Max Anfilofyev’s Post

Walmart Health and Walgreens VillageMD are models that had to step backwards from primary care (Walgreens lost $6B in this venture)but what of money hemorrhaging ▪️One Medical /Amazon with DPC hybrid as the model with its $85B in reserves? And they now offer it for $9/mo to prime members. When it was losing at $199/mo.Money can buy you love but not happiness. ▪️CVS Health closing 900 retail stores and 29 Minute Clinics (LA/New Hampshire)this year but pressing ahead via Oak Street Health-yet another seniors VBC it bought for $10.6B ? Is Oak Street’s VBC model radically different from Village MD? Will it drive more meds/DME/home infusions? Like WMT didn’t ? This is different because of whom the whitecoats work for. Big Daddy. Not a third party as WMT tried. Are these two impacted by the fall backs? Amazon News Green, who took over as CEO shortly after One Medical was acquired by Amazon for $4 billion last year, says his next priority is further integrating the two companies, such as by combining One Medical’s #primarycare with Amazon’s low-cost, fast-delivery online #pharmacy service. Expanding to new parts of the country is also on the docket, since One Medical's physical clinics currently serve only 20 predominantly coastal, urban areas, including New York City, San Francisco, and Washington, D.C. In the future, Green says, patients in more rural areas may be able to complement One Medical's #telehealth services with in-person care from local providers partnering with the company. https://lnkd.in/dpFWHACn CVS News In 2023, CVS closed two multibillion-dollar deals, acquiring home health service Signify Health and Oak Street Health, which focuses on providing primary care for seniors. Like drugstore peer Walgreens , CVS has spent the last several years growing into a larger, more multi-faceted health-care company. ″Think about the primary care as the quarterback to your health care,” Lynch said, adding that in-home care can be especially helpful for patients. “When we’re in the home, we get to open up the refrigerator and see if you’re eating well. We get to look and see if there’s rugs that you might trip on.” The company is also making changes to its retail arm. According to Lynch, CVS plans to close 900 stores as well as remove self-checkout from several locations. https://lnkd.in/dk7pshzS healthcare giant is sticking with its expansion strategy for Oak Street Health to open 50 to 60 clinics for seniors next year. CVS last year acquired Oak Street for $10.6 billion in cash, adding a large network of doctor-staffed clinics primarily used by seniors. Oak Street has more than 200 medical centers across 25 states and CVS plans to open dozens more. “We’re still opening 50 to 60 clinics next year,” CVS chief executive officer Karen S. Lynch said during an interview Wednesday just a few hours after the company reported fourth quarter earnings that beat Wall Street’s expectations. “All is working well.” https://lnkd.in/dnHEuvUT

The best intentions may still lead to divestment. This is insightful for many both in and out of the traditional healthcare provider space. Others like Amazon are still making a go of it, but Walmart has learned that there really isn’t a fortune to be made in running side clinics. To them at the end of the day, business is business. But hey, there’s still money in the pharmacy game, and maybe refocus on core competencies to drive the shareholder value. The traditional family and patient centered models are looking better than ever. #healthcare #childrenshospitals #physicians #hospitals #primarycare

Really worth reading and digesting

I read the news, WalMart clinics are closing, but I didn't realize Amazon and Walgreen's clinics are also in trouble. One of this article's quotes is healthcare is local and building trust is paramount. These clinics, with their high clinical staff turnover, not able to build patient trust certainly is a factor in their struggles. To me, access to quality care starts with an equitable partnership between clinical care teams and these business operators-Amazon, Walgreens, WalMart and many more. This seems like the logical approach to retain clinical staff and build patient trust. Are there care center business models like this out there today? Thank you Rusty McMurray, Sunshine Care Technologies, for sharing this Becker's article with me. https://lnkd.in/eE-9utUi

Last month, Walmart announced that it would close all 51 of its health centers in five states, as well as its #virtualcare services. If any company could make #primarycare work effectively and efficiently on a large scale in this country, it should have been Walmart. The fact that it couldn’t succeed as a #healthcare provider is a big deal, and a big problem for healthcare in the U.S.   In a new blog, Ken Kaufman draws important conclusions from Walmart’s healthcare failure, and urges all healthcare providers to continue to experiment and apply their unique visions and considerable talents to the goal of finding primary care solutions that work for their communities. #healthcaremanagement https://lnkd.in/gdKxugjK

Only words missing from your short commentary is AI and foundation models

Strongly disagree w Peter Bonis here. Walmart got the success formula wrong not the FFS model. That model works perfectly when the right ancillaries house with independent PCPs who take home double to triple the median with plenty of billable diagnostics within the scope of practice. All valuable to patients. Not high-end cash pay vanity offerings like Botox. Juvederm. Walmart lasered on pumping out more meds glasses and DME which they couldn’t control because they leased to docs -and then did their billing. An upsell and collections cluster. Day 1. ◾️They overspent. No one needs X-ray on-site and a tech at $80k. They are on every street corner. ◾️6000sf for 2-3 whitecoats makes zero sense and dentists don’t refer nor do eye ear and behavioral. So totally reliant on walk in. Not a “strategy” any of this. But likely Ivy League generated medical delivery rookie errors all this opex / capex silliness. And the highly publicized #shortage isn’t one. It is tomorrow as 63% of med students want nothing to do with patients. NPs is 60%. Gen Z isn’t adulting. We have enough PCPs for every American to share one with 730 others. That’s a panel 1/3 the sickcare model. What we have is an efficiency issue solved mostly by #virtualprimarycare a part of every #DPC serving 35m of us. Meet all who are scaling this right here. We are living in a future where everyone wins. www.PrimaryCareCures.com This is brought to you by Redirect Health Free report -How to Slash Healthcare Costs https://lnkd.in/gfNdnS8T Excerpt primary care has been the bedrock of health services delivery, but the traditional model is no longer sustainable. There are too few primary care doctors in practice, and many are nearing retirement or planning to cut back due to professional burnout and other factors. Source: Fierce Healthcare https://lnkd.in/gt4zX73d

Ann Kempski sadly, I am not sure that the move to integrate primary care with pharmacy (and introduce the pharmaceutical care process or CMM) for these natural champions (WG, CVS) was about creating better care, lower cost, or higher patient & provider satisfaction. While some would argue that the business model/lack of reimbursement is the reason for failure, there were few real attempts through practices under VBC to deliver on the promise of team-based care (pharmacist + MD+pt) at the practice level (going beyond Rx dispensing, pharmacist behind the counter, flu shots). Results are clear- integrated comprehensive medication management creates value by managing medication misuse, overuse, and underuse and in risk based models has shown clear ROI in multiple settings (see GTMRx Institute most recent evidence document: https://lnkd.in/eyis6cE7) For various reasons these integrated systems continue to work around the edges trying to maximize FFS reimbursement rather than take it to the practice level to truly integrate team based care and manage medication use problems like dose too high, dose too low, wrong medication or deprescribing. GTMRx Institute Ira Klein Susan M Huang, MD, MS ASHP American College of Clinical Pharmacy (ACCP) James Gelfand The ERISA Industry Committee National Alliance of Healthcare Purchaser Coalitions Karen van Caulil, Ph.D. Cheryl Larson Jane Cheshire Gilbert CPA (Views Are My Own) Jessica Brooks Woods CEO, MPM, PHR Marianne Fazen, PhD Gerri Burruel Ann C. Greiner Paul Grundy Bob Phillips, MD MSPH Allison Hickey John G. Singer Julie Schilz Chet Robson, DO, MHCDS, FAAFP Scott Conard, MD Bob Phillips, MD MSPH

In January 2013, Physician Associates Medical Group, comprised of 95 mostly primary care physicians, selected Orlando Health and joined the health network as a full partner. That was a big 'get' at the time for an organization looking to ramp up primary care to bolster its wealth of specialty physicians in heart, cancer, neuro, ortho, women's health, and pediatrics. "Choose Orlando Health Physicians" was the campaign mantra at the time. And it played well. While all this was unfolding, Walmart was building out supercenters in Orlando. The growth in Central Florida was and remains overwhelming, coming out of both the Great Recession 2008-2010, as well as the impact of out-of-state migration during the pandemic in 2020. Walmart's decision to get into healthcare was a no-brainer. Central Florida has a large population of seasonal consumers, thousands of whom work in hospitality and tourism thanks to Disney and Universal theme parks, hotels, etc. Add to that, Orlando was at the time, and likely today, the number 1 tourist destination in the world. Access, capacity, and underserved needs in routine care opened the door for Walmart Health to disrupt...and this market was eyeballed as a target-rich environment. I often wondered when this announced partnership would become a reality. It's a win-win for both businesses as well as healthcare consumers. Walmart Health gets backup from a growing world-class health network... Orlando Health gets to protect its referrals to specialty care... Consumers get more accessible, convenient, and affordable options through eight supercenters along with countless ancillary support locations throughout Central Florida. It's an easy prediction that this will become the model for other Walmart Health partnerships. Cary D'Ortona James A. Gardner Carrie Liken Ron Cohen Mary Mahoney #brand #healthcare #hospitals #primarycare #linkedin Jeanne Adam Orlando Economic Partnership City of Orlando Kena Lewis, APR,

Healthcare will break. The wave of retired baby boomers will require extensive care over the next two decades. The Walmart approach was one potential shift. They gave up. This article suggests why. “In a revealing piece by Jason Del Rey for Fortune Magazine, the ambitious healthcare vision of Walmart's founder, Sam Walton, is dissected to understand why it ultimately failed to materialize. Here's a summary with key ideas and editorial commentary: 👉🏽- **Sam Walton's Vision**: Walton's dream was to leverage Walmart's massive scale to control medical costs, a vision he passionately advocated for until his death¹. 👉🏽- **Walmart Health's Closure**: The recent shutdown of Walmart Health, a chain of 51 clinics, and its virtual medical service, marks the end of an era for the retail giant's healthcare ambitions¹. 👉🏽- **Reasons for Failure**: - **Reimbursement and Operating Costs**: Officially, the company cited a challenging reimbursement environment and escalating operating costs as reasons for the closure¹. 👉🏽- **Internal Challenges**: Unofficially, leadership turnover and internal politics, along with a miscalculation of cash-paying patients, contributed significantly to the downfall¹. 👉🏽- **Editorial Commentary**: 👉🏽- **A Missed Opportunity**: Walmart's retreat from healthcare is a missed opportunity to democratize medical services, especially for rural and underserved communities. 👉🏽- **The Walton Legacy**: Despite the setback, the Walton family's commitment to innovation remains a cornerstone of Walmart's ethos. 👉🏽- **The Bigger Picture**: The failure raises critical questions about the feasibility of large corporations making healthcare more affordable and transparent. If Walmart couldn't crack the code, who can? The article paints a picture of a noble endeavor stymied by complex healthcare systems and internal corporate struggles. It's a reminder that even the most powerful entities face significant barriers when attempting to disrupt entrenched industries like healthcare. The closure of Walmart Health is not just a loss for the company but also a setback for the broader goal of healthcare reform. Source: Conversation with Bing, 5/8/2024 (1) Insiders reveal why Walmart pulled the plug on Sam Walton’s dream to .... https://lnkd.in/gazmEsCe. (2) Sam Walton: The American Underdog/Rebel Who Changed Retail - Newsweek. https://lnkd.in/g-pigg5v. (3) How Curiosity and Humility Built the World’s Largest Company: the Sam .... https://lnkd.in/gMwYxwPd. Bing Summary #healthcare #leadership https://lnkd.in/gMBMZS3f