Fifteen years ago, we launched Take Care Health Systems, a pioneering company in retail health clinics. Little did we know that our clinics, and similar ones that followed, would become an important component of the current merger and acquisition and partnership activity currently reshaping health care.
We did recognize the novelty of health care delivered by the right caregiver, in a convenient setting, at an affordable price that the clinician and the patient both knew. At the time, these concepts were new to health care and we believed that together they held the potential to have long-term influences on how the industry would evolve. We imagined retail health clinics as one day representing the “front door” of the health care system by providing early access that would often serve to start — and even direct — patients’ journeys as they worked their way through managing their health.
Fast forward 15 years, and it turns out that our front-door vision has held water. In fact, the clinics and the tenets that sprung forth from them promise to make a larger impact today than we ever imagined.
Looking back, the retail health clinics touched everything we hold dear in health care today. They helped launch the era of patient-centric care; brought price transparency to the industry; made care for most — if not care for all — a possibility by introducing prices that were affordable and accessible; and spotlighted the value of right provider, right place, and right time. Not long after the emergence of retail clinics, the health care industry saw the rise of concierge medicine, urgent care centers, and telemedicine.
Now the media spotlight is on some of health care’s giants as they jockey for position around the themes that retail clinics set in motion — CVS and Aetna, Walmart and Humana, Cigna and Express Scripts, as Walgreens sits in the catbird seat with various options available to it.
Whether any of these mega-unions come to fruition or, who knows, Amazon may one day own all of health care, solutions for addressing health care’s ills unquestionably need to accomplish the following:
Align incentives. Specific to mega-unions, the potential to combine medical and pharmaceutical benefits could enable a patient-centric health care experience. As noted by Austin Frakt in the New York Times, the health care landscape is fragmented, and misaligned financial incentives are the name of the game. This hurts patients more than any other party. However, when patient health outcomes are managed under one roof, it will be easier to determine which treatments are improving health in the most cost-effective manner.
Educate consumers of health care. Despite tales of patients walking into doctor’s offices with Google-enabled self-diagnoses, the health care industry is woefully behind in terms of educated consumers. Transparency remains elusive. Providing deep insight into where consumers can find the highest quality care at the lowest cost, offering information on where drugs can be purchased at the lowest out-of-pocket cost, and detailing provider capabilities that include actual outcomes data is just a start. Any new companies will need to share a great deal more information with consumers.
Accommodate for social determinants of health. As we envisioned the front door of health care, retail clinics were meant to be used as a facilitator, directing patients to the right setting of care. What we learned from them shows that health care needs to be flexible enough to be delivered in multiple fashions. It’s fine to have the retail clinic act as a quarterback, but we need to go further to other nontraditional care settings, like home and virtual visits. Many players have promised to roll out new health care models that account for the varying needs of local communities and the populations they serve. Committing to innovating around the idea of managing social determinants of health, such as where people live, their socioeconomic background, and the like, is essential for health care companies in the future.
Most important and promising — and worrisome at the same time — is that all of these successful unions must act as open doors within health care. While retail clinics were the front door for many, the mega-unions must allow patients to have choices as they seek care. Without this ability, we are simply exchanging cost savings for choice — an equation that has not historically resonated with patients over the long term.
No matter where the health care industry ends up, the status quo has changed. That is a good thing for the industry. Health care is quickly evolving, from the unions in progress to the ambitions of tech players like Amazon, Google, and Apple. Whether the partnership between JPMorgan, Berkshire Hathaway, and Amazon comes to fruition, or newer models of primary care, like those pushed by Iora Health and Aledade take hold, or the fascinating potential of the recent union of an insurer and media company in the Independence Health Group/Comcast partnership is realized, we hope that the ideas we set in motion 15 years ago with the first retail health clinics will continue to transform an industry in dire need of reform.
Hal Rosenbluth and Peter Miller co-founded Take Care Health Systems, which was bought by Walgreens and is now Clinics at Walgreens. Rosenbluth is now chairman and CEO of New Ocean Health Solutions, a software design and development company focused on health and well-being. Miller is now CEO of Optinose, a specialty pharmaceutical company.