Wal-Mart, the nation's largest retailer, has spent years trying to turn some of its millions of customers into patients, offering a simple menu of medical services. Now, the store is in the throes of its most aggressive push yet to become a one-stop shopping destination for medical care.
The company has opened five primary care locations in South Carolina and Texas, and plans to open a sixth clinic today in Palestine, Texas, with another six planned by the end of the year.
The clinics, it says, can offer a broader range of services, like chronic disease management, than the 100 or so Wal-Mart acute care clinics across the country. Unlike CVS or Walgreens, which also offer some similar services, or Costco, which offers eye care, Wal-Mart is marketing itself as a primary medical provider.
Like its competitors, Wal-Mart is looking to grab a bigger share of the billions of health care dollars being spent in the United States and to benefit from the shifting delivery system that has resulted from the Affordable Care Act.
With its vast rural footprint, Wal-Mart is positioning its primary care clinics in areas where doctors are scarce, and where medical care, with or without insurance, can be prohibitively expensive. If they succeed, the company said, it is prepared to open even more.
"If they're rolling it out across the rural stores primarily, they're actually filling an important gap in the health care ecosystem," said Skip Snow, a health care analyst at Forrester Research.
But while experts agree that increased access to health care is a good thing, others say patients with chronic conditions need complex care that retail giants cannot provide. Diseases like diabetes, for example, can result in complications that are not easy to manage.
"There's not a role for retail clinics to take care of chronic, ongoing problems like that," said Dr. Robert Wergin, the president-elect of the American Academy of Family Physicians.
While the company says that about 15-20 patients use the existing primary clinics every day, a large percentage of those patients do not have a primary doctor outside Wal-Mart, according to Dr. David Severance, the corporate medical director at QuadMed, which is joining with Wal-Mart to help staff and run the clinics.
For patients with complex issues, Severance said, the goal was for Wal-Mart to be a patient's first stop.
"In that circumstance, it's our desire to get those individuals established with a primary care provider, preferably a physician within the community," he said.
While the retailer has been pushing into health care for years, its early attempts stumbled. Dozens of acute care clinics have closed, largely because of management problems.
The primary clinic model could offer some new advantages over the more basic clinics, often referred to as "retail clinics." The limited list of minor illnesses that a retail clinic can treat -- the flu, for instance -- often peaks in the winter months, Charland said, and slows down significantly at other times of the year.
Wal-Mart also says it will be better off working with just one partner, QuadMed, instead of multiple partners that each run a handful of clinics, which was the model used in its acute care clinics.
Along with medical assistants, nurse practitioners, who generally receive less training than doctors but can prescribe most of the same medications, run the primary clinics.
The Wal-Mart primary care clinics charge patients $40 a visit. Employees at the company and their dependents who are covered under its own insurance pay $4 a visit. Wal-Mart says that more than half of its 1.1 million employees currently receive health care through the company.
While they accept Medicare, Wal-Mart clinics currently do not accept third-party insurance, although the company is exploring the option, spokesman Danit Marquardt said.
Business on 08/08/2014