In a world of quick, convenient services such as Uber, Doordash and Amazon Prime that consumers have at their fingertips, CVS Health Corp. sees a massive opportunity to deliver primary health care services in a modern, frictionless fashion.
Some Rhode Island doctors, however, are wary about what the Woonsocket-based pharmacy giant has in mind.
CVS outlined its plans for a companywide transformation during an investor summit held in New York City on Dec. 9.
While closing 900 of its nearly 10,000 U.S. stores over the next three years, the company said it plans to use its nationwide footprint of retail locations to establish 250 to 350 primary care centers by the end of 2024, each staffed by two care teams, which consist of a doctor and two advanced practice nurses.
“The market is ripe for change that only we can deliver,” CEO Karen S. Lynch said at the investors event.
A big part of the CVS primary care plan is to incorporate smartphone technology to reduce the paperwork and waiting associated with a doctor’s visit, using geolocation technology to allow patients to check in and fill out forms digitally. And the care continues after the appointment, as CVS plans to maintain contact with patients through its interactive app to send reminders of doctor’s recommendations, inquire about a patient’s status, deliver further instructions and allow patients to refill prescriptions and schedule future visits.
“We’ll make it super simple,” said Alan Lotvin, executive vice president for CVS Health. “When you get to the doctor’s office, guess what? You don’t get the clipboard and get asked 150,000 questions that you know nobody is actually going to look at. No check-ins. No I’ve-got-to-stand-behind-seven-people. It’s just geofence, ‘Hello, welcome, nice to see you’re here, we’re running on time, see you in two minutes, have a seat or have some coffee.’ ”
“And really importantly,” Lotvin added, “when you leave, you will know exactly what happened, exactly what the plan is. ‘Your blood pressure is a little high? We want to lower it. Here’s the things that we’re going to do. And here’s what you want to do.’ … You not only become empowered, which is a term that’s great, but you become engaged.”
Some local doctors worry that the full-on pivot by CVS into more primary care services will just create more headaches for them and potentially cheapen the personal quality of health care in the long run.
Dr. Howard Schulman, a general internist with a practice in East Providence, said he’s concerned that quick trips to the new CVS primary care centers will not be coordinated and will leave a patient’s regular doctor in the dark before the patient’s return to their doctor’s office when a more complicated medical issue arises.
“It seems like a money-making deal, as opposed to helping coordinating care and better service for patients,” Schulman said. “We don’t need help taking cheap, five-second appointments for antibiotics, things like that.
“The most important thing when you go see a doctor is that you see a good doctor, not whether they have a [short] line outside,” he said. “If there’s a big line outside of a restaurant, that’s a reason to go.”
And it could be a financial blow to primary care physicians in private practice who are struggling with low reimbursement rates from coverage providers, while generally getting paid less than specialty doctors, Schulman said.
“It’ll be more competition, and another hassle to deal with,” Schulman said.
CVS executives said they see opportunity in the 25% of adults who do not have a primary care provider, with a 24-day average wait time to see a primary physician in the U.S., where 20% of adults didn’t see a doctor or went without recommended care within the past year. And the company said it could also reduce costs for U.S. medical patients, who on average face $11,100 in health care costs each year.
Lynch said CVS will not necessarily be in competition with primary care doctors across the country. Instead, CVS would be establishing its care facilities in markets that have low physician availability.
“Clearly, these unmet needs create opportunities for CVS Health to connect consumer experiences in ways that lower cost, increase access and improve the quality of care and improve health outcomes,” Lynch said. “They want to be part of the solution and they recognize some of their patterns might require an extension. We’re a natural extension of that. We look at this as a partner, not necessarily competing.”
Natalie Schibell, a senior analyst at Forrester Research Inc. who focuses on the health care industry, said the COVID-19 pandemic accelerated by a decade the concept of “consumer centricity,” and CVS is seizing on that consumer demand for digital communications and convenience to earn its share of the country’s $4 trillion in annual health care spending.
Schibell said she expects other companies to follow suit, including potentially Walmart Inc., which currently offers urgent care services and prescription delivery, and Amazon.com Inc., which offers telehealth services along with prescription delivery.
“I think established primary care providers should be worried because this is a convenience for the consumer,” Schibell said. “CVS, I think, is capitalizing on a rise in consumerism. … Patients are demanding everything at their fingertips. They want that same convenience in health care.”
Marc Larocque is a PBN staff writer. Contact him at Larocque@PBN.com.
