Seemingly, every morning, I flip through my inbox and come across a new headline about a large retail organization that has cut its losses in the delivery of healthcare. Over the past few months alone, we’ve seen Walgreens, Walmart and Dollar General — all heralded leaders in their respective industries — shutter their in-store clinics and telehealth services after coming to the table with bold, disruptive offerings for patients lacking access to basic healthcare services in their communities.
On the surface, healthcare as a retail operation seemed like a straightforward proposition that would yield big wins for both the organizations and patients by disrupting what can only be described as a highly complex and fragmented system that is not generally known for providing convenience and accessibility at an affordable cost. After all, few would disagree that people yearn for accessible, affordable healthcare packaged with the user-centric technology and consumer-friendly features of a retail model, such as scheduling, patient portals and text reminders. To take it a step further, they already had a customer base looking to them for health-related goods and services, such as medications, supplements and other items.
While both retailers and healthcare providers each have certain elements of care coordination figured out, the complexities of the U.S. healthcare system (as it exists in its current form) and the dexterity of the retail model put the two industries on opposite sides of a great divide. However, academic health systems have a unique and important opportunity to build the bridge.
One of the biggest challenges large retailers likely faced in their healthcare ventures is that while they created access points for care through telehealth visits and on-site clinics and to acquire medications through their pharmacies, that is only half of the strategic equation and accounts for only a piece of a person’s entire healthcare journey.
People constantly traverse the care continuum from wellness to illness, and their unique needs are often too complex to address over one FaceTime call or in a short visit to a primary care physician or advanced practice practitioner. A quick visit to a clinic at the local pharmacy or supermarket is undoubtedly convenient, but what happens when patients require a referral to a specialist or present with symptoms of a chronic condition that requires longer-term management to treat effectively?
While I have long argued that retail has the infrastructure to curate the kind of personalized, user-friendly experience healthcare should aspire to, what they don’t have — at least not on their own — is access to the same breadth and depth of academic research, clinical expertise, innovative medical technology or resources you would find within an academic health system. By partnering, instead of competing with them, retailers could take advantage of their interconnected networks of expertise and services to deliver comprehensive, world-class care to every patient.
From a cost-of-care perspective, health systems often negotiate bulk reimbursement agreements with private payers, allowing them to achieve lower prices through economies of scale. Here, health systems gain access to payer service populations and can provide care at a reduced rate, given the volume of care to be provided.
Additionally, true academic-based health systems provide a level of clinically integrated care that often does not exist in other non-academic care settings and one that allows barriers to care to be navigated, is vertically integrated and can provide community-based care all the way to the most complex. And importantly, our care models are longitudinal and not episodic. This speaks directly to a recent consumer study from healthcare consulting firm Jarrard, which noted that patients directly equated the quality of care they received with their actual treatment experience and the relationships they developed with their care providers — the more positive the experience and level of provider interaction, the higher quality of care they felt they received.
Other research has demonstrated that patients are more likely to trust their physicians if they can choose them and have a longer relationship with them, especially when they turn to them for counsel about ongoing health issues or chronic conditions. The continuity of care should be considered paramount to delivering an exceptional care experience and earning patient trust, and that is difficult to achieve when the patient is paired up with the next available provider or whoever is staffing the clinic that day.
Despite these headwinds, I still believe retail offers tremendous promise as we architect the future of U.S. healthcare. Their industry has some blind spots when it comes to healthcare, but so does healthcare when it comes to creating seamless, connected experiences. Both are still essential and very much in demand. There is a lot that retailers and academic health systems can learn from each other, and there is also limitless potential for the value we can create and provide to patients if we partner to reimagine care coordination and delivery together.