Wal-Mart moves into primary care

Wal-Mart has entered the primary care arena, opening six clinics since April with six more planned by year’s end.

With 4,200 stores across the U.S., the retail giant is poised to capitalize on growing opportunities resulting from the Affordable Care Act and fill a need in Medically Underserved Areas (MUAs).

The move follows a 14-page request for information sent to hundreds of healthcare providers in 2011 outlining its intentions to become "the largest provider of primary health-care services in the nation."

Unlike their 90 independently owned and operated acute care/ wellness clinics, Wal-Mart Care Clinics will be owned by the company and provide management of certain chronic conditions and referrals to specialists, according to Wal-Mart spokesperson Danit Marquardt.

The clinics will be staffed by nurse practitioners through a partnership with QuadMed and supervised by a non-treating physician.  

"Our Wal-Mart Care Clinic pilot is creating a new price position for retail health services that aims to give our associates and customers greater access to quality, affordable healthcare that will improve their lives,” said Marquardt.

Patients are charged $40 per visit, while employees and dependents covered under Wal-Mart’s insurance pay $4 per visit.

The clinics are expected to serve large numbers of Wal-Mart employees as well as the public. The first primary care clinic to open, in Copperas Cove, Texas, was chosen because of its proximity to other Wal-Mart locations, said Marquardt. It will provide access to 3,000 employees, while the newest location, in Palestine, Texas, will provide access to 1,800 employees.

Wal-Mart is the largest private employer in the U.S. and has been criticized for not providing affordable healthcare to all of its employees. 

The clinics accept Medicare and are starting to accept Medicaid in some locations, but do not yet accept third-party commercial insurance except for Wal-Mart’s employee plan.

The chain has broken new ground by branding the clinics as primary care facilities. Other chains like Walgreens, which has 400 acute/wellness care clinics across the country, now offer some primary care services like disease monitoring. But Walgreens does not market the facilities as primary care clinics, said spokesman John Cohn, adding that the company “strongly” encourages patients to seek continuing care elsewhere.

Retail clinics located in pharmacies, grocery stores, and big box stores, including Target, CVS and Walgreens, have been growing steadily since debuting in 2000, according to Rand Health, topping 1,200 by 2010. But because they have historically been located in metropolitan areas with lower poverty rates and higher median incomes, “evidence does not support the idea that they improve health care access for underserved populations,” according to Rand.

But Wal-Mart’s new primary care clinics may change that. Some are in semi-rural areas where the chain has a strong presence. Palestine, population 18,712, is in Anderson County, which has been designated a MUA by the U.S. Health Resources and Services Administration (HRSA).

Large numbers of rural residents across the U.S. don’t have adequate access to health care, and seven out of ten health profession shortages are in rural communities, according to the HRSA.  

Read about the predicted physician shortage in the U.S.

Five of the six Wal-Mart primary care clinics that have opened since April are located in counties designated as medically underserved, according to the HRSA.

Wal-Mart is targeting areas where “there isn't access to care," according to Marcus Osbourne, Wal-Mart’s vice president of health and wellness payer relations.

Meanwhile, the number of acute care/wellness care clinics in Wal-Mart stores declined to approximately 100 this year with the recent closing of 33 clinics. Each clinic is independently owned and operated.

Wal-Mart hasn’t yet announced where or how many clinics are planned for 2015, but Marquardt said the company will “watch the clinics closely and learn from them as we work to provide our associates and customers with access to affordable healthcare.”

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