On Thursday morning, Walgreens became the first-ever chain retailer to announce that it would become a direct provider of primary care services, moving beyond the pharmacy’s current practice of administering vaccinations to diagnosing and treating Americans with asthma, diabetes, and high cholesterol. The decision holds particular promise for Americans suffering from chronic conditions by giving them an easily-accessible “medical home” for managing illnesses that require preventative or ongoing care — and it might just herald the future of the American health care industry.
Walgreens has been planning something along these lines for some time now. In January, the company announced that it would be launching its own take on Obamacare’s Accountable Care Organizations (ACOs) — coordinated arrangements in which normally stratified health workers collaborate to provide better patient care while lowering costs — in an effort to become “care extenders” that implement the plans drawn up by physicians. As this announcement proves, they were serious about that:
Walgreens officials say they will have nurse practitioners and physician assistants at more than 300 Take Care Clinics in 18 states and the District of Columbia to do tests and make diagnoses – and also write prescriptions, refer patients for additional tests and help them manage their conditions.
“We’re not trying to take over primary care, but we think we can help support physicians and transform the way care is delivered to provide more access points at a time when people need it the most,” said Heather Helle, a division vice president at Walgreens. [...]
She said physicians will help oversee Walgreens’ clinics – and the clinics can transmit test results and other information electronically to doctors’ offices. She noted that clinics could help people find doctors too. Many would have an affiliation or other link with the stores’ clinics.
Retail clinics generally appeal to consumers looking for convenience and cost savings. Costs are roughly 30 percent to 40 percent less than similar care at doctor’s offices and 80 percent cheaper than at an emergency room, according to a 2011 study published in the American Journal of Managed Care.
The cynically-minded may point out that there’s a financial motivation to all this, as Walgreens’ main revenue source is its pharmacies, where the costs of generic versions for prescription drugs are considerably higher than at independent, online, and wholesale retailers. Still, this shift would provide substantially added value to purchasing those drugs at Walgreens chains by eliminating the need for a hospital trip, and the idea of an ubiquitous source of cheap primary care should excite health reform advocates, as the planned coordination model is exactly the sort of innovation that reformers and Obamacare are hoping will take root.
American Academy of Family Physicians president Dr. Jeffrey Cain slammed Walgreens’ decision, stating that it could be risky and confusing for patients to receive care through non-doctor practitioners — but this critique completely ignores the needs and realities of U.S. health care. The fact is, increasing reliance on practitioners and physician assistants to provide primary care is absolutely critical to meeting increased patient demand as an increasing number of Americans gain coverage under Obamacare. That’s why the reform law encourages the expansion of community health clinics and these collaborations in the first place.
Having easily-accessible chain pharmacies like Walgreens to carefully monitor patients’ chronic care needs is also likely to increase patients’ compliance with their treatments. That’s huge, considering that noncompliance — especially with medication regimens — leads to $300 billion in wasteful health expenditures every year. Pharmacy-based primary care medical homes would also open up access to disadvantaged populations, like low-income Americans or Americans living in isolated rural communities.