Walmart Care Clinics: Thinking Outside the Big Box

Pharmacy Times, October 2014 Diabetes, Volume 80, Issue 10

Walmart's first company-owned retail clinics offer comprehensive coverage and competitive pricing for health care.

Walmart’s first company-owned retail clinics offer comprehensive coverage and competitive pricing for health care.

When a person wakes up with postnasal drip, watery eyes, and a sore throat, it’s usually time to call the doctor. But why wait a week or more for a doctor’s appointment when you can head over to your neighborhood Walmart and be treated at one of its new convenient care clinics in about 20 minutes? Walmart has decided to jump on the retail clinic bandwagon and has launched its company-owned convenient care clinics, which are formatted to address acute and chronic health care concerns, as a part of a pilot program this year.

Located within retail stores, pharmacies, and supermarkets, convenient care clinics provide care for nonurgent health care concerns on a walk-in basis and are typically open 7 days a week with extended hours. Customarily staffed by nurse practitioners and supervising physicians, convenient care clinics offer health screenings, immunizations, and routine physicals, along with acute care. The new Walmart Care Clinics are not looking to be the typical convenient care clinic, however. They aim to be the go-to destination for low-cost, comprehensive health care.

“Walmart really wanted to make a difference in providing affordable, accessible, quality health care,” said Jennifer LaPerre, Walmart’s senior director for health and wellness.

Although Walmart already has convenient care clinics, the newly launched Walmart Care Clinics are the first to be company owned. In 2005, Walmart began leasing store space to local health care providers to run independently owned health care clinics. There are currently over 100 autonomous clinics operating within Walmart stores nationwide that focus solely on acute care. The big box retailer decided to delve into the company- owned convenient care clinic market in order to offer a more comprehensive form of health care to customers and employees at the lowest price. “We wanted to own the clinic model because we wanted to be able to establish a new retail price in health care,” LaPerre said.

As the largest private employer in the country, Walmart health care plans cover over 1.1 million people, which includes employees and their families who have elected the coverage. To lessen the burden of medical costs on those who have the Walmart health plan, a visit to a Walmart Care Clinic costs only $4. That same visit costs $40 for those not covered by the Walmart health plan. Supplementary services, such as immunizations, lab tests, and health screenings, are an additional fee for everyone.

The low fees are meant to be “helpful to patients who may be on a high-deductible plan or may be uninsured or underinsured,” LaPerre said.

The first company-owned Walmart Care Clinic opened in Copperas Cove, Texas, in April 2014. Since then, 9 more clinics have opened, with 4 more in Texas, 2 in South Carolina, and 3 in Georgia. These states have a high number of uninsured residents and also have not expanded Medicaid. Nevertheless, Walmart is looking to enroll in Medicare, Medicaid, and Tricare and may explore the possibility of taking commercial insurance in the future, according to LaPerre.

A Growing Industry

The Convenient Care Association, the national trade organization of retail clinics, says there are about 1800 convenient care clinics in 42 states and the District of Columbia. Since the first convenient care clinic was established in 2000, the creation of convenient care clinics has grown exponentially, most notably in recent years. According to a research brief by the Center for Studying Health System Change, the number of retail clinics less than 5 miles away from homes has jumped 5.4% from 2007 to 2010. The annual number of patient visits to retail clinics grew an estimated 9 million between 2007 and 2012, according to a study published by Marketdata Enterprises, an independent market research and consulting firm.

If the upswing trend continues, there will be approximately 2700 retail clinics in the United States by 2016, according to the study.

What is the reason for the expansion? More and more people are flocking to retail clinics because of their convenience, access, and affordability in a downtrodden economic market. But Walmart is not just looking to be accessible and inexpensive.

Retail clinics traditionally focus on acute care and have not expanded to include chronic condition management. By providing care and management for chronic medical conditions, such as diabetes and high blood pressure, in addition to acute care, Walmart Care Clinics will fill a hole in the retail clinic industry.

“We wanted to broaden the scope of services that was being provided in retail clinics throughout the industry,” LaPerre said. “The greatest amount spent in health care is occurring in the chronic condition management space.”

Coordinated care is a priority for Walmart, and the convenient care clinics work to establish referring physicians and collaborative care physicians for the nurse practitioners through local community relationships. Each clinic has a network of specialists and primary care doctors to refer to patients as needed.

According to LaPerre, about 40% of Walmart Care Clinic patients do not have a primary care provider, and Walmart strives to become these patients’ provider of choice for primary care. Additionally, Walmart strives be a part of a patient’s continuum of care and therefore has a rapport with local primary care physicians when their patients use the clinic.

Strong Relationships and a Continuum of Care

In addition to open communication locally, Walmart Care Clinics have a consistent electronic health record system. Consequently, a patient can go to any Walmart Care Clinic with the knowledge that the staff will have access to the same information.

QuadMed, an employer on-site primary care provider, is sourcing the nurse practitioners and collaborating physicians as well as managing the Walmart Care Clinics. While pharmacists are not on staff at Walmart Care Clinics, they are integral to assisting the nurse practitioners regarding a customer’s medication needs or history.

“Our objective is to make sure that there are strong relationships between the Walmart Care Clinic nurse practitioners and pharmacists because medication adherence is really important to providing comprehensive, coordinated care for our patients,” LaPerre asserted, mentioning that the nurse practitioners strive to work collaboratively with all pharmacists, not just those employed at Walmart.

Both the Walmart Care Clinic and the Walmart Pharmacy offer all the immunizations recommended by the Centers for Disease Control and Prevention year-round and for the same price. The Walmart Care Clinic can provide immunizations to children as young as 2 years, and depending on the state, the pharmacist can provide the immunizations to children of all ages as well.

Competitors of Walmart Care Clinics will be contending with their low cost as well as extended hours: Walmart Care Clinics are open for 12 hours a day during the week and 8 to 9 hours each day on the weekends.

The convenience, low cost, and expansive care of the Walmart Care Clinics, and the fact that Walmart is the biggest retailer in the United States, could eventually be a game changer in the health care market as a whole. Walmart’s slow and researched trek into the retail clinic industry has allowed Walmart to establish a competitive retail price for health services, setting up the company and its clinics to be a major contender in collaborative health care.

Katrina Rossos is a freelance writer and journalist living in New Jersey and was previously an editor for AOL. She graduated from Tulane University with a Bachelor of Arts in English and film studies