Ron Hammerle’s comment on Disruptive innovation in healthcare hasn’t begun yet: Christensen (TTA 31 Mar), posted on LinkedIn’s Healthcare Innovation by Design group, made the excellent point that a potentially disruptive and decentralizing healthcare service–retail clinics–has been sidetracked, at least in the US, leaving an open question on their reason for being. This Editor thought it was worthy of a Soapbox. Mr. Hammerle knows of what he speaks because his Tampa, Florida-based company, Health Resources Ltd., works with retail and employer-based clinics to connect them via telemedicine/telehealth systems with medical centers.
When Clayton Christensen first anticipated that retail clinics would be disruptive to the established healthcare industry, their business model was potentially disruptive. What has subsequently happened, however, is a prime example of how potentially disruptive movements can be sidetracked.
After acquiring MinuteClinic and laying the foundation for taking retail clinics national, CVS Caremark chose to make deals with hospitals, which could easily afford to rent, open and operate such clinics without making money on the front end or facing real disruption. Retail clinics were a loss leader to hospitals in exchange for large, downstream revenues, and slightly-enhanced market share for the retailer’s pharmacy.
After CVS shocked Walgreens with one-two punches involving MinuteClinic and Caremark acquisitions, Walgreens came back with three counter-punches of its own:
1. They doubled the number of their clinics (to 700) in less than two years, thwarted AMA opposition, leapfrogged ahead of CVS in clinic count and totally changed the retail clinic model by setting up politically-invisible, broader service, make-your-profit-up-front, employer-based clinics.
2. They began upgrading the design, product mix and customer experience in their stores, becoming more professional and moving closer to becoming a regular consumer destination, although still lacking what supermarket-based clinics could offer—if they chose.
3. Walgreens went global with the Alliance Boots acquisition, laying the groundwork– and beating Walmart–in developing a potential, global supply and service chain.
In the US, however, Walgreens made peace with hospitals, in exchange for permission to pick up medication management before inpatients ever left the hospital.
Walmart, Target, Kroger and Safeway have all stumbled with retail clinics, despite having a core business (with food) that sits at the fulcrum of managing, preventing and treating the three biggest chronic diseases in the world.
So, who is left as potential disruptors? “StealthCare” companies, like Google, Amazon, Apple and less than a handful of telehealth players.