Health crisis will expand clinic sites, service

When National Association of Chain Drug Stores president and CEO Steve Anderson earlier this year at NACDS Annual urged pharmacy leaders to be “disruptive innovators,” and new NACDS chairman and Walgreens president and CEO Greg Wasson called on the industry to embrace a holistic view of the total store in improving patient lives, they easily could have submitted Walgreens and its Take Care Health Systems subsidiary as an ideal case study.


“When we think about our role in health care we, for years, have been talking about disruptive transformation — positive, disruptive transformation, which is what the healthcare industry has really needed,” Peter Hotz, group VP of Walgreens/Take Care Health Systems, told DSN. “While the worksite and retail businesses are different, they both play that disruptive role. The worksite business is disrupting the way, in a positive fashion, and transforming the way that employers provide access to health care to their employees. … With the retail clinics, the focus there has been transforming access to care.”


Today, Take Care Health Systems is the largest and most comprehensive manager of worksite health-and-wellness centers and retail-based health clinics, with more than 700 locations throughout the country. And there’s no doubt that both its retail-based Take Care Clinics — whose future growth will be influenced, in part, by additional openings of the Walgreens Well Experience concept — and worksite locations are not only revolutionizing the face of health care but also are revolutionizing the entire Walgreens enterprise.


With the convergence of three major trends — a physician shortage, the nation’s deteriorating health status and rise of chronic diseases, and the upcoming increase in healthcare coverage due to healthcare reform — not only will the strain on the nation’s healthcare system intensify, but so will the need for those convenient, affordable and high-quality services provided through Take Care Health. This will further position Walgreens along the front lines of health care.


To counteract the strain on the U.S. healthcare system, Hotz said the company is embarking on several “creative solutions” that will include additional sites, services and hours. Some of these solutions are well under way. For example, Take Care Clinics is offering, in a pilot with the Centers for Medicare and Medicaid Services, the health risk assessment that must be completed as part of Medicare’s new annual wellness visit. It also recently expanded its menu of services to include new diagnostic tests and administrative physicals. The services, which include a blood test used to monitor Type 1 and Type 2 diabetes, and a lab test to help identify hidden blood in the stool, further advance the Well at Walgreens strategy as Walgreens enhances its services as a community healthcare provider and transforms to a health and daily living destination.


Going forward, technology also will play a greater role to help Take Care fill gaps in care. In fact, Hotz said the company currently is testing the application of telemedicine. 


For example, Take Care Health Systems collaborated with Cisco in late 2011 to operate the LifeConnections Health Center on Cisco’s campus in San Jose, Calif., offering employees and dependents integrated health-and-wellness services, including primary care, physical therapy, chiropractic care, acupuncture, vision, health coaching and an on-site Walgreens pharmacy. The worksite facility also is connected to Cisco’s campus in North Carolina, where employees can interact with a physician at the San Jose campus via high-definition video. 


Hotz also believes there’s an opportunity to offer video health within the retail-based clinics to provide patients access to specialists. 


Meanwhile, the clinic operator is piloting a program that offers patients mobile and online appointment scheduling services through consumer healthcare app iTriage, and is offering real-time appointment scheduling via the Web.


“The general, underlying theme is a more integrated part of the healthcare delivery system, and that’s true of Walgreens overall, and not just the retail clinics. Where the clinics started as acute treatment and a lot of independent services, they are now involved a lot more in working with the community as an extension of a health system and working in coordinated models of care,” Hotz said.


Taking a look specifically at worksite clinics, this is a market-driven, fast-growing area of the business for Take Care Health Systems that, generally speaking, is enabling employers to curb rising healthcare costs by saving roughly $2 to $4 for every $1 they invest over a five-year period. In stark contrast to the national average, many of Take Care’s employer clients are showing flat health spending trends over the past five years, Hotz explained — and some are reversing the trend altogether, he told DSN.


“We are being asked to look at the worksite health center as a platform from which we can manage not only the care that is delivered at the worksite, but also in the community. The other big trend there is the continued movement toward more of a population health management role,” Hotz said. “So, not just managing the acute issues, but really looking at that population that that employer is responsible for, and trying to work with that employer on both a macro basis and an employee-by-employee basis to try and figure out how to drive down those costs and improve the health status of that population. We are getting a lot more involved in awareness programs, wellness campaigns, long-term condition management, behavior change … and trying to get at the underlying root causes of the healthcare cost.”


As a strong indication of its belief in the worksite model, Walgreens is one of Take Care’s own corporate clients. Walgreens’ Deerfield, Ill., office campus hosts a Healthy Living Center that offers headquarters team members a full array of acute and preventive services and an impressive fitness facility.