Initial reports positive for locations at Walgreens, Kroger

One year ago, Baptist Memorial Health Care (BMHC) and Walgreens made an announcement that drew an unusual amount of attention: The two corporate giants had formed a healthcare partnership in the Memphis area. Baptist Medical Group, the wholly owned, multi-specialty physician organization at BMHC, would work with Healthcare Clinic at select Walgreens stores in Memphis.

The February announcement in 2014 quickly raised some eyebrows, along with a number of questions. Perhaps the one most frequently asked was why would a healthcare system enter into a partnership that quite likely would siphon patients away from the hospital’s emergency rooms? The answer was that the collaboration would allow BMG physicians the opportunity to handle serious conditions outside the clinics’ scope of practice and to help manage the treatment of chronic diseases.

A year later, the question is how the partnership is doing.

Since June 4, when Baptist first opened its doors to walk-in retail clinics, the Walgreens-based clinics in the Memphis area see an estimated 4,100 patients a month. The partnership involved 11 Walgreens clinics when it began, and no additional locations have been added.

“Our Walgreens partnership has been very successful,” said Sean Nelson, executive director of metro operations for Baptist Medical Group. “Patients are happy that their primary care clinic has a relationship with a healthcare system that can provide a higher level of care.”

Nelson said there are instances when a person visits for one problem and the examination leads to the discovery there are other problems he or she was not aware of.

“We’ve seen patients come to Walgreens for minor conditions such as a sore throat and we find they also have high blood pressure,” he said. “A member of the Walgreens staff can refer them to a Baptist Medical Group specialist who can help them manage their more serious conditions.”

For many people, the clinical collaboration improves their access to high-quality, convenient and affordable care in the Memphis market, seven days a week. Proponents of walk-in clinics point to a number of benefits:

No appointment is necessary

Quicker access because of expanded hours and less wait time

Increased flexibility of scheduling

Working around one’s own schedule rather than that of a practice

Increased geography proximity

Lower costs than costs associated with going to a physician’s practice

24-hour pharmacy services

The clinics are impacting the medical community in another way — by offering an opportunity to expand the role of the nurse practitioner. Sharon Adkins, MSN, RN, executive director of the Tennessee Nurses Association,  said, “With a growing demand for care, especially as the ‘baby boomer’ population ages, nurse practitioners are in place to help address the increasing demand for chronic care. The recent expansion of walk-in clinics is primarily focused on improving patients’ access to care.

“Currently, there is a shortage of family physicians, and nurse practitioners are perfectly positioned to fill that gap as healthcare providers. The public’s acceptance of family nurse practitioners to deliver healthcare is growing.”

A recent count estimated there are more than 400 healthcare clinics nationally. But partnerships such as BMHC and Walgreens remain uncommon.

Kroger operates The Little Clinics in some of its stores. Courtney Wiser, clinical recruiter for Memphis, as well as Cincinnati, Kentucky and Mississippi, said reaction at those locations has been “fabulous.”

Wiser said her employer, rather than entering into a hospital partnership, uses direct recruitment methods, such as LinkedIn and job postings on its Little Clinic website to locate and recruit affiliate doctors. Currently, there are 10 such clinics in Memphis, with two more in DeSoto County. And while there are no immediate plans for expansion in the Memphis area, the company has 144-plus clinics nationwide and expects that number to increase. 

It can be debated whether clinics such as the ones in Walgreens and Kroger will become a significant factor in the future of the nation’s healthcare industry. Clinics such as these, along with minor medical facilities, are part of the Patient-Centered Medical Home model.

The American Hospital Association (AHA) released a report in September titled ”Patient-Centered Medical Home (PCMH): AHA Research Synthesis Report,” which acknowledges that hospitals have been slow to embrace the model. But it also noted among its findings that the nation's primary-care network is ill-equipped to handle widespread implementation of the medical home model – as 65 million,  or 19 percent of Americans, live in officially designated primary-care shortage areas.

The report also states, “Hospitals face the challenge of not having a defined role in the PCMH model.”

Some researchers believe that hospitals will begin a migration to embrace the PCMH model as a natural extension of clinical IT investments and increasing care coordination. Those findings and others likely prompted the AHA to spur its members to get in the medical home game.

For the practitioners, forming a marketplace partnership also:

Ensures the use of their Electronic Medical Records (EMR) protocols

Channels patients into their medical practices

Provides integrated healthcare, with electronic medical records that interface, with the clinics and the physicians

Increases their market share   

Robert Vest, chief operating officer for Baptist Medical Group, said, “The retail clinics are definitely growing and are a needed healthcare vehicle in our community. They offer convenient, low-cost care in an easy-to-go-to environment for patients to receive primary care and, particularly, episodic care.

“About 40 percent of the patients who go to a Walgreens clinic do not have a primary care

physician. These clinics offer a location for those patients and help them make that kind of relationship. That, in turn, helps provide these patients with an opportunity to have access to all of the ancillary services that they may need in their long-term healthcare, like referrals to specialists, diagnostic testing and hospital admissions.”

Vest continues, “There’s a need for more access to the healthcare system, rather than through an emergency room, and these clinics are often that vehicle. We are trying to create a broader access to give our patients more choices, while providing them with what they are looking for in healthcare. Ultimately, for us, that is high-quality, patient-centered medical care that helps us remain competitive in a changing medical market.”   

Editor’s note: Jerome Thompson, MD, contributed to this article. Thompson is a pediatric ENT surgeon on the faculty at the University of Tennessee Health Science Center and holds an MBA degree in economics from UCLA.