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Health care transformation accelerates

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“We’re on a journey to transform health care, connecting more people to the right care at the right time — at a cost that makes sense.” So said Walmart CEO Doug McMillon following the launch of the retailer’s new 10-year collaboration with UnitedHealth Group. While the remark refers specifically to the companies’ multifaceted project to advance value-based care, beginning with senior citizens, it could also be cited as a succinct summation of the trajectory of the entire health care system.

Major retailers that not long ago defined their health care operations in terms largely limited to pharmacy are rapidly expanding their presence in areas like primary care, harnessing the power of technology to facilitate interaction with patients in the home, and forging partnerships to create fledgling health care ecosystems. Walmart’s deal with UnitedHealth exemplifies the trend. By teaming up with one of the nation’s premier insurance companies, Walmart burnishes its image as a health care provider and takes it into new territory.

Beginning in January, the two companies will offer a co-branded Medicare Advantage plan in Georgia called UnitedHealthcare Medicare Advantage Walmart Flex. In that state and Florida, 15 Walmart Health clinics will start providing seniors with value-based care through multiple Medicare Advantage programs.

Plans call for the services to be expanded to other locations over time, eventually reaching hundreds of thousands of seniors.

At the start of next year, Wal­mart Health Virtual Care will be part of the network accessible to commercial members in UnitedHealthcare’s Choice Plus PPO plan, allowing members to access care when and where they want it. In addition, UnitedHealth’s Optum division will assist Walmart Health clinicians with analytics and decision support tools, helping them to deliver comprehensive value-based care that drives improved patient outcomes.

In the long term, Walmart and UnitedHealth intend to expand the scope of the partnership by adding more Medicaid and commercial plans. Another priority is improving access to fresh food and enhancing existing initiatives targeting prescription and over-the-counter pharmaceuticals, dental and vision care, and social determinants of health.

News of the Walmart-UnitedHealth collaboration came on the heels of CVS Health’s $8 billion acquisition of Signify Health, a technology-driven platform focused on value-based care that maintains a network of 10,000 physicians, nurse practitioners and physician assistants. As in days gone by, those professionals visit patients in their homes to identify medical and social needs, with an eye toward connecting them with appropriate follow-up care and other resources.

Signify will complement CVS’ growing array of health assets, which, in addition to the eponymous drug chain, include Caremark, the country’s biggest PBM, and Aetna, a top-tier health insurer. Karen Lynch, president and CEO of CVS Health, says the acquisition will bolster the company’s health care services strategy by enabling it to reach consumers in the home and speed its expansion in value-based care. “Signify Health’s mission is to build trusted relationships to make people healthier by using actionable intelligence to understand what’s really impacting outcomes and cost today,” notes Kyle Armbrester, the company’s CEO, who will remain in that role after the deal is finalized. He adds that, like CVS, Signify is committed to offering integrated service that “supports a more proactive, preventative and holistic approach to patient care.”

Walgreens Boots Alliance is also moving toward that paradigm. It recently announced the completion of a $330 million investment in CareCentrix, giving it a 55% stake in the company, which uses technology to coordinate value-based in-home care for patients, providers and health plans. The company also employs a predictive analytics platform to refer patients newly discharged from the hospital to appropriate clinicians and sites of care.

“We created Walgreens Health to reimagine local health care and well-being for all,” says Roz Brewer, WBA’s chief executive, referring to the division that CareCentrix is joining. “Our collaboration with CareCentrix is one of the many ways we are expanding on our pharmacy and patient expertise to surround individuals with care when and how they need it.”

The moves by Walmart, CVS and WBA, along with Amazon’s recent $3.9 billion purchase of primary care provider One Medical, are strong evidence that the transformation of the health care system is under way. Companies whose stores were once rightly characterized as places to have prescriptions filled now must be viewed as full-blown health care providers. The U.S. health care system is the costliest in the world and, by many measures, delivers substandard results, paving the way for disruptive innovation. The big three “pharmacy operators” are prepared to deliver it.


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