CVS

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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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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More pluses than minuses in eventful week for retail clinics

Fri, 14 Mar 2008 07:59:59 -0400

So, it looks like retail clinic news has been a matter of two steps forward, one step back. For example, Cigna has just announced that it would pay for care delivered at another retail clinic chain, increasing its reach to quite a large number of such clinics. This bodes well for other larger commercial insurers to take similar steps, which can only help accelerate the growth of the industry.

On the negative side of the column, meanwhile, retail clinic chain Medical Marts has shuttered operations. And more worrisome, for people pushing the retail clinic model, the state of Illinois is pondering rules that would slip in a provision preventing stores that host clinics from selling tobacco or alcohol, a requirement most retailers just couldn't afford. My gut feeling is that this won't pass, though you never know how regional politics will play out. It seems transparently on the punitive side, which will turn off all but the most ardent clinic opponents.

Still, there's no sign that the industry as a whole is slowing down. For example, Walgreens has already rolled out almost 150 Take Care brand clinics, and plans to have 400 in its stores by the end of 2008. CVS/Caremark, for its part, opened its 500th clinic last week. And let's, by no means, forget about Wal-Mart, which is steamrolling ahead toward its larger goal of implementing about 2,000 clinics over the next several years--at this point, focusing largely on partnerships with providers.

Sure, if they can get away with it, state medical societies are going to continue to push measures that will limit or even prevent the emergence of retail clinics. But I don't think they will. From where I sit, the retail clinic industry may be evolving into a model where existing providers, rather than smaller entrepreneurial companies, are likely to drive the train, but I'm pretty confident the train will keep rolling. - Anne

Caremark to pay $38.5M settlement

Fri, 15 Feb 2008 06:59:58 -0500

Pharmacy benefit manager Caremark Rx has agreed to pay a total of $38.5 million to 28 states and the District of Columbia to settle charges that it manipulated doctors into changing prescriptions that favored the company. The investigation concluded that Caremark convinced doctors to switch their patients over to specific brand-name medications without disclosing its own financial interest in their doing so. Caremark, which is admitting no wrongdoing, allegedly twisted doctors' arms because it was getting big volume discounts on the drugs it was pitching. As part of the settlement, Caremark has agreed to follow terms of a prescription fulfillment policy which, among other things, forbids it from recommending drug changes if the proposed drug will cost consumers or employers more than the originally-prescribed drug.

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

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Errors encouraged by fast pharmacy pace

Wed, 13 Feb 2008 06:59:57 -0500

A new investigation by USA Today suggests that corporate policies for retail pharmacies such as Walgreens and CVS--which together fill almost one-third of all U.S. prescriptions--could promote errors by encouraging pharmacists to work at the highest possible speed. The newspaper, which looked at policies and alleged errors at the two retail chains, found related lawsuits and pharmacy board disciplinary actions in 10 states. In its analysis, it found that in cases of alleged errors, there were some common factors, including high prescription volumes, a shortage of pharmacists, reliance on technicians, incentive awards for pharmacists if they increase the volume of scripts filled, and a lack of face-to-face counseling for the majority of customers. In response to the investigation, Walgreens noted that it has spent almost $1 billion over the last 10 years on safety training and technology, and CVS noted that its error rate had been cut to "a small fraction of 1 percent" and was still falling.

To learn more about this investigation:
- read this USA Today piece

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Start-up closes 23 Wal-Mart retail clinics

Wed, 30 Jan 2008 06:59:58 -0500

Heavily in debt and unable to pay its medical staff or vendors, start-up retail clinic operator CheckUps has closed down 23 clinics operating in Wal-Marts. The clinics were based in Florida and three other southern states. CheckUps, based in New York, stopped paying some of its nurse practitioners in December, according to reports published in The New York Times. It also owes about $108,000 to Medtracker Personnel, a Louisiana employment agency which provided nurses to some of the clinics. It seems CheckUps may just have expanded too fast; it went from acquiring three clinics in Florida to adding 20 more in Louisiana, Alabama and Mississippi Wal-Marts within just one year. Given that it costs $300,000 to $600,000 per clinic over a two-year period just to break even, it takes a lot of capital to make an expansion of that size work.

Given that only 80 clinics are operating in Wal-Marts at present--all run by outside firms--losing 23 of them is a significant event. Still, it's unlikely to slow Wal-Mart' retail clinic strategy down. Wal-Mart executives said they still plan to lease space to several hundred clinics over the next two years, and to offer space to as many as 2,000 clinics by 2014. Wal-Mart CEO said he's particularly interested in more hospital partners to add to the mix. The retailer has already partnered with Wisconsin's Aurora Health Care system and the North Broward Hospital District on Florida's southeastern coast.

To learn more about Wal-Mart and CheckUps:
- read this piece in The New York Times
- read this Wall Street Journal item

PLUS: Though CheckUps may be closing clinics in Florida, the retail clinic industry is still expanding there. In South Florida, for example, Walgreens and CVS are opening clinics at a rapid rate. Article

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Retail clinic opposition emerges in Tenn.

Thu, 24 Jan 2008 06:59:56 -0500

Though retail clinic firms don't seem much slowed by their efforts, medical associations around the country continue to make efforts to regulate their operations. The latest front in this battle seems to have emerged in Tennessee, where the Tennessee Medical Association is looking at proposing additional regs that would impact retail clinics.

Originally, the Association had planned to ask the state's Board of Medical Examiners to impose rules which would require a supervising doctor to be within 30 miles of a clinic and spend additional time on site. This expands on existing rules, which require nurse practitioners to be supervised by a doctor, but don't specify how close the supervising doctor needs to be geographically. After noting that the clinics can have some beneficial effects, particularly on access for rural patients, the TMA has since backed off from its original proposal, but still plans to recommend other unspecified rule changes.

To learn more about the Tennessee retail clinic situation:
- read this piece from The Tennessean

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Study: Retail clinics at about 1,000 in U.S.

Wed, 16 Jan 2008 06:59:55 -0500

A new study of U.S. retail clinics has found that there are about 1,000 in operation in the U.S. at present. The study, by Verispan, listed a total of 921 clinics currently open today. According to Verispan research, the clinics are operating in 36 states. The fastest growing player in the sector is Minute Clinics, which are operated by CVS Caremark. There are currently more than 390 Minute Clinic locations. CVS is followed by Take Care Clinics, which are currently operating in 136 Walgreens stores, The Little Clinic, with 40 locations in five states, and Redi Clinic, with 33 locations in various Wal-Mart and H-E-B retail settings. Of the top 10, to our knowledge only Aurora Quickcare (22) is run by a health system, so it appears that independent clinic operators are well in the lead.

To find out more about the study:
- read this Healthcare Finance News piece

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Boston's mayor objects to retail clinic approval

Fri, 11 Jan 2008 06:59:57 -0500

Just yesterday, it looked like it would now be clear sailing for CVS Caremark, which had sought approval from Massachusetts authorities to open 25 to 30 MinuteClinics around the Boston metro area. While imposing some limitations on their operations, after months of deliberations the state's Public Health Council had agreed that they could proceed. Now, it seems that Boston Mayor Thomas Menino wants to make sure the clinics never open.

Not only is Menino criticizing the council's decision vigorously--arguing that it "jeopardizes patient safety"--he's asked the city's Public Health Commission to consider banning retail clinics from Boston. Now, the panel is investigating whether it can bar them through the back-door method of forbidding stores with clinics from selling tobacco products, a requirement which would prove very costly to the stores. Given the 11th hour timing of Menino's broadside, it makes one wonder what motivated him to come forward. Seems to me that Menino and the Massachusetts Medical Society must have had a frank dialog, to say the least.

CVS Caremark executives must be mad enough to spit nails at this point, but in their public statement, they only said that they'd "be happy to talk to Mayor Menino about any of his concerns." We'll see how this shakes out, but man, this is a particularly nasty dispute, isn't it?

To learn more about the controversy:
- read this article from The Boston Globe

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Coalition urges changes in controlled-substance prescribing

Thu, 06 Dec 2007 06:59:58 -0500

A group of IT and pharma-related companies has begun lobbying for changes in the rules around controlled drugs which would allow physicians to prescribe them electronically. Members of the group, the Controlled Substances Coalition, include BlueCross Blue Shield, CVS, the American Society of Consultant Pharmacists, Wal-Mart and Sage Software.

At present, the companies say, many doctors cite the requirement to write paper prescriptions for controlled substances as the main reason they aren't converting all their scripts to digital form. Physicians and pharmacists say that they're reluctant to switch to e-prescribing if they're going to have to maintain both a paper and an electronic process for prescription management. Group leaders, who testified in a Congressional hearing yesterday, are calling on the Drug Enforcement Administration (DEA) to change its policies in this regard. The DEA seems reluctant to do so, however, arguing that non-paper methods may not be secure.

To find out more about the debate:
- read this Healthcare Finance News article

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