The healthcare system is a dynamic and complex environment, which always seems to be in a constant state of transition. These transitions occur for a variety of reasons such as cost, technology, policies, etc. The growing influence of Walmart in the healthcare space clearly displays this fact. The retail giant is now starting to provide basic healthcare services.
The New Players in Healthcare:
The movement of these tech-based companies into the medical industry have been occurring for a number of years. Well-known technology companies like Amazon, Apple, Facebook and Google all have a stake in the healthcare marketplace. These corporations have experienced great success with providing software, hardware and internet applications. They are positioning themselves to replicate similar results in the field of healthcare.
Walmart has for years offered healthcare-related products and services. The company first started offering pharmacy-related services back in 1978. Since then, they have expanded their retail presence across the United States and now operate over 5,000 retail pharmacies, 3,000 vision centers and 400 hearing centers.
Consumerism and healthcare are sometimes tricky subjects to explore. It is a challenge to deliver high-quality healthcare while simultaneously controlling medical expenses. Yet, if anyone has experience in maintaining customer satisfaction, while controlling cost – it is Walmart.
Walmart is Transitioning into a Healthcare Provider:
In 2019, the Walmart Corporation was in negotiations with the insurance provider Humana. The merger of these two corporations would have granted the retailer a more substantial presence in the U. S. healthcare system. However, this proposed merger never occurred, but Walmart was able to acquire Humana’s former senior VP of health and wellness.
This former Humana employee helped Walmart has introduced its new pilot wellness/healthcare program for its employees. The program offers a list of high-quality healthcare providers, but has fewer choices than under the current employee plan. The new program will help Walmart employees connect with local doctors in areas like primary care, cardiology and obstetrics.
The retailer already operates several healthcare clinics in several southern states. Industry observers speculate that these new services by Walmart will allow the chain to compete with companies like CVS and Walgreens.
Standalone Health Centers:
The retailer opened its first standalone health centers in Georgia called Walmart Health. These freestanding clinics/facilities will offer a variety of healthcare services including primary care, x-ray, labs, optometry, behavioral health, audiology, nutrition and dental.
The company has announced that they plan to open several more standalone health centers. They have stated that they will “continue to learn as we open several more and design the ideal model to provide customers with better and unique solutions for their everyday healthcare needs.”
In a nod to price transparency and lower cost, prospective patents/consumers can view the price for services and schedule appointments online.
The company has been comparing the metrics of various physicians and other clinicians. According to the Wall Street Journal, the retailer is collecting data on healthcare costs and trying to eliminate providers with poor performance metrics. Walmart officials have stated that they are finding success in selecting healthcare professionals. Their new employee health plans have narrowed the provider/physician networks and have focused on hospitals and physician groups instead of individual doctors.
Independent healthcare providers and small practices are aware of the changes that companies like Walmart have on the Healthcare system. Smaller practices have for many decades had to make their way through a challenging environment. According to the American Medical Association, in 2016, 47% of physicians owned their own practice. But, in 1983, 76% of physicians owned their own medical practice.
Smaller Practices & Independent Providers:
For these practitioners, companies like Walmart are just part of the ever-changing medical industry’s landscape. They are familiar with dealing with issues that range from negotiating reimbursement rates, access to insurance panels, stopping revenue leakage, claims management, office staffing, promoting their practice, etc. Other operational costs arise from back office billing staff, IT support, etc.
Physicians and other healthcare professionals understand that there are rising operational costs for their practices and clinics. Unlike larger companies like Walmart, they do not benefit from the economy of scale. Smaller practices realize that they need to be more flexible and creative if they are going to find success.
One way to reduce their overhead is to outsource some of the non-clinical tasks such as medical billing and credentialing. This will save medical practices valuable time and money in the long-run.
By outsourcing non-clinical functions, smaller practices can focus on their strengths. They can strive to deliver customizable and personal healthcare to their patients. This is a potential advantage that they may have over larger entities such as Walmart.
The retail industry has changed dramatically over the past few decades. Will the same changes occur in the healthcare industry? Time will tell.
ABCS RCM provides revenue cycle management services for a variety of healthcare specialties. Beyond medical billing services, they also offer insurance credentialing, online marketing and workforce management tools for agencies that provide services to the I-DD community. For additional questions about this topic or medical billing in general, please contact the staff at Advanced Billing & Consulting Services.
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