Walmart has taken a big step towards fixing the “broken” U.S. health Care system by creating Walmart Health. These are clinics that offer primary medical care, mental health counseling, X-rays, labs, dental services, and vision and hearing services at one location. As of December 2020 Walmart has 14 health clinics. Customers can fill prescriptions a Walmart super store pharmacies that offer a 30 day supply of Rx for a $4 copayment among other low cost drugs.
The unique approach of the Walmart Health Centers is that they place the needs of the patient/customer ahead of the medical providers and the insurance and pharmacy companies. In his presentation at the 2019 HLTH Conference, Marcus Osborne, the Walmart VP of Health Transformation, gave an excellent overview of the reasons that Walmart created these medical clinics and he also describes the services customers receive.
In this 2018 presentation at the same conference Marcus Osborne and Lisa Woods, Senior Director of Health Benefits for Walmart, describe their experience covering one million Walmart employees in the company medical insurance plan. To better focus on medical quality – not the cost of care – Walmart set up “Centers of Excellent” to improve outcomes for their employees. Using evidence-based medicine, Walmart partnered with the Mayo Clinic and other high quality medical facilities to review and evaluate the diagnosis and recommendations for treatment for a variety of medical procedures including spine surgery, transplants, joint replacements, cancer treatment and bariatric surgery. Their results are startling.
As an example, for spine surgery Walmart found that 50% of members whose local physician recommended spine surgery did not actually need spine surgery. For those who did need surgery, Walmart would fly the patient and family member to a center of excellence to have the procedure done. The outcomes were equally astounding: a 95% lower hospital readmission rate when compared to surgery done in a local non-center of excellence facility. The patients also returned to work 3 weeks sooner when they had treatment at a center of excellence.
The results of better care and lower cost are just as impressive for joint replacement, bariatric surgery to treat morbid obesity and cancer treatment. Ms. Woods reported that Walmart recommends about one-third of the people diagnosed with cancer to travel to Mayo Clinic. Of those cancer patients who travel to Mayo Clinic, “55% get a new treatment plan or an adjusted treatment plan and… 10% of associates get a new diagnosis. We have associates who have been told that they have cancer but when they get to the Mayo Clinic, they learn that they don’t have cancer.”
In the face of outcomes where 10 percent of people are misdiagnosed with cancer – which would have been avoided had the doctors followed evidence-based medical practices; these Walmart executives ask why the health care system is failing so many people. They clearly state that Walmart is not going to stand for this poor quality of care any longer.
Walmart says that the U.S. health care system fails to measure medical professionals to determine “whether they are doing the right thing and whether they are delivering high value care.” Questions that payors should ask doctors include:
- Was the care needed?
- Did I follow the latest evidence?
- Was the care the best choice for the patient’s overall health?
According to Walmart, “people need to get the best care from the highest value providers.” Walmart is doing this by setting up provider networks that include only high-quality providers and eliminating doctors who refuse to follow an evidence-based approach to medical care.
Walmart has also introduced “new transparency tools” that enable patients “to know whether the provider they are using delivers the highest value care. Not just about price but about the total package: appropriateness, quality and price.”
By focusing on the needs of the customer, Walmart seeks to improve the health care delivery system in the United States. Let’s hope that they succeed, and that insurance companies and medical providers follow their lead.
Benefits Café assists small to mid-size employers with their medical insurance plans as a broker, agent, advisor. Please give us a call (800-746-0045) if you feel that we can assist you and your company.