Reform slows, WAG flexes ‘Complete Care’ for payers

Since September 2009, Walgreens has immunized almost 5.5 million people for seasonal flu and more than 1 million people for H1N1 through its drug stores, Take Care clinics and worksite health centers.

Step by step, Walgreens is moving to position itself at the intersection of two powerful trends in American health care. One is the unsustainable rise in the nation’s publicly and privately funded healthcare bill. The second is the inexorable shift of the health delivery system itself, as that system moves steadily from a doctor- and hospital-driven, fee-for-service model to an evidence-based system that focuses on preventive care, successful patient outcomes and the kind of localized, periodic patient interventions that pharmacists are uniquely qualified to perform.

Both have spawned an increasingly urgent search for new, more cost-effective ways to deliver care and improve patient outcomes. That search is opening a wide window of opportunity for community-based pharmacy and healthcare providers.

That’s especially true for such retailers as Walgreens with the market reach, economic scale and flexibility to recast their companies as convenient point-of-care solutions —both for patients and for the employer- and government-sponsored health plan payers that cover their health care. Walgreens, in short, is positioning itself as an extension of physicians’ services.

With or without a legislative mandate, employers and other health plan sponsors aren’t waiting for health reform as they seek new solutions to rising health costs. Indeed, hundreds of companies already are contracting with Walgreens to deliver more cost-effective health and preventive services directly to their health plan members. It’s a matter of accessibility. In the future, Walgreens president and CEO Greg Wasson said, the success of a more cost-effective, patient-centered healthcare system will depend on accessible points of care for patients as much as any other factor. And Walgreens has about 8,000 of them.

“Over the past several years, we have built a powerful suite of pharmacy and healthcare services, unmatched in the industry,” Wasson said early this year. Within Walgreens’ nationwide health delivery arsenal: more than 350 Take Care Health Systems in-store ambulatory care clinics; some 380 worksite health centers where employees can obtain clinical and preventive health services; about 100 hospital- and professional-center-based pharmacies; five long-term care pharmacies; five mail-order centers; and a growing network of specialty pharmacies throughout the United States to serve patients with such serious conditions as HIV, cancer, organ transplant rejection, multiple sclerosis and infertility.

Anchoring that powerful network are 7,162 Walgreens drug stores in all 50 states. “All these services leverage our center of gravity, which is community-based pharmacy and health care,” Wasson said.

Together, all those outlets total more than 8,000 points of care, staffed by 70,000 pharmacy and health professionals. Aware of the potential power of that network, Walgreens leaders have focused hard to connect the dots between each point of care in order to build an integrated, “One Walgreens” model. The goal: a national retail and clinical healthcare brand that can provide a single, holistic go-to-market solution for a wide range of patient needs.

In search of “better healthcare outcomes,” Walgreens “will integrate capabilities across all of our platforms, including pharmacies, retail clinics, call centers and mail service, to enable patients to better control their conditions,” Wasson said. To that end, the company is aggressively expanding its integrated healthcare services to employers desperately looking for ways to cap their spiraling employee health costs.

That offering, Complete Care and Well-Being, is an “employer-centric” pharmacy, health-and-wellness program that puts Walgreens pharmacies and Take Care clinics right on employer worksites. Some 200 U.S. companies already are Complete Care clients, and more are signing on every month.

“This is a great example of innovation taking place in the private sector,” Wasson noted. Such big employers as Disney, Harrah’s and lawn care giant Scott’s already are on board. And beginning in January, Walgreens began providing transparent prescription drug pricing to Caterpillar, in a deal to lower drug costs for the world’s largest manufacturer of construction and mining equipment—and reduce out-of-pocket expenses for its 70,000 employees, as well, by offering many commonly prescribed generic medicines at no co-pay to the company’s health plan members. The two companies also agreed to explore, through Complete Care and Well-Being, additional ways to extend integrated healthcare and pharmacy services to Caterpillar employees.

Walgreens also has begun providing wellness services to Health Care Service, which operates through Blue Cross Blue Shield plans in Illinois, New Mexico, Oklahoma and Texas, and to High-mark Blue Cross Blue Shield, headquartered in Pittsburgh. Last month, Walgreens struck again, opening a Take Care worksite health center at Health Care Service’s Chicago headquarters, staffed by a part-time physician, nurse practitioner, registered nurse and front-desk registrar. The center serves some 5,000 employees.

“Large employers are going to continue to look for new and creative solutions to managing their healthcare and medical costs,” Wasson told Drug Store News in a 2009 interview. “What this does is allow a ground-based approach, with clinicians on the ground, in the center, touching employees daily…connecting to whatever benefit design or structure they may have under their current program. Our goal is to make sure it’s a one-patient, one-employer, one-employee view of Walgreens,” Wasson added. “We want the employer to understand that Walgreens can bring all these solutions to bear.”

Walgreens also is adding new store based health initiatives. The newest is Walgreens Optimal Wellness, a self-care education program, launched early this year for patients with chronic conditions. The program initially will focus on people with Type 2 diabetes. “The core of the approach features Walgreens healthcare providers, including community pharmacists and Take Care nurse practitioners, leading a program of individual health coaching and diabetes counseling,” the company noted.

Since September 2009, Walgreens also has immunized nearly 5.5 million people for seasonal flu and more than 1 million people for H1N1 flu, according to Wasson. The program draws on “more than 17,000 immunizing pharmacists, nurse practitioners, registered nurses and physician assistants providing flu vaccinations,” according to the company. “What this tells us is that the American public values the value and convenience of community pharmacy,” Wasson noted. “We think we can play a big role in vaccinations.”

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