The retail-based healthcare market has been booming for years, forcing hospitals to decide whether these other providers are friend or foe. But with similar goals for more convenient and affordable healthcare, hospital systems are joining the trend and teaming up with retail clinics like CVS' Caremark's MinuteClinic and Walgreens' Take Care Clinic. Just last month, the largest inpatient and outpatient health services provider in New Jersey, Hackensack University Health Network, affiliated with MinuteClinic.
Last spring, we spoke with Andrew Sussman (pictured), M.D, president of MinuteClinic and senior vice president/associate chief medical officer of CVS Caremark, about the huge growth of retail clinics. FierceHealthcare checked back in to see what's happened since. Read on to learn more about hospital-retail clinic partnerships and what they mean for the healthcare industry.
FierceHealthcare: What is MinuteClinic's business plan? How much market share do you expect to take from emergency rooms and primary care physicians?
Andrew Sussman: We see our model as being complementary to emergency rooms and primary care providers in the markets we serve. We currently have about 600 clinics inside select CVS/pharmacy stores in 25 states and the District of Columbia.
About half the patients we see have no primary care provider. When this occurs, we have a resource list that helps them find local physicians who are accepting new patients. We also provide access to care on evenings and weekends when their only other option might be the ER, which is more expensive and may not be necessary for the more basic conditions we routinely treat.
FH: Aside from the length of time it took for the retail health clinic concept to catch on, what other hurdles has MinuteClinic faced? How did you overcome those?
AS: Our patients have needs outside of the traditional winter cold and flu season. We have added services to meet these needs, including monitoring services for chronic diseases, such as diabetes, hypertension and hyperlipidemia, as well as physical exams for camp and sports. These services have enhanced our portfolio and made our clinics more popular with patients, year round. We also have integrated much more tightly with healthcare systems by forming affiliations around the country.
FH: After years in the retail healthcare market, what have you learned about consumer behavior (e.g. getting customers to overcome their habits of seeing a doctor or going to the ER)?
AS: Driving awareness and educating patients about the services we offer remains a key objective, but we enjoy extremely high patient satisfaction ratings--94 percent overall satisfaction--once patients visit a MinuteClinic. We also have a net promoter score (a measure of recommendation to family and friends) of 80 percent, on a par with some of the best-known brands like Apple Computer and Amazon.com, and above other healthcare providers.
FH: When was MinuteClinic's first hospital affiliation. What was behind MinuteClinic's decision to start forming partnerships with hospitals and health systems?
AS: Our first affiliations were formed in 2009 with Cleveland Clinic in Northern Ohio and Allina Hospitals and Clinics in the Twin Cities. MinuteClinic has since formed affiliations with another 16 health systems, including Emory Healthcare, Henry Ford Health System and Advocate Health Care. These are some of the largest and most prominent medical delivery organizations in the country. Many are led by physicians and medical groups. Taken together, the 18 health systems represent 157 hospitals and more than 38,700 physicians. We are forming these affiliations to best address the primary care shortage.
FH: How will MinuteClinic and its affiliated hospitals work together?
AS: Under the agreements, the hospital system physicians serve as medical directors for MinuteClinic in the regions we mutually serve. We also work to integrate our electronic medical records, to allow sharing of clinical information, with patient permission.
These systems also collaborate with us on patient education and disease management initiatives. Based on these collaborations, the health systems will accept patients requiring a level of care outside the scope of MinuteClinic's walk-in services. MinuteClinic also may be recommended to patients when health system physicians are not available.
FH: Are there plans for future affiliations? And what does MinuteClinic look for in a potential hospital partner?
AS: We have announced four clinical collaborations with health systems this year, and plan to form additional clinical collaborations throughout the United States. The most recent agreement was announced last week with Florida Hospital Medical Group in Central Florida. We look for systems that share our geographic footprint in the community and who share our commitment to clinical quality, collaboration and increasing access to care.
FH: What are the incentives for hospitals to affiliate? How will the affiliations affect patients?
AS: The hospitals are looking to expand access to care in the community by adding providers in the retail setting near where patients live and work. By integrating our electronic medical records, the health system physicians and our clinicians can share patient files and view records from both MinuteClinic, as well as office visits and other hospital-related services.
FH: How have hospitals been responding to the affiliations and the retail clinic concept?
AS: It's been very positive, and as we complete the process of integrating electronic medical records systems with more of our affiliates, we think the opportunities for collaboration will grow.
FH: Health reform requires collaboration across the healthcare continuum. How does MinuteClinic fit into that?
AS: As a country, we face enormous medical challenges. An epidemic of obesity affects nearly a third of our citizens and related diabetes could impact 75 million Americans in 10 years. Our population is aging, with 10,000 baby boomers turning age 65 every day for the next 20 years.
All of this is backdrop to the changes ushered in by healthcare reform. If the healthcare reform law is not overturned by the U.S. Supreme Court, 32 million Americans will acquire health insurance coverage beginning in 2014. Regardless of that outcome, the challenge is we simply do not and will not have enough primary care physicians to meet all of these urgent medical needs, and we think MinuteClinic is well positioned to fill these gaps, in collaboration with patients' primary care medical home.
FH: How has MinuteClinic's strategy changed and where do you see Minute Clinic headed in the next 10 years?
AS: We continue to expand the scale of our practice. In 2011, we added 100 new MinuteClinic sites nationwide. We added to more than half of our existing markets, and we established several new markets. We expect to continue adding clinics over the next five years and to expand to more than 1,000 full-time clinics in 2016.
In addition, we are continuing to expand the scope of services we provide. Non-acute, prevention and wellness care is our fastest growing segment. These services include chronic disease monitoring for diabetes, hypertension, high cholesterol and asthma, with associated point of care testing. These services are important because chronic diseases are leading causes of morbidity and mortality, and with the PCP shortage, our clinicians can help provide some of this care.
Editor's note: This interview has been edited for length and clarity.