John Standley, president of Walgreens

Primary Care

Walgreens Doubles Down on Primary Care

In a move to accelerate its value-based primary care strategy, Walgreens announced that it plans to take an ownership stake in VillageMD with a $5.2b investment.

The investment gives Walgreens a 63% stake in the primary care company, making it “the first national pharmacy chain to offer full-service primary care practices with primary care physicians and pharmacists co-located at its stores all under one roof at a large scale.”

• The partnership originated with a 2019 pilot program of five co-located primary care practices designed to more closely coordinate care between patients’ physicians and pharmacists. It has since expanded to 52 co-located primary care practices, with plans to have at least 1k “Village Medical at Walgreens” locations by 2027.

• VillageMD offers same-day appointments with its physician-led teams that include nurses, lab techs, and behavioral health specialists. It also helps physicians transition to risk-based care models, an approach that appears to be working: full-year expected revenue is $1.3b, a sharp increase from $217m in 2017.

• Walgreens announced a new division called Walgreens Health to house VillageMD and its other clinical services, which includes the recent purchase of a 55% stake in care-at-home company CareCentrix. Walgreens Health’s goal is to provide whole-person healthcare to the 75% of Americans who live within five miles of a Walgreens.

Industry Impact

Retail clinics are quickly becoming a popular pursuit as companies like Walgreens, Walmart, and CVS Health rush to expand their clinical footprints to cater to the growing number of consumers seeking convenient care close to home.

Walgreens stated that it plans to make consumer health a key “growth engine” through partnerships in primary care (VillageMD) and post-acute services (CareCentrix), driving more volume of in-store health products while expanding healthcare access.

Patient Engagement

Unsatisfied Patients Turn to the Internet

According to a new study from the AHIMA Foundation and Kelton Global, there is a large disconnect between the information shared by doctors and their patients’ understanding of it.

This communication breakdown leaves patients confused about how to proceed, prompting many to turn to other resources to feel more in control of their health.

• The survey was distributed to a nationally representative sample of US adults in August 2021 (n=1,059), finding that 76% of Americans “do not leave their doctor’s office on a positive note,” due in part to lacking clear answers to questions (24%) or not having the chance to ask any questions (17%). 

• After these visits, 62% of Americans are “not extremely confident” in their understanding of information discussed with their doctor, while 15% admit feeling more confused about their health than they did before their appointment.

• As a result, 80% of Americans research medical recommendations online following an appointment, reporting that they are confident the information on the internet is credible (86%) and that it allows them to feel more confident in their doctor’s recommendations (35%).

The Solution

The researchers conclude that having access to a complete picture of your own health, whether through a doctor’s visit or internet research, is the key to seeing better health outcomes. Most Americans seem to agree, with 81% of survey respondents saying that if they had access to all their health information, such as medical records and test results, they’d see at least one improvement in their health management.

Nuance’s Patient Engagement Must-Haves

Consumer demands are shifting, and they’re looking to get more out of their digital health technology. Nuance outlines the 5 must-haves for your patient engagement strategy here.

The Wire

• Improving Hypertension: Researchers at UC San Francisco enrolled over 28k participants into Hello Heart (at-home blood pressure [BP] monitoring paired with a patient engagement app) between 2015 and 2020, marking the first long term study of a digital health application for BP management that produced clinically meaningful results. The study found that combining health coaching with RPM lowered BP in 53%-85% of patients depending on baseline hypertension severity, improving upon past studies that found BP self-monitoring is insufficient to lower BP without other co-interventions.

• Conversational AI Funding: Digital chronic condition management company Lark Health closed $100m in Series D funding ($185m total funding), which it will use to deepen its health coaching platform’s virtual care integrations with health plans and payers. Lark’s platform leverages conversational AI to help users manage chronic conditions in a personalized way and at a lower cost than traditional in-person services.

• EHR Use Predicts Turnover: A study of 314 physicians published in JAMA Network Open investigated which EHR use metrics were associated with physician departure, finding that inbox time (odds ratio, 0.70) and demand (ie, proportion of available appointments filled: OR 0.49) were linked to turnover. Counterintuitively, less time spent on the EHR was associated with physician turnover (OR 0.96), suggesting that tracking the metric could identify physicians at high risk of departure.

• Last Mile Healthcare: On-demand care provider Sprinter Health raised a $33m Series A round ($38m total funding) to help build its team of mobile nurses and phlebotomists providing in-home lab draws, vitals checks, and COVID-19 testing. Sprinter is looking to become the “DoorDash for lab draws” by removing the limits of remote care with physical access to patients when needed.

• National Insomnia Treatment: Scotland recently became the first country in the world to make digital therapeutics for anxiety and insomnia available nationally, offering all adults unlimited access to Big Health’s cognitive behavioral therapy apps Daylight (anxiety) and Sleepio (insomnia) as part of their NHS services. Nearly 70% of Big Health users in Scotland have gained seven additional hours of sleep per week, and the success of the strategy could provide a blueprint for future digital therapeutics partnerships.

• Provider Selection: Kyrus’ 2021 Patient Access Journey Report shows that consumers prefer digital channels when finding healthcare, with 60% of the survey’s 1k respondents conducting online research when looking for a new provider. While healthcare delivery organization websites (60%) remain the top resource for provider research, health plan websites are gaining popularity (52%, up 10% from 2020), underscoring the need for a strong digital experience to supplement patient access efforts.

• Automated Documentation: Following a successful year-long pilot, the University of Michigan Health-West is expanding its use of the Nuance Dragon Ambient eXperience (DAX) to its entire primary care group, offloading physician administrative tasks to the automated clinical documentation solution. After using DAX, 79% of physicians report improved documentation quality, while 81% of patients say their physician is more focused during visits.

• Care Gaps: According to research from Parks Associates, 27m US households were unable to visit a physician in the first half of 2021, highlighting the persistent care gap that telehealth looks to fill. Of the 64% of households that had used telehealth over the previous 12 months, 34% used the service because it was the only way to see their provider, although the 28% that cited convenience (up from 22% in 2020) signals that users are beginning to turn to virtual visits as a more normalized care option.

• Continuous Monitoring API: Garmin just became the first partner to utilize Dexcom’s recently FDA-cleared API that allows third-parties to view data from the company’s continuous glucose monitor (CGM). Garmin users can now easily monitor their glucose levels via the Dexcom Connect IQ smartwatch app, taking advantage of a recent CMS coverage change that eliminated a requirement for patients to perform frequent self-monitoring blood glucose tests as a prerequisite for initiating CGM use.

• Advanced Care at Home Coalition: A group of healthcare organizations helmed by Mayo Clinic and Kaiser Permanente announced the launch of the Advanced Care at Home Coalition, aimed at extending existing hospital-at-home federal waivers to ensure continuity of care following the pandemic. The coalition hopes to establish a new delivery model through the CMS Innovation Center that will enable the implementation of a long-term remote care framework while delivering quality outcomes and health equity.