Walmart may consider new services for in-store clinics

LOS ANGELES – Retail giant Walmart Stores Inc. is exploring ways to expand the kinds of health care services it offers at dozens of stores across the country, potentially setting the stage to turn the nation’s largest retailer into a major primary care service provider and drive down costs for millions of Americans.

The Arkansas retailer is looking to partner with outside health care companies to treat and manage a range of serious medical conditions – including HIV, diabetes, arthritis and clinical depression – at 140 store clinics nationwide.

Any expansion of the retailer’s clinics would come as millions of Americans prepare to gain health insurance in 2014 under President Barack Obama’s health care overhaul, which will provide government subsidies to people who otherwise could not afford coverage.

“It seems that Walmart could be well-positioned to care for a dramatic increase in the number of paying patients out there,” said Larry Levitt, head of the nonprofit Kaiser Family Foundation’s Initiative on Health Reform and Private Insurance.

Walmart’s strategy was spelled out in a confidential, 14-page document sent to health care vendors and made public Wednesday as part of a National Public Radio report. The document said the company “intends to build a national, integrated, low-cost primary care health care platform.”

But Walmart downplayed the significance of its efforts, saying its internal document – a “request for information” – was only a preliminary move to test the feasibility of moving forward.

The confidential paper “is overwritten and incorrect,” Dr. John Agwunobi, president of Walmart U.S. Health & Wellness, said in a statement. “We are not building a national, integrated, low-cost primary care health care platform.”

Walmart declined to elaborate or say if it is considering adding more in-store clinics.

Regardless of the extent of Walmart’s expansion plans, one Orange County, Calif., customer praised the effort, saying it would be a good alternative to expensive doctor visits.

Shelby Barone, 34, said she already shops at the Walmart near her Aliso Viejo, Calif., home once a week. Taking her three children to a clinic inside the store would be “so convenient,” she said.

“Why would I spend $300 to take my child with a late-night fever elsewhere when I can spend $75 to do it at Walmart?” she said. “It’s one stop. I wouldn’t hesitate. If any company could tackle this and make it work, Walmart can.”

Walmart isn’t the only major retailer operating in-store clinics. It has competition from several chains, including Walgreens, CVS Caremark and Target. As of last year, there were nearly 1,200 retail clinics across the country, many staffed by nurse practitioners and physician assistants treating minor ailments such as cuts and coughs, according to think tank Rand Corp.

Some health care analysts said the extensive primary care services envisioned in the Walmart document would set it apart from the others.

The company’s massive size also might allow it to negotiate better deals with outside companies that provide medical services in its clinics and the insurance companies that pay its customers’ medical bills. Driving hard bargains could lower costs for consumers.

“It can potentially create an entirely new model” for delivering health care, said Paul Ginsburg, president of the Center for Studying Health System Change.

But Ginsburg and other health care experts warned of challenges, including a shortage of primary care doctors, particularly in rural areas where Walmart is a dominant presence. And the American Academy of Family Physicians has criticized retail health clinics, arguing that they often aren’t well equipped to deal with chronic medical conditions.

“I would question if they really understand what it’s like to deliver primary care with good outcomes and cost efficiency,” Dr. Glen Stream, president of the academy, said about Walmart. “It’s a lot more complex than people would think. I would be concerned whether a retail chain is the right place to do that.”

For Walmart, however, offering a wide range of health care options could help the retailer remain relevant and retain customers in an environment marked by low consumer confidence and stiff competition.