Following the purchase of Aetna, the third largest U.S. health insurance company, CVS has lost no time in describing the healthcare goal for this large new entity: a community based care model (see: CVS and Aetna seek community-based care model in giant healthcare deal). I have previously blogged about this same topic (see: Possible Purchase of Aetna by CVS; Strategic Healthcare Implications). Below is an excerpt from this current article:
Through their $69 billion deal, CVS Health and Aetna are swinging an axe at the traditional ways in which patients access healthcare in hopes of building a new kind of model that's lower cost and more convenient for the consumer. At the center of this strategy is what's commonly called the new front door to healthcare [see: Designing health care's new front door]: the walk-in clinic, and CVS has nearly 10,000 of them....The companies agreed that CVS will take over Aetna, with the No. 3 U.S. health insurer becoming a standalone unit inside the pharmacy giant....Because the storefront pharmacies and Minute Clinics are embedded in local communities and have become places that Americans frequent,...the combined company will be better able to manage patients with chronic diseases, who may see their primary care doctor only three or four times a year. Patients with chronic diseases represent the lion's share of healthcare spending. According to the Centers for Disease Control and Prevention, 86% of the nation's $2.7 trillion annual healthcare costs go to patients with chronic and mental health conditions....Already, insurers and self-insured employers have been steering patients toward lower cost care settings. Even hospitals have been opening retail clinics to capture patients and pull them into their systems. The cost of care at a retail clinic is much lower than in a doctor's office, and evidence has shown that the care quality is equal.
In abbreviated form, here are a series of bulleted points about how I think this community model of care will evolve:
- Executed through CVS's MinuteClinics, services will be offered for minor ailments as before but now with chronic disease care grafted on the mission. Offering care in a neighborhood setting rather than more centrally reinforces what I have called in the past the centrifugal direction of healthcare (see: Could Apple Be Trying to Develop a "Patient Portal" for the iPhone?).
- Although CVS may augment their MinuteClinic workforce with physicians, it's also possible that they may offer telemedicine visits. This would allow them to perhaps partner with hospital system(s) and provide specialty care. I think that a number of hospitals would compete to provide such telemedicine partnerships in order to obtain the CVS acute care and surgery referrals.
- I predict that at least three types of lab testing will be soon be offered: (1) low complexity tests that are currently offered on-site (see: Details about CVS' MinuteClinic POCT Strategy; Lab Testing Now Being Offered in Walgreens California Stores); (2) a broad array of tests provided by national reference labs with the CVS stores serving as patient service centers (PSCs) (see: Walgreens Partners with LabCorp for Patient Service Centers in Drug Stores); (3) it would also be feasible for CVS to launch point-of-care testing (POCT) services to generate rapid test results in the MinuteClinics.
- An interesting question is how the new entity will provide medical imaging. If they do anything at all, it will probably be to develop relationships with standalone imaging centers which are already low-cost providers (see: Anthem Won't Pay for Outpatient MRIs and CT Scans in Hospitals).
In August, 2006, I discussed the minor efforts of health systems to compete with retail drug walk-in clinics (see: Health Systems Launch Walk-In Clinics). This then prompts the question about how our large U.S. healthcare systems will react to this merger news. This answer for me is easy -- they will do little or nothing (see: The CVS-Aetna Merger Is A Mortal Threat To U.S. Hospitals). Most will just wring their hands, having thus far been unable to develop a low-cost ambulatory solution to compete with the walk-in clinics.