Georgia and South Carolina. The care clinic resembles a small physician's office with a private waiting area; three dedicated, private exam rooms; and a full-service lab with a chain-of-custody bathroom for drug-testing needs. It is staffed by nurse practitioners, a laboratory technician and a medical assistant, and is conveniently located near the pharmacy and vision center.

These clinics aren't like the approximately 100 retail clinics the company hosts in its stores through leases with local hospitals. They differ in several ways, including: They are fully owned by Wal-Mart, they are open seven days a week (12 hours a day during the week and at least eight hours per day on the weekend), they provide ongoing primary care to patients (half of current users do not have a primary care provider) and they serve as employee clinics as well as customer clinics.

So, why is Wal-Mart piloting a role in the healthcare industry? There are abounding opportunities:

·         Meet people where they shop. Seventy percent of U.S. residents spend 40 minutes at Wal-Mart twice a month. Consumers and employees alike can easily schedule appointments to coincide with these visits.

·         Make the most of existing investments. The retailer has invested in providing consumers with fresh foods and organic products. The stores also offer fitness equipment and athletic apparel, so it's a natural fit for a consumer to marry a visit with a nurse practitioner to a health- or wellness-oriented purchase.

·         Support complementary health-related businesses. Wal-Mart already owns the third-largest pharmacy and second-largest vision-center businesses in the country. And nearby Sam's Clubs provide hearing centers.

The other aspect of these clinics you can't ignore is the affordable pricing. All visits are a flat $40. Wal-Mart associates and their family members who are on the company's health plan pay $4 per visit. And most lab tests are $8, while a few are $15.

While I was writing this column, I needed treatment for a 10-day-old sinus infection. I found myself at a Wal-Mart competitor's retail clinic because I could not get an appointment with my primary care provider for five days. The visit was $79 and I noticed that a cholesterol test cost $69, compared with Wal-Mart's price of $8. The differences were noteworthy.

The only part of my retail-clinic experience that was better than a Wal-Mart care clinic was the nurse practitioner directly billed my insurance company. At some point, I will owe money for this visit, but it felt more convenient to not exchange cash or a credit card with the provider. The only insurance Wal-Mart accepts, beyond its own employee health insurance, is traditional Medicare and-in South Carolina and Georgia-Medicaid.

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Daniel Stein, Wal-Mart's director of medical services, says the goal of the clinics is to reduce barriers to care and to focus on population health. Visits with the nurse practitioners are scheduled for 20 minutes, and the company expects one practitioner to see 30 to 40 patients during a 12-hour shift.

Wal-Mart anticipates the majority of care-clinic patients will be from the community; however, the facility also acts as an employee health clinic for its associates. Associates who are on the Wal-Mart health plan and have a health-reimbursement account are charged the $4 fee, while associates with a health-savings account must be charged the full $40.

Stein says other employers already want to take advantage of the service. Several hope to supplement their own on-site clinics with the extended hours available at Wal-Mart. Options for employers include:

1.   Direct contracts;

2.     Subscription offers and contracts for: (a) office visits alone; (b) lab work

services; or (c) only immunizations; and

3.     Pharmacy offerings with access to Wal-Mart's low price network.

So, it seems, the institution that is Wal-Mart may completely upend healthcare institutions, change how consumers and employees are treated for wellness and prevention visits as well as acute and chronic health conditions, and "save people money to help them live better."

And I, for one, will not vilify the company for it.

< Carol Harnett is a widely respected consultant, speaker, writer and trendspotter in the fields of employee benefits, health and productivity management, health and performance innovation, and value-based health. Follow her on Twitter via @carolharnett and on her video blog, The Work.Love.Play.Daily.


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