HIMSS 2017: Business opportunities abound outside of traditional care delivery settings

Editor’s note: This story is the first of a two-part series. Part two will focus on how technology, including telehealth, can help engage patients in a variety of settings.

ORLANDO, Fla.—When you hear the oft-cited axioms “put patients first” and “meet patients where they are,” your thoughts might turn to familiar settings like patient-centered medical homes or more convenient ones, such as urgent care centers.

But you should also be thinking outside of the existing care delivery system, where business opportunities abound.

Alex Hurd

It boils down to basic math, says Alex Hurd, senior director of product development, growth and payer innovation for the health and wellness division of retail giant Walmart.

“Because if you have a primary care doctor … then you’re going to see that person once or twice a year, on average. But you’re in the pharmacy once or twice a month. And you’re in your grocery store probably once a week. And so, if you really want to focus on the patient, then why not go to where patients … are already spending time?”

Hurd joined Roy Schoenberg, M.D., CEO of telehealth company American Well and Jody Holtzman, senior vice president of market innovation at AAPR for a session moderated by FierceHealthcare during the HX360 event at this year’s meeting of the Health Information Management and Systems Society in Orlando, Florida, this week.

Walmart looks for healthcare partners

Walmart has been edging into the retail healthcare space for a while now, but is experimenting with ways to go further. At the company’s health fairs, which are conducted at stores across the nation, nurses and pharmacists conduct about 300,000 free blood pressure, glucose level, BMI and other screenings.

And here’s the partnership opportunity that providers and payers could be getting in on: “One in three individuals who get a screening have not engaged with the healthcare system at all in the previous year,” he said. Walmart wants to build an “ecosystem” that facilitates referrals to specialists or preventative and wellness care.

Although Walmart has begun partnering with payers and providers, there’s no clear business model, Hurd said.

“I really give Walmart credit,” Holtzman said. “Because jumping into something for a large organization where you don’t see, for the bean counters, what the return on that will be … is hard.”

It’s a disruption of brand and a disruption of traditional healthcare access, he said.

“It’s marketing 101. Go to where people are … Don’t expect them to come to you unless they’re [already] coming to you.”

AARP invests in innovation

AARP is working to foster healthcare innovation that will affect its 40 million members, Holtzman said, working with startups and entrepreneurs. It also invites its members to demo days.

“One of our goals is to see more investment in and more funding of innovative companies that are going to benefit our constituents with their innovative products and services,” he said. “You have an emerging market in plain sight.”

As Clay Christensen predicted, healthcare is moving to less expensive settings and is delivered by people with less specialized training, Schoenberg said.

 “We have an opportunity to literally redistribute healthcare altogether … We’re going to not make people go to where healthcare is; we’re going to allow healthcare to go where people are in different ways,” he said. “You walk into a Walmart and the retail clinic represents a care setting that is lower than the hospital, usually staffed by nurse practitioners who are at the top of their profession but [not] the surgeon that you would see if you walked into a medical center,” Schoenberg said.

American Well says technology is the bridge

“The new opportunity for care delivery is going to be technology,” Schoenberg said. “We work with most of the health insurance companies out there that commercially embrace the notion that getting Americans very quick access to clinicians is a good thing for the system.” Partners include Anthem, United, Cigna and several Blues plans.

If you really take a step back, don’t think of [technology] as a way to get convenient care more quickly, but as a platform or as a capability to deliver care over technology. Another world of healthcare opens up,” he said. “This is no longer a technology to have a blind date with whoever is available that second, but rather as an instrument for physicians to follow up with their own patients.”

Already a hot market, telehealth will really take off as reimbursement for remote care becomes more prevalent.“We don’t know, going forward, what will and won’t be reimbursed,” Holtzman said. Another big question mark: The new Trump administration.

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“We don’t know if the fundamental trend of moving from volume to value is going to continue at HHS,” Holtzman said. “We have a new head of HHS that does not bring the perspective of an Andy Slavitt. [Tom Price is] bringing the perspective of a surgeon, who did very well, by the way, with fee-for-service. So his concern is a view of an individual provider. That opens up an interesting challenge. But in both cases, I think [it’s clear] that the opportunities are going to be market-based.”