Startup Homeward inks partnership with Rite Aid to provide primary care in rural communities

Two months after launching her new rural healthcare startup Homeward, former Livongo executive Jennifer Schneider, M.D., has landed a big partnership with retail pharmacy Rite Aid.

The two companies are partnering to provide primary care services on-site at up to 700 Rite Aid pharmacy locations in rural communities. Homeward will start by providing in-network clinical services, including primary care and specialty care—beginning with cardiology—using its mobile vans parked in Rite Aid parking lots at stores in Michigan in the third quarter of this year. The services will be offered to Medicare and Medicare Advantage members.

The goal is to eventually expand to additional markets nationwide, although the companies did not announce a timeline for expansion.

The key is to make it convenient and accessible for patients who live in rural areas, where people typically drive multiple hours to the closest large health system, Schneider, Homeward's CEO, told Fierce Healthcare.

"When you start to look at the flow of life for people in rural markets, they spend time in retail and retailers, right? And that's part of their daily shopping experience, part of their social experience," she said. "Second, pharmacists are the most trusted people in these markets when it comes to healthcare delivery. Patients have the most frequent touch points with the pharmacist, even more than with their doctor."

With access to Homeward's mobile care services right in the parking lot, Rite Aid's senior customers can pick up their prescriptions and see a care provider in one visit.

Through the partnership, Rite Aid pharmacists will be able to introduce Medicare-eligible customers to Homeward's clinical services, including annual wellness visits, screenings, risk assessments and diagnostic testing.  When appropriate, Homeward clinicians will refer members to regional health systems and specialists for more complex care.

The partnership aims to leverage Homeward’s focus on rural healthcare paired with Rite Aid’s scale and pharmacy expertise, Schneider said.

Rite Aid has over 6,300 pharmacists across 2,300 locations, including 700 pharmacy locations in rural areas, many of which are healthcare deserts with limited access to doctors and hospitals.

Schneider helped build up chronic condition management startup Livongo, then helped lead the company through a massive IPO and the industry's largest merger with Teladoc. At the ViVE 2022 conference in Miami Beach in March, Schneider and other Livongo veterans unveiled their newest healthcare venture to tackle rural healthcare.

Homeward's executive team, which includes Amar Kendale, former chief product officer at Livongo, and Bimal Shah, M.D., former chief medical officer at Livongo, aims to "rearchitect" rural healthcare.

"Healthcare delivery in rural America is not kind of broken, it's massively broken," Schneider said. Studies have shown that people living in rural areas have worse health outcomes than their urban counterparts do. In a study of Medicare beneficiaries, researchers found that rural residence was associated with a 40% higher preventable hospitalization rate and a 23% higher mortality rate compared to urban residence. 

"We're excited to be in this space and to bring a new care model through our partnerships, like with Rite Aid, in a way that we can deliver the services that are needed in order to make healthcare delivery work in rural America," Schneider said.

Homeward will be the first comprehensive provider to take on full risk in rural markets, according to executives. 

"In these areas, we can't assume that 'if you build it, they will come.' Instead, we're creating convenient opportunities for care within the daily lives and routines of rural Americans," Schneider said. "Rite Aid is a highly recognized and trusted pharmacy services company with rural locations that serve many thousands of people every day. Through our partnership, we'll be able to connect individuals to our services as we improve access to critical, frontline services in these communities."

Homeward plans to deliver a hybrid model of technology and services that will immediately increase access to primary care and specialty services. Homeward providers see members both in community-based mobile clinics and in members' homes. The startup also provides virtual care and in-home remote monitoring that keeps patients connected to their care team.

By providing mobile care via vans parked at Rite Aid locations, the startup also avoids the overhead costs of trying to build a clinic inside a retail pharmacy, Schneider noted.

In October 2020, drugstore chain Rite Aid unveiled a new strategy and brand relaunch that doubled down on its pharmacy business. The corporate rebrand comes as Rite Aid competes with CVS and Walgreens as well as new digital players such as Amazon's PillPack and e-pharmacy startups like Capsule and NowRx.

Rite Aid executives said the revamped stores would feature a pharmacy that looks more like an Apple Store Genius Bar: virtual care rooms that will enable consumers to remotely connect with care teams.

Homeward’s partnership with Rite Aid builds on the retailer’s pharmacy-focused strategy, with an increased focus on expansion in underserved communities. 

It also marks Rite Aid’s first push to bring real clinical services into their stores while Walmart and CVS also continue to push in these areas.  

"Rite Aid is deeply committed to improving the lives of our customers with expanded pharmacy and healthcare services in underserved rural communities," said Rite Aid President and CEO Heyward Donigan in a statement. "We are proud to support the innovative work that Homeward is doing to introduce a new, hybrid care model that will play a critical role in our customers' health journeys."

Rural communities are saddled with widespread hospital closures and physician shortages, both of which exacerbate health disparities, significantly poorer clinical outcomes and higher total costs.

Schneider points out that telehealth, by itself, has not solved rural healthcare disparities. Homeward offers an integrated care model that combines mobile, community-based care with ongoing care management that enables longitudinal care for rural patients, she notes. By offering home-based care visits, Homeward providers can see the patient's living environment firsthand.

"That's particularly important for people with Medicare with high fall risks. You're looking at things like heating issues, air conditioning issues and mold issues. What you see from a social determinants of health perspective during a home visit is light years different from what you see when they come into a doctor's office," she said.

Homeward's thesis is backed up by venture capital firm General Catalyst, which led an initial $20 million investment in the startup to help fuel its launch.

While many healthcare players are getting into the primary care market, including CVS and Walgreens with in-store clinics, Schneider says partnerships like the one between Rite Aid and Homeward will be key to improving healthcare in rural communities.

"When you think about what it is going to take to make a difference in rural America, it's not one person coming in and trying to own it all. It is about how can we partner and rearchitect the experience for the individual so that people are not left by the wayside," she said. "It's not going to be one dominant player in this whole ecosystem. It's going to be partnerships that allow for the navigation for the individual to optimize their care."