Outsourcing of retail clinics–another reason for HealthSpot’s demise? (US)

Walgreens earlier this week announced another round of outsourcing their in-store health clinics to a local health system, this time in the Midwest US with Advocate Health Care. It affects 56 locations in the Chicago, Illinois area which will operate as Advocate Clinic at Walgreens in May 2016. It’s an interesting spin on the much-touted integration of healthcare services into retail pharmacies. It gives an integrated health system a prime location for community services–a clean, well-lighted place (to quote Hemingway, minus the daiquiris) with minimal overhead that provides one-stop-shopping for patient pharmacy and OTC products. It also solves part of the ‘fragmentation of care’ problem for Advocate patients as their records will go straight into their EHR. For Walgreens, it offloads the licensure and operating expenses of a clinic, gives a strong competitive advantage lent by the legitimacy of a leading provider, and attracts Advocate patients to their locations. Walgreens release  Last August, Walgreens turned over the keys of 25 Washington and Oregon clinics to Providence Health & Services in what now can be seen as a trial balloon.

What is surprising is how few Walgreens have clinic services–400 of over 8,100–over nine years of operations, starting with the acquisition of former travel industry executive Hal Rosenbluth’s 25 or so TakeCare Clinics around Philadelphia back in 2007. Yet further clinic expansion has been difficult as many locations have no physical space, there are restrictive state laws and the competition is everywhere between over 1,000 CVS Minute Clinics and local urgent care clinics. CVS also recently acquired 80 Target pharmacies and walk-in clinics. It’s reported that profitability has been a challenge for Walgreens in the clinic biz. Expect to see more of these arrangements to grow Walgreens’ clinic network.

Why might this be a contributor to HealthSpot Station’s end? A change of direction and a need for cost cutting that wasn’t there a year ago.  (more…)

Soapbox: How healthcare disruption can be sidetracked

click to enlargeRon 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. (more…)