Walmart Health shutters health centers, Walmart Virtual Care, in sudden move (updated–why?)

In a shocker, Walmart throws in towel on onsite primary care, urgent care, and telehealth, effective today (30 April)Walmart’s release stated that “we determined there is not a sustainable business model for us to continue” either service since “the challenging reimbursement environment and escalating operating costs create a lack of profitability that make the care business unsustainable for us at this time.” Analysts also attributed the difficulties to the rising cost of labor, real estate, complex billing procedures, and reimbursement rates that haven’t increased in years.

The boom was lowered only three weeks after Walmart announced that they were slowing down 2024 openings of its primary and urgent care centers from 30 to 22 [TTA 5 April]. From aggressive promises back in 2018 of at least 1,000 locations, later revised to 4,000 locations by 2029, to serve the underserved with primary care, dental care, and basic lab and imaging services, only 51 centers were opened in superstores in six states–Arkansas, Florida, Georgia, Illinois, Missouri, and Texas. The top executive spot became a revolving door. 

The release did not disclose when the center closures would be effective. From the screenshot above from the Walmart Health website, it can be inferred that because appointments must be scheduled within the next 30 days and no new patients are being accepted, the closures will be start to be effective 30 or 31 May. The centers employ physicians, dentists, and nurse-practitioners. Walmart Health also had recently inked high profile partnerships with Centene’s Ambetter-Sunshine Health plan as an ACA preferred provider [TTA 8 Nov 23] and with Orlando Health in Florida for care coordination. It is not known what will happen to these latter partnerships. Update. UnitedHealthcare and Walmart have ended their co-branded Medicare Advantage “Walmart Flex” plan. This was part of a 10-year deal inked last year. The MA plan was available in Georgia only, with ambitions to expand. Other partner programs were available in Florida and Georgia. Becker’s

Walmart Health Virtual Care, in contrast, has no such notice on its website. Virtual Care services may be more problematic to shut down as they are provided to health plan members (e.g. UnitedHealthcare) and employers. Walmart Health acquired MeMD telehealth in May 2021 in very different times–at that time, they had five million members. Virtual Care also covers behavioral health. That winddown may differ in timing based on contracts and patient handoffs.

The release affirms that ~4,500 Walmart pharmacies and 3,000 +optical centers will continue and grow. Pharmacies already offer Testing and Treatment services, health screenings, access to specialty pharmacy medication and care, as well as other essential services such as medication therapy management. In vision care, Walmart recently acquired 200 Vision Centers.

Employees affected will receive either the opportunity to move to another location or separation benefits. The practices are “partners’ and will be paid for 90 days. Walmart’s wobbliness on the health provision front, along with rising costs, less reimbursement, and more competition than they thought, caught up to them in the end–as it did with VillageMD/Village Medical and Walgreens.  Healthcare Dive, Becker’s, Crain’s Chicago Business

Update. Perhaps there’s another trend here. A user of Walmart Health, ‘Wiggles’, posted on the always interesting HIStalk making some excellent points. Many of their appointments were canceled due to lack of available clinicians. He or she surmised that physicians (and this Editor would add, nurse-practitioners) don’t find putting in hours at a Walmart Health carries any prestige for the money earned nor that they enjoy ‘care-by-wire’. Your Editor would add that the areas where Walmart built the clinics may be areas of clinician scarcity–that they are booked solid. Add to that two cited reasons for shrinking Walgreens’ VillageMD operation–that they cannot fill the patient panels for each physician in many areas (saturation?), nor can they get the physicians in other areas to work in the space offered at a co-location (undesirable working conditions?). Could it be, as ‘Wiggles’ surmises, that here’s an opportunity for clinical professionals to take back control? (This is on top of the actions that pharmacists are taking across Walgreens and CVS on their working conditions.)

Early news roundup: Envision exits Ch. 11, splits; Walgreens’ new CIO; Philips’ $60M from Gates Foundation; more on Walmart-Orlando Health partnership; Cigna may sell MA business

Staffing firm Envision Healthcare exits Chapter 11 bankruptcy, splits off AmSurg clinics. One of the Big Bankruptcies earlier this year has been reorganized, cutting $8 billion in debt by 70% and spinning off its AmSurg surgical clinics to new ownership. The hospital and physician staffing company was hurt as early as 2020 with shortages of available staff, then the pandemic which cut patient volumes, and conflicts with payers around out-of-network billing charges. The last put the company in conflict with the ‘no surprises’ patient protection billing law that took effect this year. One particular legal spat with UnitedHealthcare tied up both companies for years, but was won by Envision after an independent arbitration panel this past spring awarded Envision $91 million, finding that UHC breached its in-network contract. KKR, which had taken Envision private in 2018, lost $3.5 billion in equity, one of their largest corporate investment losses. Henry Howe, the company’s chief financial officer, takes over as interim CEO on 1 December as current CEO Jim Rechtin leaves to join Humana. Healthcare Dive  Background: TTA 12 May, 16 May   

Walgreens fills its chief information officer vacancy with the interim CIO. Neal Sample was appointed last Wednesday (1 Nov) as CIO and EVP, reporting to new CEO Tim Wentworth and joining the executive and IT governance committees. Sample was appointed last month as an IT advisor after CIO Hsiao Wang left suddenly on 2 October. Both Wentworth and Sample worked with each other at Express Scripts, with Sample holding both COO and CIO positions there, then departing for the CIO position at Northwestern Mutual. Walgreens release, Retail Dive

Philips receives an additional $44 million from the Gates Foundation for further Lumify Ultrasound System development. The total of $60 million in grants starting in 2021 was for the development of AI-enabled applications to improve obstetric care in low- and middle-income countries. The Lumify handheld ultrasound system assists frontline health workers, such as midwives, in interpreting obstetric images and identifying possible complications during pregnancy in hours versus weeks of training. The system’s Kenya trial was successful. The additional funding will be used to expand global adoption in underserved rural communities. Philips release  This follows Gates Foundation grants to GE Healthcare ($44 million) and Butterfly Network ($5 million) for easily deployed ultrasound and imaging systems to support low-income countries’ rural maternal health and respiratory scanning. Mobihealthnews

More on Orlando Health’s partnership with Walmart. Briefly noted here last week in Walmart’s release and reporting on Walmart Health’s new partnership with Centene’s Ambetter plan in Florida was the Orlando Health hospital partnership. This will coordinate care for patients admitted to the health system’s hospitals or who need specialty care. It is a first for Walmart as it has not previously partnered with local health systems on specialty and hospital care as an extension of its clinics. Eight of its 48 clinics are in the Orlando area. Becker’s Health IT 1 Nov, 6 Nov

Cigna is exploring a sale of its Medicare Advantage (MA) business. According to the exclusive report by Reuters (may be paywalled), Cigna is in early stages, at this point consulting with an investment bank. Cigna is not much of a player in the difficult state-by-state, county-by-county MA business, with 599,000 members as of 30 September, which is about 3% of their 19 million total insurance members. But it has been problematic, with Cigna recently paying CMS $172 million to settle allegations that it violated the False Claims Act by submitting incorrect data to obtain higher payments. By comparison, UnitedHealthcare and Humana have nearly half (47% or 14.5 million) of the national 30.8 million MA members (KFF). Becker’s