Providers + Retailers - The New Front Door to Health

25 August 2015 Health Care Law Today Blog

During last week’s webinar on providers and retail health, the second in a series sponsored by Foley and Oliver Wyman, top executives representing different industry sectors shared their points of view on the challenges and opportunities presented by rapidly emerging alternatives to traditional primary care settings. Highlights include:

Alex Hurd, Senior Director, Product Development, Growth and Payer Innovation for Health & Wellness at Walmart, said his team’s mission is to be the “#1 retail provider of affordable health care.” While he said Walmart has already established a strong network for providing vision and audiology services and over-the-counter medications, the company is now focused on building out its capabilities in primary care, chronic disease management, and consumer engagement, with a major expansion of its “Healthcare Begins Here” health insurance education platform planned.

Tom Beauregard, Chief Innovation Officer for UnitedHealth Group, described how he is looking for solutions that extend evidence-based care into more convenient settings that engage consumers in their care and offer peer support and other options that contribute to positive outcomes. His team is also conducting more research into provider and consumer needs to help them design differently with their customers’ perspectives in mind. He added that “transparency is critical in any consumer market” and that data has to be organized and presented in ways that are useable and accessible to consumers. He expects retail care to further expand as it becomes more integrated into payer models.

From the provider’s perspective, Stephen Lockhart, Chief Medical Officer for Sutter Health, emphasized the importance of considering access, convenience, and price when developing programs for today’s health care consumers. He said Sutter, in particular, is well-positioned to “be a laboratory for change in health care” and the system is partnering with CVS Health to pursue new care coordination strategies and with MDLIVE to provide virtual consults to employees. “It’s important to view the system from the customer’s viewpoint,” he noted. “It’s by maximizing the patient experience that we’ll build brand and patient loyalty.”

Alexis Finkelberg Bortniker, Senior Counsel for the Health Care Industry Team at Foley & Lardner LLP, provided a perspective on the legal issues that can arise as organizations expand into the heavily regulated area of retail health. Among the top concerns are licensure and certification, which can vary by state, ownership questions, scope of practice, and fraud and abuse concerns. She observed that retail health is poised for growth, fueled by the increasing need for and interest in chronic disease management, interconnectivity, telehealth, employee health and wellness, and payer partnerships.


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