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Leading Retail Clinics Expanding Their Roles

January 06, 2011 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Dow Jones Newswires – Philadelphia Bureau, 1.5.2011

Drug-store clinics, supported by hospital systems and insurers, are girding to play a broader role in delivering medical care as the U.S. health system faces a growing doctor shortage.

Where retail clinics met skepticism from the medical community a few years ago, industry leaders see them gaining acceptance and taking on greater responsibility, complementing rather than replacing primary physicians.

Retail clinics operated by national pharmacy chains CVS Caremark Corp. (CVS) and Walgreen Co. (WAG), which together represent two-thirds of the market, are forming partnerships with health systems and have expanded the scope of services offered, moving beyond flu shots and sore-throat care into screenings and monitoring of chronic conditions.

“From a quality perspective and an affordability (perspective) we present a good solution,” said Dr. Andrew Sussman, associate chief medical officer of CVS Caremark and president of its MinuteClinic business. “We are at a unique and in some ways defining moment.”

Clinics see their role growing as millions more people gain insurance coverage under the U.S. health overhaul in 2014, intensifying a national physician shortage also heightened by an aging and increasingly diabetic population.

The health-system partnerships, in turn, are expected to help drive expansion of a decade-old U.S. retail clinic industry that peaked at 1,211 as of December, according to consultant Tom Charland of Merchant Medicine LLC, who tracks the industry in his ConvUrgentCare Report.

“We are predicting much greater clinic expansion in 2011 vs. 2010, largely because of these partnerships,” Charland said.

Merchant Medicine estimates the industry added 28 clinics net this year, a 2.4% increase. Wal-Mart Stores Inc. (WMT), which house independently owned clinics, led that growth, more than doubling the sites in its stores to add 63 clinics, Merchant Medicine said.

MinuteClinic and Take Care Clinic chains, though, both have seen double-digit percentage growth in patient visits this year. Although MinuteClinic closed a few locations in 2010, it expects to add 100 clinics a year to reach about 1,000 by 2015, roughly double the current number.

Drop-in clinics, generally staffed by nurse practitioners, say they don’t aim to become a “medical home” for patients, although a significant percentage of those visiting them–more than half of those using MinuteClinic and 40% at Walgreen’s Take Care Clinic–lack a primary physician.

“We are increasingly playing a role as an advocate and navigator for these patients,” said Peter Hotz, vice president for Walgreen’s health and wellness division.

Walgreen wouldn’t say whether its clinics are profitable, although Hotz said they should contribute to revenue and earnings as they grow. CVS expects MinuteClinic to be break-even by the end of 2011. Neither company breaks out the financial figures for its clinics.

CVS Caremark sees MinuteClinic, which added monitoring of diabetes, hypertension and cholesterol in 2010, as a partner with health systems in a “medical home network,” Sussman said. The company has entered collaborations with hospital systems in several states and is in talks with others.

Ohio’s Cleveland Clinic academic medical center has called its relationship with MinuteClinic “a true continuity of care model,” and the two organizations are working to integrate electronic medical records systems to facilitate sharing of patient information.

For Walgreens, which operates 359 Take Care Clinics plus 370 worksite health centers, the expanded retail clinic role fits a strategy to make its pharmacies “health-care destinations,” Hotz said. The clinics recently formed a collaboration with the Ochsner Health System in New Orleans and are developing other potential partnerships.

Insurers appear to support an expanded role for clinics. Roughly 70% of visits at MinuteClinics and Take Care Clinics are covered by commercial or government insurance.

“Most insurers cover all of our services, including chronic-condition monitoring. Payers have expanded coverage as our range of services has expanded,” CVS Caremark spokeswoman Carolyn Castel said.

While WellPoint Inc. (WLP), the largest U.S. managed-care company by members, prefers patients use primary care doctors as their medical homes, “we also recognize that not every market has an adequate supply of primary care physicians to fill this role and that not every member desires such an intimate relationship with a (physician),” spokeswoman Jill Becher said.

Although WellPoint doesn’t cover the comprehensive chronic-condition monitoring that some retail clinics have started to offer, it does contract with all the major clinics and as of March it will cover an additional 24 services offered by nurse practitioners at retail clinics, including conducting lipid panels, glucose monitoring and testing for tuberculosis and HIV.

Local pharmacies leery of Caterpillar Rx policy

July 09, 2010 By: Nadia Category: Free Prescriptions, HealthCare, Medtipster, Prescription News

www.Medtipster.com Source: Winston-Salem Journal, 7.9.2010

A group of independent local pharmacies supports Caterpillar Inc. opening a plant in Winston-Salem, but not if it costs them customers.

That’s why they are appealing to city and county officials to make equal prescription-drug access to potential Caterpillar employees a part of any incentive package with the company.

The pharmacies are concerned about a preferred prescription-drug agreement that Caterpillar has with Walgreens and Wal-Mart.

The agreement, which runs through 2011, provides for lower or no co-pays for Caterpillar employees who fill their prescriptions with Walgreens and Wal-Mart. Employees pay more if they fill their prescriptions through an online or mail-order pharmacy, other chains or independent pharmacies.

“With Caterpillar’s policy, if one of our customers gets hired by Caterpillar, we could lose them,” said Dave Marley, the president and chief executive of Marley Drug in Winston-Salem.

“This, combined with the fact that our own tax dollars were used to entice Caterpillar, and it becomes wholly unacceptable.”

Caterpillar has named Winston-Salem as one of three finalists, along with Montgomery, Ala., and Spartanburg, S.C., for a proposed $426 million manufacturing plant with 510 company and contract employees.

Last week, Winston-Salem and Forsyth County offered Caterpillar a combined $23.4 million in incentives. Caterpillar plans to make a decision in August.

Marley said that the pharmacies are “willing to accept the exact same reimbursement terms given by Walgreens and Wal-Mart.”

“We feel there is no way this would be negotiated after the fact, so if there is going to be a change in Caterpillar’s policy, it has to be raised now and discussed now,” Marley said.

Also making the request are Andrews Pharmacy, East Winston Pharmacy, Gateway Pharmacy, Jonestown Pharmacy, Lewisville Drug, Medicap Pharmacy on Liberty Street and Medicap Pharmacy on Reynolda Road.

Mayor Allen Joines said the city “will bring this concern to the company’s attention if we are lucky enough to be negotiating a contract.”

At cathealthbenefits.cat.com, Caterpillar said the “direct contracts with Wal-Mart and Walgreens use a transparent cost-plus pricing methodology that is intended to eliminate unnecessary and hidden costs in the prescription-drug supply chain.”

Caterpillar did amend its policy to allow independent pharmacies to participate at the Walgreens and Wal-Mart tier in rural areas that don’t have easy access to those stores.

A small percentage of employers have adopted similar policies regarding prescription drugs, said Steve Graybill, a senior consultant for Mercer, a human-resources consulting company.

David Howard, a spokesman for R.J. Reynolds Tobacco Co., said that in 2009, the manufacturer opened up its health-care plan to give employees access to more than 59,000 pharmacies, including national chains and many local pharmacies. Before that, Reynolds provided most medical care for its employees through company-sponsored clinics such as Winston-Salem Health Care.

The bulk of local Reynolds employees have still chosen to use Winston-Salem Health Care and its pharmacy for years, Howard said. “Employees have the option to go outside of network for health care and prescriptions, but they will have higher out-of-pocket costs,” Howard said.

Media General Inc., the parent company of the Winston-Salem Journal, has a contract with Medco, a mail-order pharmacy that provides discounts for employees, but employees can fill prescriptions elsewhere, as well.

Short on Vaccine, Tall on Profit?

November 03, 2009 By: Tylar Masters Category: H1N1 News, Medtipster

blackout03

Satellite Image of the Blackout of 2003

Will shortages of seasonal flu and H1N1 vaccines cause cost increase?

The State of Connecticut’s Attorney General Richard Blumenthal wrote inquiries to 13 different manufacturers of the seasonal flu vaccine, in an effort to ensure the price of these immunizations are staying at the national average price. His office has received complaints that suspect previously negotiated agreements between manufacturers of the vaccine have been reneged, causing clinics and pharmacies to stop offering shots, increase the price, or altogether close doors to consumers.

In my last blog, I showed you a picture of a large retail chain’s pharmacy posting of an 8.5” by 11” white sheet of paper with a typed notice, “FLU SHOTS CANCELLED.” Is this an indication that manufacturers and suppliers are going to pull a “black-out” on us? Remember August 13, 2003 when most northeast and midwest states were powerless for hours and, in some cases, days? Remember what happened at gas stations? In Michigan, we saw lines of cars stretching for a half mile from gas stations to fill up on gas for over $5.00 a gallon!

Will flu shot prices double or triple at some pharmacies? Think about this: a neighborhood pharmacy in a small town knows the vaccine is limited, and there is an easy way to double or perhaps triple a profit. Will they do that to their customers? Will you know if these prices are standard in comparison to the other chain pharmacies, like CVS, Walgreens, Wal-Mart, or Target?

Price comparing on vaccinations is not as easy as price comparing a new washer and dryer from Sears. You won’t get Progressive Car Insurance’s “price comparison” leader board when you walk through your pharmacy’s door. You can’t place a bid on EBay for your healthcare. And definitely don’t expect to see William Shatner, aka “priceline negotiator,” standing in your hallway ready to break out the best deal for you on your healthcare, vaccinations or prescriptions! He’s just good for deals on vacations, you know, since we can all afford* to take one!

Medtipster.com is the only website specifically designed to locate these vaccinations for you, at the lowest cost available, in your neighborhood. Don’t spend hours calling pharmacies, searching online or driving around when www.medtipster.com has the information you need.

*Sarcasm.

Tylar Masters
Manager of Marketing and Communications
Medtipster, LLC.
email: tmasters@medtipster.com
web address: www.medtipster.com

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