Most people go to a CVS or Walgreens to grab a quick snack, buy laundry detergent, or pick up a prescription and some cold medicine. Well, what if I told you that pretty soon you could be going there to get your blood glucose levels checked or flu symptoms examined? With a healthcare industry that is hyperfocused on consumer convenience, this may very well be the case in the near future. Retail health clinics are popping up across the country at pharmacies and big-box stores, with CVS, Walgreens, and Walmart being the most popular brands trying to get into primary and acute healthcare. Before examining the specifics of each clinic and the limitations of this business model, it is important to understand what exactly these health clinics are.
As the name indicates, retail health clinics are health centers located directly in retail stores. They are designed to provide a convenient and cost-effective location for patients to receive acute treatment or preventive services. While the three previously mentioned companies differ slightly in the specific services offered, retail health clinics are generally staffed by nurses or nurse practitioners and are designed to treat minor issues including flu-like symptoms, rashes, scrapes, sprains, bronchitis, etc. The clinics do not require an appointment and offer fixed prices for all their services that can be found online, features that make the clinics more attractive than seeing a primary care physician or waiting hours at an emergency department [1]. With a basic understanding of what retail health clinics are, let’s examine the nuances between those located in CVS, Walgreens, and Walmart.
CVS Health MinuteClinics and HealthHUBS
Upon its acquisition of major health insurer Aetna, CVS Health proclaimed its goal to transform the way consumers experience healthcare [2]. The company has aimed to do so through two different types of retail clinics: MinuteClinics and HealthHUBS. The original MinuteClinics, located in regular CVS stores and some Targets, offer treatments for several minor health issues, such as strep throat and shingles, in addition to providing mental health counseling, smoking cessation programs, and weight-loss plans. The HealthHUBS is an expansion from the MinuteClinics and is more specialized to focus on treating chronic conditions such as diabetes, asthma, and high cholesterol. In addition to offering sleep apnea assessments and blood draws, the HealthHUBS house an in-store dietitian and wellness rooms for yoga classes [3]. Despite the impediment on construction due to COVID-19, CVS is still on track to meet its goal of having 1,500 HealthHUBS operating by the end of 2021 [4].
Village Medical at Walgreens
Walgreens Boots Alliance has entered the retail health world in a slightly different way than its competitor CVS, partnering with medical services provider VillageMD as opposed to running the clinics itself. The VillageMD clinics also differ in how they are staffed, with primary care physicians working in tandem with pharmacists to find the best treatment path for patients. The services offered are similar to those provided at HealthHUBS, including chronic disease management, annual wellness checkups, women’s health services, and vaccinations. The clinics also offer several diagnostic screenings, including bloodwork, urinalysis, and EKGs. Other unique offerings are around-the-clock telehealth appointments and at-home doctor visits designed for the elderly or immunocompromised. By 2025, Walgreens plans to open up to 700 clinics across 30 U.S. markets, staffed by primary physicians and potentially including nurses, social workers, and therapists [5].
Walmart Health
Walmart is perhaps the most surprising of the three organizations to get into the retail health space given its history as perhaps the most established big-box store in history. In Fall 2019, the retailer unveiled its first Walmart Health clinics in Dallas and Georgia, located adjacent to Walmart Supercenters with a separate entrance. The clinics are similar to Walgreens’ in that they are led by doctors as opposed to the nurse practitioner model of CVS’ clinics. The clinics offer a variety of services ranging from traditional primary care to audiology, optometry, and dental exams [6]. To date, Walmart has twenty operating clinics and plans to open up more than fifteen by the end of 2021, although their commitment to this plan has been questioned due to an Insider report in February 2021 stating the organization is slowing its rollout [7].
Looking Ahead and Limitations
While it is evident that retail health clinics are more convenient and affordable than other options, there are some drawbacks that may limit their future potential. Most notably, it is easy for care to become fragmented when patients have so many access points to get treated. Most of the retail clinics do not have a standard system for sharing records with other providers, potentially making it difficult for primary care physicians to understand what remedies their patient has already tried [8]. Additionally, a 2016 study found that the convenience of the clinics may actually increase total costs since patients are more likely to utilize care that they otherwise would not have. Only 42% of subjects used the clinics as a substitute for visiting their doctor or a hospital, with those who visited the clinic instead of staying home creating an average increase of $35 per visit in healthcare spending [9]. While consumers may be elated over the convenience of going to their local Walmart or CVS to get an ear infection treated or have their blood pressure checked, it is important that patients are educated on when to use these clinics so as to not unnecessarily increase healthcare spending.
References:
1. Weinick, R. M., Pollack, C. E., Fisher, M. P., Gillen, E. M., & Mehrotra, A. (2011). Policy Implications of the Use of Retail Clinics. Rand Health Quarterly, 1(3), 9.
2. Kodjak, A. (2019, February 21). CVS Looks To Make Its Drugstores A Destination For Health Care. Retrieved April 04, 2021, from https://www.npr.org/sections/health-shots/2019/02/21/695216345/cvslooks-to-make-its-drugstores-a-destination-for-health-care
3. CVS is opening 1,500 HealthHUBs. What's their endgame? (2019, July 19). Retrieved April 04, 2021, from https://www.advisory.com/en/dailybriefing/2019/07/19/cvs
4. Paavola, Alia. (2020, May 7). CVS' goal of opening 1,500 HealthHubs on track despite pandemic. Retrieved April 04, 2021, from https://www.beckershospitalreview.com/pharmacy/cvs-goal-ofopening-1-500-healthhubs-on-track-despite-pandemic.html
5. Pifer, R. (2020, July 08). Walgreens Invests $1B in Primary Care Clinics With VillageMD Deal. Retrieved April 04, 2021, from https://www.healthcaredive.com/news/walgreens-invests-1b-inprimary-care-clinics-with-villagemd-deal/581208/
6. Reuter, Elisa. (2020, June 28). Walmart divulges plans for ‘healthcare supercenters.’ Retrieved April 04, 2021, from https://medcitynews.com/2020/06/walmart-divulges-plans-forhealthcare-supercenters/
7. Dodge, B., & Livingston, S. (2021, February 19). Walmart is slowing its ambitious push into healthcare, employees and leaked documents reveal. Retrieved April 04, 2021, from https://www.businessinsider.com/walmart-slowing-healthcareclinics-strategy-2021-2
8. Evans, M. (2014, February 15). Fragmented care: Data-sharing between retail clinics, health systems hits hurdles. Retrieved April 04, 2021, from https://www.modernhealthcare.com/article/20140215/MAGAZINE/3021 59939/fragmented-care-data-sharing-between-retail-clinics-healthsystems-hits-hurdles
9. Wicklund, E. (2016, March 08). Do retail Clinics actually increase healthcare costs? Retrieved April 04, 2021, from https://mhealthintelligence.com/news/do-retail-clinics-actuallyincrease-healthcare-costs