CVS Ramps Up Retail Clinics with Provider Affiliations

A new player in the healthcare delivery system is taking on an old challenge: primary care.

Relief for a common side effect of healthcare reform—increased demand for primary care services—may come from a place well known for soothing many ills.

CVS Caremark, one of the biggest retail pharmacy brands in the country is playing a major new-entrant role in healthcare delivery.

With several new provider partners announced last week, the Woonsocket, RI-based company has established clinical affiliations with more traditional healthcare providers in six states: Hartford HealthCare and ProHealth Physicians in Connecticut, Memorial Health in Georgia, Lahey Health and Baystate Health in Massachusetts, Texas Health Resources in Texas, Palmetto Health in South Carolina and The Baton Rouge Clinic in Louisiana.

The centerpiece of the pacts are MinuteClinics, which offer treatment for conditions that do not require a trip to an emergency room or an urgent care center, CVS officials said via email Monday.

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"MinuteClinic locations are not intended to act as primary care sites, but instead complement the work of the primary care physicians by supporting their efforts in providing convenient and accessible care," CSV said. "MinuteClinic provides treatment for common family illnesses and administers wellness and prevention services, including health-condition monitoring for patient with chronic diseases."

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CVS Caremark cited research indicating that the quality of care at "retail clinics" is equivalent to traditional healthcare delivery settings such as hospitals. It is "on par with the care provided at ERs, urgent care centers and physician offices, which was demonstrated through a Rand-sponsored study, published in the September 2009 issue of the journal Annals of Internal Medicine," CVS said, noting the research "was largely based on MinuteClinic data."

With headquarters in Fort Worth, Texas Health Resources is a faith-based, non-profit health system that includes 25 acute care and short-stay hospitals. Texas Health doctors are set to serve as "collaborating physicians" at 34 MinuteClinic locations in the Dallas-Fort Worth area, according to the health system and CVS.

"Texas Health Resources and Texas Health Physicians Group are collaborating with CVS Caremark as part of our strategy to coordinate care for people across the continuum of health needs through each stage of their journey from birth to end of life," said Donald Fowler, MD, a family physician at Sunnyvale Medical Group.

"We believe this affiliation with CVS Caremark will reinforce our ability to keep people healthy and out of the hospital. That will enhance their overall well-being and help fulfill our mission to improve the health of the people in the communities we serve."

Fowler said Texas Health physicians "will provide medical supervision of nurse practitioners and physician assistants who staff the MinuteClinics." The new partners will have an integrated electronic medical records capability in place next year.

And because MinuteClinic is migrating its EMR to an Epic system, "bidirectional, real-time connectivity will be available between MinuteClinics and THPG practices," he added. "The migration begins this fall and should be complete by the end of 2015."

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Market conditions are ripe for healthcare organizations to boost primary care services in Texas and nationally, said W. Stephen Love, president and CEO of the Dallas-Fort Worth Hospital Council. "Nationwide, a lack of primary care providers is something hospitals are looking at. There is a shortage of primary care," he said.

Love said regional economic growth, which includes a fracking boom in the petroleum industry, is contributing to the need for more primary care services. "As you look at North Texas and you see the growth rate in North Texas, the hospitals are reaching out to their communities," said the leader of the Fort Worth council, which includes 85 hospitals.

"Providers are looking at ways to provide services in the communities they serve in a collaborative way and to offer the best primary care services they can."

The MinuteClinic deal in North Texas is designed to meet a market need, Fowler said. "Approximately 50 percent of MinuteClinic patients report that they do not have a primary care provider."

"Patients without a primary care physician are given a resource list of primary care physicians in the area, which will include Texas Health Physicians Group practices and others. If a patient indicates she has a primary care provider, with the patient’s permission, MinuteClinic will send a visit summary to the named provider.

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"One of our goals is to expand access to quality primary care close to where people live and work," Convenient access to primary care, medication monitoring, and other information promises to enhance care coordination and improve outcomes.

In addition to the 34 MinuteClinics that Texas Health and CVS are opening this year, the partners have announced plans to open seven more North Texas clinics by early 2015.

The Rhode Island-based retail giant also appears to be looking for broader retail clinic growth in the near future. "CVS continues to explore opportunities to collaborate with health systems, hospitals, integrated delivery systems, patient-centered medical homes and accountable care organizations throughout the country," the company said.