In a bid to ease access challenges, CVS Health will offer in-network primary care to Aetna members in certain markets through its MinuteClinics.
The services are available to certain individual plan and commercial members in Houston, San Antonio and greater Atlanta, with an eye on future expansion. There are about 1,100 MinuteClinics across the country, with the walk-in retail health clinics located at CVS pharmacies.
Creagh Milford, D.O., MPH, president of retail health for CVS, told Fierce Healthcare in an interview that while the national average wait time for a primary care visit is about 26 days, when he would visit MinuteClinics patients would report wait times of three months, six months and even a year before they could see their PCP.
He said a lack of access to primary care instead leads to more expensive visits to the emergency room or urgent care center as well as limits access to critical preventive services.
"This is all about changing the patients' perceptions from cough, cold, flu and immunizations to a longitudinal relationship-based model," he said, "and we're making great progress in the clinics that we've launched in select markets so far."
Milford said that MinuteClinics treat about 5 million patients, and data suggest that about half of those patients do not have a relationship with a primary care provider or have not seen their PCP in years. This created a significant opportunity to reach people who could benefit from primary care, he said.
The MinuteClinic team has already seen notable interest in primary care services in the pilot markets, he said.
MinuteClinics have historically offered wellness visits, chronic condition management services and behavioral health, and, in the initial markets, that's expanded to a full suite of primary care options. Through its electronic health record relationship with Epic, the team is also able to do full-scale population health and track data to identify gaps in care for patients.
The data and technology components make it easier for the MinuteClinics to engage in value-based care for primary care, Milford said.
Building out primary care in MinuteClinics also requires investing in enhancements for the clinics themselves, he said.
"We will be doing some infrastructure improvements to make the clinic format more intimate," Milford said.
CVS' pharmacies are fixtures in most communities and may for some patients be the easiest access point for them to connect to the healthcare system, Milford said. The trust that consumers have in the brand, which grew substantially thanks to COVID-19 and the vaccine rollout, helps get people through the door who may otherwise never visit a provider.
The locations are staffed by nurse practitioners and physician assistants, and Milford said that part of the trust equation is the growing confidence patients have in being treated by advanced practice clinicians rather than physicians.
Physicians support the MinuteClinic staff, he said, where they review patient charts and answer calls when needed.
"MinuteClinics, I think, gives us the right to win in this space and create an easy model for people to access when and where they want to access healthcare," he said.
As CVS eyes this push into primary care through MinuteClinics—Milford said the team plans to bring two additional markets online this year, with more to come in 2025—it is with the backdrop of a mixed year for retail health.
Walmart, for example, pulled the plug on its health clinics at the end of April, while pharmacy rival Walgreens is considering a sale of its primary care division, VillageMD.
Milford noted that MinuteClinics are about 20 years old, so building out these units is "not a new strategy" for CVS. He also said that what makes CVS' approach here different from others in this space is the number of "integration points," from primary care through Oak Street to the retail pharmacies to Aetna health plans.
That makes it easier for CVS to manage the end-to-end journey for the patient who may connect for primary care, he said.
"As it relates to the channels of engagement, whether you're going to schedule in-person or virtually or engage with us digitally, I think that those are parts of the patient journey that we've spent a lot of time and effort to develop and make sure that those are as integrated as possible to drive that trusted engagement," Milford said.