Imagine this. You’re outside raking leaves early one fall afternoon. Everything’s going fine but what’s that? You feel like there’s something crawling on your leg… and there it is! IT’S A SPIDER!

You brush it off, but it’s already too late. It bit you, though you don’t start to notice that until a few hours later, when the afflicted area is itchy, swollen, red, and really starting to bother you. By that time, it’s too late to go see your primary care physician. Their office is closed, and besides, would you really have been able to get in today anyway? Probably not. You don’t want to wait until tomorrow to try to get an appointment, so what can you do? It looks like the ER is your only option, right?

Not anymore. Thanks, retail healthcare!

What Is Retail Healthcare?

Retail healthcare is currently one of the fastest growing industries in the U.S. The phrase also describes a growing movement to make healthcare more accessible, convenient, and affordable for individuals, just like how retail stores make their products and services readily available for customers. Oftentimes, this means health care providers and/or insurance providers team up with retailers to put health care clinics in retail stores.

The phrase describes a growing movement to make healthcare more accessible, convenient, and affordable for individuals, just like how retail stores make their products and services readily available for customers.

The appeal of these clinics is that their operating hours typically include and extend beyond those of “normal” doctors’ offices. They also generally accept walk-ins. These clinics can be a great option for non-life-threatening ailments or illnesses that you want to get immediate attention for, like bug bites; minor cuts or wounds; minor illnesses, like allergies, earaches, pink eye, sinus infections, sore throats; screenings; vaccinations/other shots; and physicals and other wellness services. It’s also key to note that they’re focused on their patients’ overall health care experience, much like how retail stores focus on their customers’ overall experiences.

Think about the last time you went to a large, chain grocery store. Was there a pharmacy in there? What about a health clinic? If not, there may be soon!

Why Should Agents Take Note?

Health insurance agents should, at minimum, know the basics of retail healthcare, and who’s involved in it, for three reasons. One, these clinics provide valuable, and oftentimes, affordable care to health insurance members, agents’ clients. Two, health insurers are getting in on this action. This may affect their plan offerings and networks, changing the way you analyze, offer, and recommend plans. And three, provider groups are getting involved in retail healthcare, too! (More on that later!)

Who’s Entered This Industry So Far?

If you live in North Carolina, you may have recently seen in the news that Walgreens and Novant Health have announced a retail healthcare collaboration. North Carolinian shoppers can expect to see “Novant Health Express at Walgreens,” their joint retail health clinic, at three Walgreens in their state next year. But retail health isn’t new to Walgreens or other large, chain grocery stores.

Walgreens already offers retail health clinics, like their MedExpress urgent care clinics. They also have pharmacies in stores. Walmart is another large retailer that offers health care clinics, as well as pharmacies. In fact, the first “Walmart Health” center opened this past September, and it offers even more services than its in-store care clinics. Target also has retail health clinics, and Rite Aid offers their RediClinic® program. And, let’s not forget CVS Health, a retailer known for pharmaceutical services, MinuteClinic® services, and brand-new HealthHUB locations.

Let’s not forget CVS Health, a retailer known for pharmaceutical services, MinuteClinic® services, and brand-new HealthHUB locations.

In fact, many health insurers are taking steps toward expanding their retail healthcare offerings and partnerships. Just look at the Walgreens Boots Alliance and Humana senior clinic venture. There’s also the Anthem-Walmart program that launched in January 2019. Additionally, Walmart has a co-branded Medicare prescription drug plan with health insurance giant Humana. And, consider the even bigger CVS-Aetna merger. Insurers have been moving to bring pharmacy benefit managers in-house (e.g., the Aetna-CVS deal), but their attempt to gain more control over pricing and further integrate members’ care hasn’t stopped there. They, too, have realized that, by teaming up with retail stores, they can help make healthcare more accessible, affordable, and convenient for their members!

It’s also worth mentioning that provider groups are taking notes and participating in the retail healthcare movement in their own way. Take for example Oak Street Health, a network of health centers focused on providing care to seniors in Pennsylvania, Indiana, Michigan, and Ohio, which is partnered with Humana. Their centers, like some other provider groups’ centers, are sometimes conveniently located in strip malls — a retail atmosphere!

It’s also worth mentioning that provider groups are taking notes and participating in the retail healthcare movement in their own way.

Analysts speculate that e-commerce giant Amazon may even soon get in on the action. Not only is Amazon starting to open brick-and-motor grocery stores after their acquisition of Whole Foods, a health food store, but they also recently bought PillPack, a unique online pharmacy start-up, and have started Haven with Berkshire Hathaway and JPMorgan Chase. Haven is a joint health care venture by the companies to find ways to improve health care outcomes and costs for their 1.2 million employees. It’s likely only a matter of time before Amazon takes the leap and starts putting retail health clinics in their Whole Foods grocery stores.

What This Means for Medicare Beneficiaries

Currently, there are more than 3,000 retail health clinics across the U.S. Many of these facilities accept people of varying ages, from kids to younger adults to older adults, and insurances, including employer insurance, marketplace insurance, Medicare, and sometimes, even Medicaid. In short, retail health clinics provide another way for Medicare beneficiaries to get some of the non-life-threatening care they may need. If they’re faced with a certain dilemma, like a spider bite or a burn from boiling pasta water or a sore, strep-infected throat, they don’t have to go to the ER if they need care outside of their primary care physician’s office hours. They can save time, and potentially save money, by visiting their local grocery store’s health clinic.

Medicare beneficiaries can save time, and potentially save money, by visiting their local grocery store’s health clinic!

With Medicare, beneficiaries are entitled to an Annual Wellness visit. Some retail health clinics allow members to get that visit at their facility for free. Additionally, many retail health care clinics can help Medicare members get their annual flu shot or even help them monitor their chronic conditions (e.g., diabetes, high cholesterol) via screenings. Partnerships with health care clinics could be seen as another way for certain Medicare plans to provide more value-based care to their members on multiple levels.

In some cases, going to a grocery store’s retail health clinic may be more convenient and affordable for Medicare members. (That’s the goal of retail health clinics anyways, right?) Some Medicare plans have transportation to these types of facilities embedded in their benefits, which is great for beneficiaries who have trouble traveling away from home. If a member lives in a rural area, there may be a retail health clinic that’s closer to them than their nearest stand-alone doctor’s office or hospital. Of course, these members may also have access to telehealth, too, but sometimes, they may actually need to travel to an in-person facility for medical assistance. (And, don’t think retail healthcare isn’t infiltrating telehealth! Consider Best Buy’s 2018 acquisition of GreatCall. Google’s parent company has also entered the health care space, with Alphabet investing $375 million in Oscar Health back in August of 2018. It plans to use data to revolutionize the industry.)

Note: While some retail health care facilities have primary care physicians on staff and actually serve as a doctor’s office, others may just have rotating nurses and physician assistants.

Note, we don’t think that these new outpatient outlets should take the place of doctor’s offices and hospitals. While some retail health care facilities have primary care physicians on staff and actually serve as a doctor’s office, others may just have rotating nurses and physician assistants. Regular doctor office visits can be important to managing chronic conditions and a patient’s overall health. Good preventative care can lower one’s health risks and future health care costs. So, if your nearest retail health clinic doesn’t have board-certified doctors on staff, remember to keep checking in with one.

That said, however, retail healthcare clinics can be a good health care option, and they certainly aren’t going away. Instead, they’re revolutionizing when and how people can get the care they need. It’s theorized that retail healthcare clinics may have some serious cost-cutting power for consumers, especially if they can help avoid higher-cost ER visits. Insurers could possibly benefit in this way, too. The savings they see from these partnerships could even be passed down to members, eventually! This movement is still in its early stages, though, and more research and analyses will need to be done, as more of these care clinics have some time to grow.