Independent clinical laboratories may continue to see their customer numbers drop as more consumers choose healthcare delivered in non-traditional locations
More clinical laboratory companies are offering testing in non-traditional locations with non-traditional delivery systems to serve busy healthcare consumers and ambulatory patients. One such company is eTrueNorth, a pharmacy‐based clinical laboratory services network.
This is yet another example of a company responding to the
public’s demand for convenient healthcare delivery, including clinical
laboratory testing.
Pharmacists as Care Givers
eTrueNorth has quietly built a 5,500-location network of independent CLIA-waived laboratories in retail pharmacies. By bringing point-of-care testing to community pharmacies, the company says it can close gaps in healthcare.
“By empowering local pharmacists to administer preventative
healthcare screenings and close gaps in care, eTrueNorth is working in
partnership with retail pharmacies, self-funded employers, third-party payors
and pharmaceutical manufacturers to identify undiagnosed conditions and better
manage chronic diseases,” the company’s website states. “By leveraging the
accessibility of retail pharmacies, eTrueNorth expands the scope of services
provided to consumers to be more effective, of higher quality and, at the same
time, enhance the pharmacy’s value as a key participant in a multidisciplinary
healthcare delivery model.”
The website states that eTrueNorth’s ePOCT software suite “simplifies administrative processes for CLIA-waived labs that conduct point-of-care testing.” It provides the infrastructure for CLIA-waived laboratories to meet all applicable federal, state, and local regulations. In addition, the company provides documentation to medical professionals as they track compliance with quality-control efforts for diagnostic devices.
In an exclusive interview with Dark Daily, Coral May, eTrueNorth’s CEO, President, and co-founder, said the company’s growth will continue to accelerate.
“In the next few months, we will be adding quite a few more [eLabNetwork
locations] because we will be bringing on a couple of other major brands,” May
said in a telephone interview.
May explained that all eLabNetwork pharmacies have standing orders for their limited test menu. This means consumers do not need a physician’s order to receive clinical laboratory services. As a result, however, consumers currently cannot submit a claim for the eLabNetwork service to their insurer. This is about to change.
Coral May (above) is CEO and President of eTrueNorth, a pharmacy-based clinical laboratory services network spanning more than 5,500 locations. “With the assistance of local pharmacists, eTrueNorth is making obtaining laboratory testing easier for individuals,” she said in a news release. “By leveraging the convenience of retail pharmacies, consumers are able to fit healthcare into everyday life.” (Photo copyright: LinkedIn.)
Health Plans May Soon Partner with eLabNetwork Pharmacies
May announced that in the second quarter of 2020 eTrueNorth will
launch “within several different health plans” the ability “to provide and
submit claims for tests that will close quality measures, gaps in care.”
Though May could not yet announce which health plans will be
partnering with eTrueNorth, she stated that participating insurers would be
communicating with their members directly to steer them to eLabNetwork pharmacies
where they can receive CLIA-waived testing.
May previously pointed out that health plans benefit from eTrueNorth engaging plan members at the pharmacy counter and addressing gaps in care ranging from diabetes testing to hypertension control and medication adherence. She cited as example an insurance plan member with diabetes who has not yet had an A1C test for diabetes or needs an microalbumin [urine] test.
“Our goal is to make it easier for individuals to have
affordable and increased access to additional healthcare from the convenience
of their local pharmacy,” she stated in a news
release.
Another of eTrueNorth’s stated objectives is to increase the
number of participants in the Center for Disease Control and Prevention (CDC) National Diabetes
Prevention Program (National DPP), which was created in 2010 to increase
evidence-based, cost-effective interventions that help prevent Type 2 diabetes.
In order for Medicare Advantage-eligible patients to participate in the program, they must have a fasting blood glucose test. eTrueNorth believes increasing access to point-of-care blood testing could boost participation in the DPP.
“The eTrueNorth Voucher Solution is designed to maximize participation in wellness-screening events by providing convenient access to screenings,” May said in a news release. “Local pharmacists are trusted medical providers to the community. The eTrueNorth Voucher Solution allows individuals to obtain the same high-quality, accurate testing at retail pharmacies as they would from their primary-care office.”
How the Voucher Solution Works
The company’s voucher program enables employees who miss onsite wellness screenings, or who work remotely, to visit a local pharmacy to obtain point-of-care testing and on-the-spot counseling.
Through eLabNetwork’s website, an employee can confirm
eligibility, choose a pharmacy based on zip code, schedule an appointment and
create a voucher. In addition, the eLabNetwork transmits results to the
wellness plan and/or patient’s physician, invoices wellness plan vendors, and
sends payments to participating pharmacies for:
Full lipid panel;
Glucose;
Hemoglobin A1C testing (for individuals already
diagnosed with diabetes); and
“With 95% of the US population living within five miles of a
retail pharmacy, eTrueNorth envisions a future where consumers can access healthcare,”
May said in a company
statement. “This expanding list of retail pharmacies has the potential to
make a significant impact on how healthcare is delivered.”
Will independent clinical laboratories be affected by these
events? Almost certainly. Dark
Daily has reported often on the public’s increasing demand to receive
healthcare in convenient, nearby locations, such as shopping malls and retail
pharmacies. This is just another example of that expanding trend.
Lab leaders will want to keep a close eye on it and plan
accordingly. It’s a trend that could potentially threaten clinical
laboratories’ bottom lines.
Expanding healthcare services into communities is expected to increase orders for clinical laboratory tests, promote precision medicine, and lower overall costs
Clinical
laboratories continue to adapt to servicing providers in non-traditional
healthcare settings. These include freestanding urgent care centers as well as
mini-clinics in retail locations. Dark Daily has covered this trend
extensively in previous
e-briefings.
To secure a share of this new market, national retailers,
pharmacy chains, and grocery stores are increasing their health and medical
service offerings and forging partnerships with other organizations, such as
tech developers.
One such recent partnership involves Walgreens Boots Alliance Inc.
(NYSE:WBA) and the Microsoft
Corporation (NASDAQ:MSFT). In January, both parties announced a joint
venture to develop new healthcare solutions that will improve patient outcomes while
lowering cost through research and development, funding, and technology.
“Our strategic partnership with Microsoft demonstrates our
strong commitment to creating integrated, next-generation, digitally-enabled
healthcare delivery solutions for our customers, transforming our stores into
modern neighborhood health destinations, and expanding customer offerings,”
said Stefano
Pessina, Executive Vice Chairman and Chief Executive Officer of Walgreens,
in a Microsoft press
release.
Through this partnership, Walgreens plans to provide personalized healthcare (aka, precision medicine) by connecting its customers to pertinent health information through digital devices and in-store expert advice. The goal is to proactively engage patients in their own care to improve medication adherence, reduce emergency room visits, decrease hospital readmissions, and provide customers with lifestyle management solutions.
In addition, the two companies will share each other’s
market research and work with consumers, payers, providers, and pharmaceutical
manufacturers to devise solutions that improve health outcomes while lowering
costs.
“[Walgreens Boot Alliance] will work with Microsoft to harness the information that exists between payers and healthcare providers to leverage, in the interest of patients and with their consent, our extraordinary network of accessible and convenient locations to deliver new innovations, greater value, and better health outcomes in healthcare systems across the world,” Pessina said in the press release.
As part of this partnership, Walgreens will move the majority of its IT infrastructure onto Microsoft Azure, a cloud computing and artificial intelligence (AI) platform. Walgreens also will provide Microsoft 365 to more than 380,000 employees and stores located throughout the world. Microsoft 365 is a business solution which bundles Windows 10 and Office 365 with advanced security features.
Other Walgreens Collaborations That Provide Healthcare at
Retail Locations
Walgreens also announced several collaborations with other
companies to become more competitive and secure their share of the healthcare
market.
Through its partnership with Chicago-based VillageMD, a national provider of primary
care clinics, Walgreens will open five primary care clinics next to Walgreens
stores in the Houston area. These clinics, called “Village Medical at Walgreens,”
will offer customers comprehensive primary care services, pharmacists, nurses,
and social workers.
“This collaboration with VillageMD demonstrates our ongoing commitment to create neighborhood health destinations that bring affordable healthcare services to customers and provide a differentiated patient experience to the communities we serve,” stated Patrick Carroll, MD (above), Chief Medical Officer, Clinical Programs and Alliances, Walgreens, in a Walgreens press release. “VillageMD has a strong track record nationally of improving outcomes and reducing the cost of healthcare through their transformative primary care model.” (Photo copyright: Walgreens.)
Another collaboration involves Verily Life
Sciences, a research arm of Alphabet Inc. (NASDAQ:GOOG), Google’s parent company. The
agreement is for multiple projects to improve health outcomes for patients with
chronic illnesses. The two companies will be exploring the use of technology, such
as sensors, and software to help prevent, manage, screen, and diagnose disease
with the ultimate goal of deploying those technologies at Walgreens retail
locations.
“The
continued rise in chronic diseases today can be costly to patients as well as
to our healthcare system,” Pessina told Business
Wire. “Working with Verily, we’ll look at how we can best support
integrated and value-based care to meet our patients’ needs, as well as
opportunities to address other chronic conditions over time.”
Service Agreements with LabCorp and Quest
In 2018, Walgreens
announced a significant expansion of their collaboration with LabCorp, to increase the number of patient
service center (PCS) locations within Walgreens stores. The two companies
agreed to open at least 600 additional LabCorp-at-Walgreens facilities across
the US over the next four years. At the time of the announcement, LabCorp operated
17 facilities at Walgreens in Florida, Colorado, North Carolina, and Illinois.
Along the same lines, Quest
Diagnostics (NYSE:DGX) also has opened hundreds of patient-serviced centers
within various food and drug retail stores throughout the US, which Dark
Daily reported in 2017.
“Healthcare is too complicated, too big, and if I can say, a
little too messy,” Pessina told Digital
Commerce 360. “We cannot be helpful to our patients if we don’t team up
with many, many different, practically all, the players in this industry.”
CVS HealthHubs Offer Blood Testing, Health Screenings,
and Other Services
To remain competitive, CVS also is trying new ways to
capitalize on the growing healthcare market.
In February, CVS announced
the creation of three newly designed stores in the Houston area as pilot
projects. These stores, called HealthHubs,
will include expanded health clinics with medical laboratories for blood
testing and health screenings. They’ll also feature dieticians, respiratory
specialists, and dedicated space to assist customers with the management of
some chronic health conditions, as well as wellness rooms for yoga classes and
health seminars.
“We’re pleased and surprised pleasantly with the ecosystem
of healthcare that we’ve created here and how approachable it is, how much
people are interested in it, and there are certain things we can take to all
stores,” Kevin
Hourican, Executive Vice President, CVS Health and President, CVS Pharmacy,
told Becker’s
Hospital Review.
With more retailers
adding an ever-increasing number of healthcare services to their offerings, the
number of medical laboratory tests available at those locations will likely
also increase. Although this trend may boost competition for clinical
laboratories, it could also benefit them by creating new opportunities to
provide value-added services to their clients.
Agreements to open PSCs in the nation’s largest retail grocery and pharmacy chain stores shows a willingness by clinical laboratories to attract customers through convenience
Greater use of retail stores as the location for patient services centers (PSCs) may be an important new trend for the clinical laboratory industry. That’s because, historically, medical laboratories placed most of their patient service centers in hospital campuses or near medical office buildings.
However, in recent months, both of the nation’s billion-dollar lab companies signed deals with national retailers to put patient service centers in their stores. Dark Daily believes that the motivation for a lab company to put a PSC into a grocery store or retail pharmacy is to make it easier and more convenient for a patient to get their specimen collected at a location that is closer to their home or office. In other words, it is faster for the patient to get to their nearest grocery store for a blood draw than to travel to the hospital campus in their community.
Various news reports indicate that Quest Diagnostics (Quest) may be more active than Laboratory Corporation of America (LabCorp) in opening PSCs in grocery stores and retail pharmacies. Over the last four months, Quest has announced plans to open patient services centers with several retailers, particularly in the states of Texas and Florida. Similarly, in the past four weeks, LabCorp disclosed an agreement with Walgreens Boots Alliance (Walgreens).
Ground zero for this current interest in putting PSCs into retail stories is Phoenix, Arizona. In 2014, to serve its direct-to-consumer lab testing business model, Theranos had PSCs in about 40 Walgreen’s pharmacies. Pathologists and clinical laboratories will recall that in November, 2015, Sonora Quest Laboratories of Phoenix opened a patient service center (PSC) in a Scottsdale, Ariz., supermarket owned by Safeway. It was the first PSC Sonora Quest had opened in collaboration with a grocery store chain, but it was not the last. Less than a year later, Sonora Quest and Safeway expanded their operations by opening additional PSCs in stores throughout the Grand Canyon State.
At the same time Sonora Quest was stepping into the retail blood-drawing business, Theranos of Palo Alto, Calif., was exiting it after opening 40 PSCs in Walgreens pharmacies, most of them in Arizona. However, before leaving the lab-testing business altogether, the embattled company put a lot of effort into educating consumers about the benefits of purchasing lab tests without a physician’s order. Theranos had even supported a bill (HB2645) the Arizona State Legislature passed that allowed patients to order tests without a physician’s requisition.
Now, in 2017, Quest Diagnostics (NYSE:DGX) appears interested in following a similar strategy as Theranos and Sonora Quest by developing Quest-branded PSCs in retail chain stores. On its website, Quest states that in the past several years it has opened 106 PSCs in Albertsons, Randalls, Safeway, Tom Thumb, and Vons retail stores in nine states.
This Quest patient service center operates within a Safeway store location. (Photo copyright: Quest Diagnostics.)
In June 2017, Quest announced it would open 10 additional PSCs in Tom Thumb retail stores in North Texas by the end of the month. Thom Thumb is a division of Albertsons, a food and drug retailer with stores nationwide. In the same announcement, Quest said it plans to open PSCs in 200 Albertson’s-owned stores nationwide by the end of the year.
Give Blood Then Shop
Also in June, Quest and Walmart (NYSE:WMT) announced a deal in which the two companies would open co-branded PSCs in 15 Walmart stores in Florida and Texas by the end of 2017.
In these locations, Quest encourages patients to have their blood drawn and then shop. Such locations can accommodate collecting specimens for routine blood work, such as total cholesterol and white blood cell count, as well as complex gene-based and molecular testing. Even patients with such chronic conditions as cancer, diabetes, and hepatitis, are encouraged to use these PSCs, the lab-testing company stated in the announcement.
Not to be outdone, LabCorp also announced a deal with Walgreens in June. In Forbes, Bruce Japsen reported that Walgreens (NASDAQ:WBA) announced it would collaborate with LabCorp (NYSE:LH) to develop and operate PSCs in Walgreens drugstores in Colorado, Illinois, and North Carolina.
The deal is the first for Walgreens since its troubled relationship with Theranos ended last year. Walgreens’ collaboration with LabCorp will initially begin this summer with five patient service centers in Denver and one in Morrisville, N.C. A seventh location in Deerfield, Ill., will open by the end of the year. Financial terms of the partnership were not disclosed.
Lessons Clinical Laboratories Learned with PSCs in Retail Stores
For Quest, the speed with which it is opening new PSCs is significant, because it seems to have taken lessons that Theranos and Sonora Quest learned earlier in Ariz. and applied them to markets nationwide. It’s worth noting that Safeway and Albertsons were already two of the largest retail grocery chains in the nation before they merged in 2015.
So, while Sonora Quest was working with Safeway, its parent company, Quest, was working with Albertsons.
One other point that is significant about Quest’s efforts is that not many other clinical laboratories have a presence in retail stores. It’s unknown just how much specimen volume these retail operations generate for Quest, one of the largest clinical lab companies in America. And, it is unknown if these PSCs in retail settings are breaking even or making a profit.
One result, however, is clear. That Quest is being so aggressive in opening PSCs testifies to the company’s level of interest in serving consumers directly. In other words, these PSCs are not primarily a direct-to-consumer play, but are aimed at building market share by adding regular lab testing done for patients. In this way, the direct-to-consumer business that Quest generates is a bonus.
The deals by Quest and LabCorp also imply that both clinical laboratory companies are willing to bet on the fact that consumers may prefer the convenience of using PSCs located in retail stores they currently frequent, rather than going to patient service centers in hospitals and sitting in a waiting rooms.
As popularity of retail clinics grows among consumers, so does the likelihood of increased clinical pathology laboratory testing at these locations
Retail clinics (RC)—often called “rapid clinics”—are growing at a phenomenal rate. At the same time, more hospitals and health systems are deciding to participate in this growing trend, either by owning and operating such retail clinics in their communities or by providing the clinical staff.
Since the inception of this new care delivery model about six years ago, Dark Daily has predicted that consumers will support rapid clinics located in certain retail settings. Events to date bear this out. For that reason, pathologists and clinical laboratory managers should expect to see, over time, a steady increase in the menu of diagnostic testing offered by retail clinics. (more…)
Hospitals Opening Retail Clinics to Capture Greater Market Share Walk-in rapid medical clinics in retail stores are so popular with consumers that now hospitals want in on the action. Some of the nation’s most famous hospitals have inked agreements to put their brand on rapid clinics located inside many of the country’s largest retail and pharmacy chains. Hospital-branded rapid clinics are inside 25 Wal-Mart stores nationally, according to a New York Times article. Additionally, Cleveland...
