National brands are driving healthcare into new settings for care delivery

Search “healthcare changed forever by COVID-19” online. Millions of results pop up, from a “forever changed” supply chain to a “forever changed” industry landscape due to mergers and acquisitions to “forever changed” care delivery via telehealth.

Instead of giving COVID-19 premature credit for all these changes, though, we’d rather call it a catalyst that could accelerate the industry’s response to a trend we’ve been tracking for almost a decade: the rise of consumer-driven, on-demand healthcare and related business models, such as nationally-branded care delivered locally outside of traditional care settings. Several announcements this summer suggest this care delivery model is gaining traction, both in the home and in a pharmacy/retail setting.

No Place Like Home

In announcing its “advanced care at home” plan, The Mayo Clinic has laid out an ambitious vision to greatly expand the types of medical care that can be delivered anywhere. Mayo plans to offer advanced hospital care in patients’ homes, with pilot implementations this summer in Jacksonville, Fla., and Eau Claire, Wisc., and then a gradual national expansion of the model. Mayo Clinic physicians will oversee nurses, paramedics and other caregivers as they provide infusions, skilled nursing, medications, laboratory and imaging, behavioral health, and rehabilitation services. Patients who qualify and opt-in will quickly transition from the hospital directly to their home. The venture is part of the Mayo Clinic Platform, which is designed to leverage emerging technologies and a partner ecosystem that complements Mayo’s clinical capabilities. With this development, the Mayo Clinic is pushing virtual care into “care anywhere.” While telehealth has greatly expanded during the pandemic, largely because of patients trying to avoid the virus, some patients still need hands-on care. The Mayo Clinic’s model serves to endorse the idea that even sophisticated medical care can be safely administered outside of traditional provider settings. The president of the Mayo Clinic Platform envisions hospitals eventually becoming large emergency departments, with most other care delivered elsewhere. A lingering pandemic might increase support for this care delivery model.

Northwell Health is delivering in-home care, including respiratory support, for COVID-19 patients in New York. Now, other hospitals in hard-hit states may adopt Northwell’s approach. Familiarity with in-home care, combined with a national brand such as The Mayo Clinic, could make this a substantial channel for care delivery.

Care, Just Down the Street

In June, Walgreens announced it is partnering with Village MD to open 500 to 700 “Village Medical at Walgreens” primary care clinics in more than 30 U.S. markets during the next five years, with the “intent to build hundreds more” after that. The company says more than 3,600 primary care providers will staff the clinics. The pharmacist, not surprisingly, will be a key member of the team. Walgreens has more than 9,000 retail stores and claims 78% of the U.S. population lives within five miles of one of its stores.

Meanwhile, HealthHubs from CVS are doing well despite the pandemic, with the company planning to open 1,500 of the hybrid clinic-stores by the end of 2021. In a CVS HealthHub, more than 20% of the retail space is dedicated to health products and services. The company operates 1,100 Minute Clinics and 9,900 stores.

Certainly not least, Walmart Health continues to roll out its flat-rate medical clinics. The retail giant is testing a new format this summer in Arkansas and announced it will introduce Walmart Health locations in Florida next year. The Walmart Health locations are full-service, standalone clinics that offer a comprehensive range of services, including primary and urgent care, labs, X-rays, diagnostic tests, counseling, dental care, optical and hearing.  Prices are flat rate, regardless of insurance status. This model aligns with the McHealth model we’ve envisioned, with process and technology innovations enabling quality healthcare to be delivered at a good value in a scalable model. Walmart  also offers Care Clinics staffed by nurse practitioners in Georgia, South Carolina and Texas.

Get Catalyzed

Clearly, COVID-19 hasn’t stopped some major healthcare players from testing new business models that address the industry’s chronic condition: high costs.  Healthcare costs accounted for almost 18% of GNP in 2018, or more than $11,000 per person. Political, cultural and corporate pressure to rein in those costs will almost certainly increase, especially if the pandemic continues to hamper the world economy.

Care delivered at home can cost 32% less than providing the same care in a hospital. Telemedicine that keeps patients out of emergency departments saves between $19 and $121 a visit.

Healthcare organizations that want to sustain and grow market share as big brands drive care delivery into nontraditional settings should consider the following actions:

• Expand virtual care capabilities. To be a truly robust alternative to in-person office visits, telehealth capabilities must include the ability to receive and analyze data from in-home remote monitoring and next-gen med devices.

• Explore partnerships. Mayo Clinic executives say they plan to build out their national hospital-at-home system by forming alliances with regional healthcare providers, community organizations and other, non-healthcare companies with complementary offerings such as broadband services. Aligning with a strong national healthcare brand could be a lifeline for smaller regional and rural providers, many of which struggled financially even before COVID-19 fears drove down revenues from elective procedures and well care.

• Accelerate compliance with interoperability regulations, then build on it. The new interoperability rule, which takes effect Jan. 1, 2021, can enable true portability of important health data. Consumers accessing care anywhere will need their health data at their fingertips. Healthcare organizations that provide apps showing consumers their health plan coverage, their medication list, a thumbnail medical record, etc., will be positioned to capture loyal customers. Organizations should think of the future services they can offer based on data interoperability and ensure their current compliance strategy will deliver the necessary capabilities for these services.

• Simplify pricing. Price transparency rules require providers to clearly communicate costs to consumers. Providers and payers could partner to develop value-based pricing on bundled procedures with in-home recovery components. Be innovative: Create virtual service packages for younger and/or self-employed and gig economy workers, at reasonable flat rates or via monthly subscriptions.

• Find your platform. Platforms enable healthcare organizations to tap into the creativity and speed of entrepreneurial companies, squeeze more value out of existing systems and deliver frictionless experiences. Platforms also can host services to which other healthcare organizations may subscribe, such as remote monitoring of ICUs or providing artificial intelligent (AI) agents for in-home care management and patient coaching.

No one knows what COVID-19 will change “forever.” Instead of predicting the future, healthcare organizations can use today’s indicators, such as increased use of telehealth services, to inform their thinking about how to deliver cost-effective care when and where consumers want it.