The healthcare industry has been an attractive one for outside disrupters of late.
In 2019, Amazon, JPMorgan Chase and Berkshire Hathaway shook up the traditional landscape by unveiling their still-mysterious joint venture Haven. Tech giants like Apple and Google have thrown their hats in the ring to chip off a piece of an industry that accounts for nearly 20% of the U.S. gross domestic product.
And then there's Walmart, the largest retailer in the world, which made a splash a year ago when it opened the first of its clinics in Dallas, Georgia.
The health center now offers a slew of services there ranging from primary care to dental care to behavioral health care at a flat fee regardless of insurance status, along with on-site lab testing and imaging.
Marcus Osborne, who is the senior vice president of Walmart Health, told Fierce Healthcare that the company saw the challenges patients face with cost and experience in navigating the system and believed their "save money, live better" mantra would be a perfect fit for healthcare.
"If you go back to 'save money, live better,' I don’t know that it was intentionally designed with healthcare in mind," he said. "But when you realize the challenges facing the average American, I think that is it—it is 'save money, live better' in healthcare."
Walmart Health has only grown since the launch of its first center, with plans to have at least 22 such locations open in Georgia, Florida, Illinois and Arkansas by the end of 2021. Walmart has also made a push into health insurance by launching a Medicare-focused brokerage and teaming with Clover Health on co-branded Medicare Advantage plans.
We caught up with Osborne to discuss Walmart's approach to designing its clinics, disrupting the industry and responding to COVID-19. Here's more from our conversation:
Fierce Healthcare: How and why do you see Walmart fitting into the healthcare industry?
Marcus Osborne: The lens that we see everything through is through the lens of the consumer, through the lens of the individual, through the lens of the family. And what we see is a reality that people—it just is what it is—that if you ask the question, “What is the main point of stress and angst and concern that people have in the United States, that the average American has?” Healthcare tends to be, if not the top issue, it’s certainly one of the top. It has been obviously in the age of COVID, yes. But even before COVID—a year ago, five years ago, 10 years ago, 50 years ago, frankly.
You asked the question why. It’s issues of affordability. That people can’t afford the care they need for themselves and their families. It’s issues of access. It means I can’t get what I want for myself and my family. It’s issues of complexity—it’s too complex, it’s too uncaring, too un-serving. So, when you kind of put that together the result is that people aren’t getting what they need. They’re deferring, delaying or never getting the care they need in the moment.
Why does Walmart think we have a right to play? That really is the business that we’ve been in. Walmart’s business has been about helping people afford the things they need, getting them in a more accessible, convenient way and doing it in ways that are simple. Healthcare’s no different in that regard.
FH: You have a growing collection of clinics, and Walmart is entering the insurance space as well. What else is Walmart looking to disrupt?
MO: For us, a lot of the opportunity is just about bringing what we’re doing to more people. I think about Walmart Health and what we launched a little over a year ago in Georgia, and the impact we’ve seen in the communities where it launched. I think one of the biggest things to do is how do we continue to find ways to make that model work so we can reach more people with it in more communities.
I think the same with the health insurance work: "How can we continue to find ways to expand it?" I think in some ways, it’s not being overly cute or creative. It is about basics but then figuring out ways to do that at more scale.
Certainly, some of the things that we are looking at will involve the ways in which we can take what we’re doing and reach more people more effectively—looking at ways to do things digitally, in a more omnichannel way. But that was always kind of part of the vision and strategy with what we’re doing at Walmart Health.
FH: How have Walmart Health clinics evolved?
MO: We had old retail clinics that we had leased spaces to people since the middle of the 2000s, and more recently had gone into the care clinics business, which was more of a primary care-oriented business. We had a partnership with Beacon Health where we had tested behavioral health. We had dental centers in our stores, and we certainly had hearing centers in our Sam’s Clubs. We had a number of services businesses.
But I think what was different about Walmart Health was the idea of instead of doing these kind of one-off, there’s great value in bringing them together in an integrated way and building a consumer experience around that ... We didn’t want to overly design it, we wanted to put something out here and allow consumers to begin engaging with it.
And in engaging with it, we were going to learn. Walmart is probably unique among organizations that I’ve worked with over years, we’re a company that definitely learns by doing. So I think the act of actually getting it open and seeing how consumers engaged and what they valued and what they wanted that we weren’t doing, what did we need to change—I think it’s been a great test for us to understand what consumers are looking for. Our big challenge is to take that learning and look for ways to continue to improve and iterate and evolve the model, which we’ve done.
FH: What do you mean?
MO: Almost immediately, we started to see two things. One is we started to see customers coming in who were dealing with social realities. We had a community health worker model that was in there, but I think we realized we were going to have to expand what we're having those community health workers do to help address some of the social health realities that people were coming in with.
It wasn’t just enough that if you were a diabetic to help you manage your diabetes. If you were also caring for your aging parent, and that kind of pressure and the stress related to it was having an impact on your health, it behooves us to help you find ways to be a better caregiver, to help you find support resources to help you better care for your mom or your dad or whoever you’re taking care of.
Another was we saw a whole lot of people coming in who were dealing with unaddressed and unsupported musculoskeletal issues. They were dealing with back issues or neck issues, knee or hip or ankle issues. So we’re now running two test pilots around physical therapy with two different partners.
FH: What is the typical experience for a patient who walks in the door?
MO: As you think about traditional healthcare and health and wellness service experiences, whether you’ve gone into a doctor’s office or a dentist’s office, the first thing you do is you typically walk up to a check-in desk and that’s where people go to feel bad. Those experiences at check-in are ones in which you often feel less human.
So, as you think about the experience we’ve created, we said we don’t want a check-in desk. We want to create an experience where there’s an individual there who greets you and makes you feel welcome, and so as you think about the typical experience, when you come in if we’re doing it well you should be greeted by a care host. They should thank you for coming into Walmart Health, they should ask you how they can serve you.
I would say your experience probably started before that. You wanted to schedule an appointment, well that shouldn’t have been that hard to do. If you go on to the Walmart Health site, it’s just a couple of clicks. You give us your name, you give us your date of birth, you give us a way to contact you and you tell us what you need an appointment for, and pick a day and a time. That’s all you need; you don’t have to give us all the facts about your life and your mother’s last 12 jobs to get an appointment—it should be something really simple.
So the view of that experience I think for the customers is one in which they have been treated well. We valued their time and made it easy for them to do what they wanted to do. It’s easy to schedule an appointment, we didn’t make them wait. But they also were valued as a human through the process, and I think that has resonated. We have, I think, a long way to go. This is a learning exercise for us. We knew from the day we opened the first one that there were things we needed to improve upon, but even with all of that, I think we have been very pleasantly surprised by the consumer reaction.
It may sound kind of soft, but honestly, I think that, if we want people to engage in their health, those are the experiences we need to create.
FH: How did you adapt your approach to the demands of COVID-19?
MO: There are, I think, some things that we did even before COVID that actually prepared us significantly for COVID. Some of these may be small, but one of the things that we had seen and understood is that we have been very clearly focused in making sure that these spaces are clean and sanitized and that it was clear to the customers that was the case.
So when you actually go in, instead of hiding people cleaning, the cleaning people are always there and engaging. I think we saw a lot of other healthcare service providers had to significantly change how they operated to ensure that they had spaces that were in fact sanitized and hygienic. We were already at a standard that was well beyond even what COVID would require. So I think that was a positive.
Beyond that, it was also a recognition that, because some of the states limited the ability of customers to come in and get care at that time frame, we did pivot and enabled greater access to telehealth and teleclinical solutions ... It has, I think, probably more than anything reinforced what we already believed: that at the end of the day consumers are going to look for omnichannel experiences in healthcare. I want to be cared for the way I want to be cared for in that moment, and that may mean going into a center and getting care or maybe it means talking to a doctor through some sort of Zoom, WebEx, teleclinical way. Or maybe it means engaging with a digital app in which there is no provider involved, all AI-driven and technology-driven. Or maybe it means having somebody come into your home and provide some support care.
From our perspective, that omnichannel experience, that’s what we’ve got to figure out how to enable.
FH: If you look five years or 10 years down the road, where do you hope to see Walmart Health?
MO: I have a really simple view on that. My goal is that we have done the work on Walmart Health as a model, to really get it to work from a consumer perspective and get it to work in a way that it scales effectively, that we are able to reach more people.