I have discussed in a number of previous notes the history of walk-in clinics in retail drug stores, particularly CVS's Minute Clinics and Walgreens' Healthcare Clinics (see: Epic EHRs Added to In-Store MinuteClinics; the Pursuit of Connectivity; Retail Chain Drug Stores Ramp-Up Their Healthcare Delivery Services). I also blogged some time ago about big box stores such as Walmart opening co-branded walk-in clinics that provided competition for the clinics in retail drug stores (see: Wal-Mart Launches Co-Branded Walk-In Medical Clinics in Three Cities; Cleveland Clinic Partners with Minute Clinic in Retail Health Services). I also made reference in the past to health systems which began to operate walk-in clinics in malls (see: Mayo Clinic to Open Walk-In Clinic in Mall of America).
Over this time period, I began to assume that the walk-in clinic business model was stable with the national retail drug chains owning the facilities as opposed to the model whereby the chains would affiliate with hospital systems (see: Tighter Integration of CVS' MinuteClinic with Chicago's Advocate Health Care). However, a recent article suggested that the hospital leased model is far from obsolete (see: Providence to own healthcare clinics inside Walgreens stores in Ore. and Wash.). Below is an excerpt from it:
Renton, Wash.-based Providence Health & Services will lease space to own and operate healthcare clinics in multiple Walgreens drugstores across Oregon and Washington state. The deal marks the first time ...Walgreens Boots Alliance has allowed a health system to own and operate its in-store healthcare clinics, and it's the first time Providence has placed providers in a drugstore setting. Together, the companies plan to outfit up to 25 stores with clinics within the next two years, and expect to open the first six clinics in the Portland and Seattle metropolitan areas by early 2016....Nurse practitioners from Seattle-based Swedish Health Services, a Providence affiliate, will staff the three Seattle-area clinics, while Providence will staff the other three in the Portland area. Providence-owned clinics that run on the system's protocols and, more importantly, its electronic health record, will make for a smoother experience than what customers are used to now in retail clinics....He said primary-care providers have increasingly complained about a disconnect, especially with EHRs, between what happens to a patient at the retail clinic and what happens in the health system and their EHR....Although the deal gives Providence ownership rights for clinic space within its store, it represents much more than a lessee-lessor relationship....Providence won't be sharing revenue from the clinics, but the two organizations will engage in a “collaborative leadership governance council” made up of representatives from both who will jointly work on furthering their retail health efforts. As Walgreens moves away from managing its own retail clinics, Woonsocket, R.I.-based CVS Health, its major competitor, is investing in more. Following the acquisition of big-box retailer Target Corp.'s pharmacy and clinics business, CVS said it will take over as many as 80 of Target's clinics and rebrand them as CVS Minute Clinics, with plans to add 20 new clinics in Target stores over the next three years
Given this recent move by Walgreens, there now appears to be two models emerging for walk-in clinics located in retail drug stores -- the hospital leased approach and the drug chain owned approach. Here are what I see as the major advantages of the hospital-leased approach:
- Since such clinics can be immediately integrated into an existing and usually well known health system, hospital referrals for more complicated cases and also EHR support will be automatic. The clinics thus have the capability of managing more acute and complex patients than those normally seen with relatively minor problems.
- Although the article quoted above was silent on the idea of lab testing in walk-in clinics, I would bet that it would be easy to implement some POC testing on-site with the hospital-leased model (see: Some New Insights into Point-of-Care Testing and Devices). Lab testing has bedeviled Walgreens with its Theranos relationship that is now under review (see: Walgreens Scrutinizes Its Theranos Relationship More Closely).
- Walgreens obtains the increased drug store foot traffic with the leased Providence sites and will also experience a bump in prescription work without any of the hassles of managing a clinic.
- As to some kind of deeper relationship between Walgreens and Providence, the article hinted at such with the following statement: the two organizations will engage in a “collaborative leadership governance council." Stay tuned as to where this will end up and what type of retail relationships the Providence system is seeking.