February 15, 2008 
Conceptually, I think the walk-in clinics are great. They are convenient. You go when you feel bad and don’t have to plan ahead. The copay is less than the urgent care or ER.
Of course, the question is how many can we sustain and of course, whether the level of care is any different. On paper, if you are going there for the right reasons (i.e., not for a heart attack), the care should be equal. I found the article on Wal-Mart’s expansion in this space to leave me with more questions than answers. Here were a few:
- I don’t understand the Wal-Mart branding here. They talk about wanting to have their branded clinics. They also talk about partnering with RediClinics, a Revolution Health company. They also talk about having local partners with a trusted brand (e.g., local hospitals).
- It says that clinics aren’t profitable and take up to 3 years to recover the start-up costs. I see the upside for Wal-Mart of foot traffic and potentially more prescriptions. What do these other constituents get?
- I also have to question this as a fast follower strategy (which can sometimes be a great strategy). Walgreens and CVS have both gone into the PBM market. Wal-Mart is considering the same. Walgreens and CVS have both gone into the clinic market. Will Wal-Mart acquire a company and do the same?
- It is also confusing that one of their vendors (for almost 25% of their clinics) went out of business due to bankruptcy and is now supposedly raising funding to re-open them within Wal-Mart. Didn’t they say earlier that they were going to be branding them as their own? If the clinic company isn’t financially stable, why are they working with them? If they already had 23 clinics that closed, why was that – no customers, wrong financials? And, why didn’t they just buy the assets to jump start their clinic model?
“We have learned that people are willing to receive their health care from the front of a store or the back of a drugstore,” said Dr. John Agwunobi, a medical doctor who is a Wal-Mart senior vice president. “But customers also have said they would rather it be delivered by a trusted name, a local health care practice, a trusted local provider of care.”
Enabling Healthy Decisions 
It makes a lot of sense for Wal Mart to have in-store clinics, especially as their employee base (1.2M employees, est. 41% health-care coverage – see Brennan Institute, “What Do We Know About Wal-Mart?”) is larger than some HC plans. The move means they can ensure some HC costs/revenue are kept ‘in the family’, and get they get significant taxpayer assistance as well… after all, WM is the nation’s largest employer of Medicaid recipients (far bigger than McDonalds).
The obvious opportunity for Wal-Mart and other retailers with in-store pharmacies and clinics is the incidental purchase-volume generated from pharmacy and clinic visits. It would be interesting if any readers have reliable data on average retail per-visit consumer spend…
Wegmans in the Northeast is also considering the convenience clinic market. Here’s the article: http://www.allbusiness.com/retail-trade/food-stores/4263716-1.html
I was in touch with Wegmans’ pharmacy director about this a month ago and sensed hesitancy, mainly due to stringent NY health law requiring physician oversight, which could increase the cost exponentially.
What I don’t understand is how Wal-Mart manages to adjust to laws in different states so efficiently!?