walgreens

Walgreens settles Medicaid billing allegations

Anne Zieger — Wed, 01 Oct 2008 12:44:03 -0400

Pharmacy chain store giant Walgreens has agreed to pay the U.S. and four additional states, $9.9 million to resolve allegations that it falsely billed the Medicaid program. According to the allegations, Walgreen's submitted claims to Medicaid agencies in four states for prescriptions dispensed to persons with both Medicaid and private third-party insurance. Walgreens allegedly turned around and charged the four state Medicaid programs the difference between what privacy insurers paid and what the programs would have paid without private insurers.

The feds decided that this was a false billing situation, concluding that Walgreens was only entitled to what it would have gotten if the claims were submitted to the private insurer, probably a co-pay amount. Since Walgreens submitted claims to Medicaid that exceeded co-pay amounts, they were out of line, officials said.

To learn more about the case:
- read this HealthcareFinanceNews article

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Study: Retail clinic users don't have personal doctors

Anne Zieger — Thu, 25 Sep 2008 13:50:59 -0400

For years now, many primary care physicians have battled the rise of retail clinics, arguing that such clinics would interfere with their patient relationships. However, a new study suggests that their fears are misplaced--as the patients may never have been theirs in the first place.

Retail clinics are attracting patients who largely don't have a primary care relationship in the first place, according to a survey by Rand Corp. More than 40 percent of patients visiting retail clinics were ages 18 to 44. Meanwhile, 23 percent of that group had a primary care doctor relationship, said researchers, who looked at more than 1.3 million visits to retail clinics from 2000 to 2007.

Researchers speculate that such patients value the convenience of the clinics more than the continuity of care a private physician can offer. The study comes as the number of retail clinics in the U.S. surges past 1,000, driven largely by giants like pharmacy chains CVS and Walgreens.

To learn more about the study:
- read this Chicago Tribune article

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Trend: On-site company clinics keep winning fans

Anne Zieger — Thu, 31 Jul 2008 09:45:10 -0400

Just yesterday, we told you that the expansion of the retail clinic market may be slowing down a notch. Fortunately for clinic operators, however, demand seems to be growing for another type of convenient clinic. With no relief in site from staggering healthcare costs, on-site clinics run by employers are becoming steadily more popular. Employers say the clinics help lower health costs by encouraging workers to seek primary care before they need more-costly emergency services or hospitalization, and nudging them to use cheaper medications. Meanwhile, the clinics are also seen as a benefit by employees, who appreciate not having to scramble to get to an off-site appointment when they're sick. Employers are encouraging this thinking by cutting co-pays for workers who use the clinics.

Companies bringing clinics on-site include the North American unit of Toyota and Nissan, Harrah's Entertainment and Walt Disney Parks & Resorts. And this could just be the tip of the iceberg. According to benefits-consulting firm Watson Wyatt Worldwide, 32 percent of employers with more than 1,000 workers either have an on-site clinic in place or expect to build one by 2009.

One of the firms getting a foothold in this business is Walgreens, whose Take Care Health division already operates almost 200 clinics in retail settings. Take Care, which runs Toyota's on-site clinic, contends that employers get back $3 to $5 for every dollar invested in setting them up. Where do these savings come from? Take Care Employer Solutions, the company's on-site clinic division, says that clinic management companies under its wing refer 40 percent fewer patients to specialists compared with traditional primary care doctors, and that emergency department visits are down 72 percent at companies where Take Care runs clinics.

To learn more about this trend:
- read this Business Week piece

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Retail clinic market growth slowing

Anne Zieger — Wed, 30 Jul 2008 10:18:15 -0400

With the U.S. economy facing problems and investment firms tired of waiting for a payoff, the retail clinic market expansion is slowing down, according one industry watcher. According to research and consulting firm Merchant Medicine, which advises providers and employers on how to work within the retail clinic industry, the number of retail clinics in the U.S. fell by 12 last month to a total of 969. This was the first net drop the firm had recorded in the two years it had been following the sector. A year ago, in contrast, the clinics were opening at a rate of roughly one per day, according to the firm.

In today's market, clinics that are backed by giants--such as Walgreens, which bought clinic operator Take Care Health Systems--are doing better than those that lease space from retailers and run their operations independently. Even being based in a high-traffic location like a Wal-Mart offers no guarantee of success. For example, early this year New York-based CheckUps closed up 23 retail clinic locations based in Wal-Marts, unable to pay all of its bills. (Wal-Mart has since said that it plans to focus more on partnering with hospitals on retail clinics.)

Part of the reason for slowing expansion in this niche may be the relatively long time it takes for such ventures to become profitable. For example, while Walgreens' retail clinics are seeing a profit in St. Louis and Kansas City, Mo., it took two years for them to get there. Particularly given today's difficult credit market, any private investors are reluctant to wait that long, researchers note. For example, investors recently pulled out funding for a physician-staffed model of retail medicine known as Medical Marts.

To learn more about this trend:
- read this Chicago Tribune piece

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Expansion of retail clinics slowing

Sterling Meyers — Thu, 24 Jul 2008 11:19:13 -0400

Merchant Medicine, a Minneapolis-based research and retail clinic consulting firm, found that 12 retail clinics were shut down in June--a sign of the slow, but steady growth for retail clinics. The clinics were shuttered because of a weak economy and investment firms that have grown impatient, according to Merchant Medicine, which has been tracking the progress of retail clinics for two years. Although there are 969 retail clinics in the United States, June was the first month the firm has seen a net drop, said Tom Charland, the firm's chief executive.

The clinics that seem to shut down with the most regularity are those that are not financed by private investors who partner with large retailers. Charland said that when big retail clinics close, it's likely because they're backed by private investors rather than by large retailers. Figures show that in 2007, retail clinics opened at a rate of one each day, and despite last month's decrease, Charland said that this month's numbers have shown continued growth, thus far.

Walgreens plans to have 400 clinics--operating under the Take Care Health Systems brand--in place by the start of 2009. A spokesman for Walgreens noted that it has taken about three years for the retail clinics to start turning a profit consistently. Wal-Mart said it will open 400 in the next three years.

To learn more about this:
- read this Inside Health Care piece

Walgreens battles CVS for MA retail clinic market

Thu, 12 Jun 2008 06:59:58 -0400

Over the past year, drugstore chain CVS has engaged in a protracted battle to get permission to open its MinuteClinics in locations across the Boston metro area. The effort involved not only getting permission from state regulators, but also fighting the displeasure of Boston Mayor Thomas Menino, who opposes the retail clinic model. Despite the struggles CVS has faced, fellow drugstore giant Walgreens has decided that it, too, wants a piece of the Boston retail clinic market, seeking state approval to open such clinics inside 16 of its Massachusetts stores. Walgreens' Take Care Health Systems subsidiary has asked permission to build clinics stretching across a broad swath of the state. Its plans also include opening a clinic in Roxbury, a move which is likely to further upset Mayor Menino. Walgreens, which already operates 173 clinics in 14 states, hopes to open its first Massachusetts clinics in the fall. All told, it expects to have 400 clinics running across the U.S. by the end of this year.

To learn more about Walgreens' efforts:
- read this article from The Boston Globe

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Walgreens agrees to $35M drug-switching settlement

Thu, 05 Jun 2008 06:59:58 -0400

Walgreen Co. has agreed to pay $35 million to the U.S. Department of Justice to resolve allegations that it had switched patients to more expensive drugs to boost its Medicaid reimbursement. In the settlement, Walgreen Co. denies any wrongdoing. The case arose from a whistle-blower suit filed in 2003; the whistleblower asserted that between 2001 and 2005, Walgreens dispensed capsules rather than tablets of generic Zantac and Prozac, and brand-name and generic Eldepryl to Medicaid patients when doctors hadn't specified. Forty-six states and Puerto Rico will share the $16.4 million, and the federal portion of the settlement is $18.6 million. Whistleblower Bernard Listiza should receive a total of $5 million, which will be drawn from those moneys.

To learn more about the case:
- read this Modern Healthcare article (reg. req.)

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Kroger chain invests in retail clinic operator

Tue, 03 Jun 2008 06:59:58 -0400

Retail grocery chain Kroger Co. made what it terms a "significant investment" this week in The Little Clinic LLC, a Brentwood, TN-based chain of retail clinics. The Little Clinic already operates centers inside of 26 Kroger stores, using nurse practitioners and physicians' assistants. It's operated by Solera Capital, a private equity firm that acquired the retail clinic operator's predecessor in 2005.

With the investment in hand, The Little Clinic will begin a "substantial" clinic rollout across the retailer's family of stores. It's unlikely that the pace of its rollout will allow it to catch up with competitors like Wal-Mart, which as of a year ago was beginning a 2,000-store introduction of retail clinics in its stores. However, with Wal-Mart recently hitting a snag as one of its partners fell apart financially, perhaps Kroger and The Little Clinic see an opportunity to gain some sort of ground. All told, Kroger operates a total of 2,486 supermarkets in 31 states.

To learn more about this deal:
- read this piece in The Tennessean
- read this Kroger press release

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ALSO NOTED: Tool calculates ROI on quality programs; Doctors resist e-mailing patients; and much more...

Thu, 01 May 2008 06:59:50 -0400

> A new tool could help health plans and providers demonstrate the return on investment from quality improvement. FierceHealthFinance

> While many patients like the idea of corresponding with their doctors via email, few physicians have gotten on the email bandwagon. FierceHealthIT

> San Diego, CA-based Scripps Health has acquired Sharp Mission Park Medical Group. The deal gives Scripps access to 35 family and internal medicine and pediatric physicians. Article

> Another health plan gets on the retail clinic train. Blue Cross of Tennessee has struck a deal with Walgreens' Take Care clinics. Article

And Finally... It seems the governor of this Chilean suburb wants to make sure its seniors get their jollies. Article

Walgreen goes into work-site clinic business

Tue, 18 Mar 2008 07:59:57 -0400

Pharmacy giant Walgreen Co. has said that it will buy two companies that operate work-site health centers, creating a new division to manage health centers and pharmacies at large companies. Walgreen, of Deerfield, IL, will buy Chadds Ford, PA-based I-trax for $278 million in cash, along with Whole Health Management of Cleveland for an unnamed price. I-trax already counts among its client roster such large employers as BMW of North America, Lowe's Co. and Toyota, while Whole health Management's clients include Continental Airlines and Sprint Nextel. With the closing of this acquisition, Walgreens will have a total of more than 500 work-site and retail clinic in 40 states. Ultimately, Walgreens is projecting that the market for work-site health centers and pharmacies could include more than 7,600 corporate campuses with 1,000 employees or more.

To learn more about the deal:
- read this Modern Healthcare piece (reg. req.)
- read this Walgreens press release

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