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Attention, Walmart Patients

By KIM BELLARD

When Walmart announced earlier this summer that it was opening an insurance agency to sell Medicare-related products and services plans, I thought, “that’s it?”  When Walmart announced later in the summer that it was partnering (first with Microsoft, then with Oracle) in the bid to buy TikTok, I thought, “well, isn’t that interesting?”  And when Walmart announced a few days ago that it was partnering with Clover Health to offer Medicare Advantage plans, I thought: “it’s about time.”

You know Walmart.  265 million people (worldwide) shop at its stores each week.  Ninety percent of Americans live within 10 miles of a Walmart store.  It is estimated that 95% of Americans shop at Walmart during the year.  In over 200 U.S. markets, it accounts for at least 50% of grocery sales.  It is the fifth largest pharmacy chain by revenue. 

And Walmart has been shaking up healthcare for some time.  Way back in 2006, it introduced its $4 Prescriptions program that upended pharmacy pricing.  In 2008, it started offering in-store retail clinics, initially in partnership with hospitals and now operates on its own

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PBM Startup Capital Rx Starts Prescription Drug Pricing Shake-Up with Walmart Partnership

By JESSICA DaMASSA, WTF HEALTH

A startup PBM? Partnered up with Walmart to bring “everyday low prices” to prescription drug pricing? Is this too good to be true? A.J. Loiacono, founder & CEO at Capital Rx, gives us a quick primer on “Pharmacy Benefit Managers” (PBMs) and why they’ve become known for the element of mystery they bring to prescription drug pricing. With three big PBMs (CVS’s Caremark, Express Scripts, and UnitedHealth’s OptumRx) controlling three quarters of the total market, it’s no surprise that VC-backed challenger companies in this space are rare. So, how does A.J. believe Capital Rx will shake things up? Learning about this new kind of tech-enabled, customer-focused PBM not only inspires hope for a clear future of prescription drug price transparency, but also makes one wonder about the new vision for American healthcare unfolding at Walmart.

Health in 2 Point 00, Episode 133 | PBMs galore, Genome Medical, & the FCC’s Rural Health Program

Episode 133 of Health in 2 Point 00 is brought to you by the letter P — that’s P for PBMs, of course. In this episode, Jess and I talk about Genome Medical extending their series B and getting another $14 million on top of the $23 million they already raised for their remote genetic counseling services, the FCC adding another $198 million to their rural health program, bringing the funding to a whopping total of $802 million, Anthem’s PBM IngenioRx acquiring pharmacy startup Zipdrug, and Capital Rx, a startup PBM, announced a deal with Walmart. —Matthew Holt

Health in 2 Point 00, Episode 128 | Proteus, Walmart, Kyruus, Headspace and CareAcademy

On Episode 128 of Health in 2 Point 00, Jess and I talk about Proteus filing for bankruptcy, Walmart buying the tech from CareZone for prescription drug management for an unconfirmed $200 million, Kyruus raising another $30 million for referrals and scheduling for large health systems, Headspace raising another $47.7 million, and CareAcademy raising $9.5 million in a Series A to provide online training for professional caregivers for seniors. —Matthew Holt

Health in 2 Point 00, Episode 97 | Walmart and Fertility

Today on Health in 2 Point 00, Jess is in Berlin for the Bayer G4A Signing Day where they’re announcing which startups are going to get deals and Glen Tullman is doing a fireside chat with Eugene Borukhovich. In Episode 97, Jess and I talk about Walmart and fertility. Fertility benefits startup Progyny files for IPO and I’m blown away by this relatively new company. Another startup—Halle Tecco’s Natalist—raises $5M to send care boxes to help women get pregnant. Finally, Jess has a conspiracy theory, noticing that Walmart is sneaking into all aspects of health tech… Walmart is expanding Grand Rounds, partnering with Doctor On Demand and HealthSCOPE to offer telehealth to their employees, Sam’s Club is offering $1 telehealth visits to members, and they just announced a partnership with Embold Health for employees in the southeast. Finally, I’ll be at Society for Participatory Medicine next week in Boston—see you all there. —Matthew Holt

Health in 2 Point 00, Episode 42

As I’m back from a week’s vacation, Jessica DaMassa is slowly pulling me back into the groove with questions about Walmart dumping Castlight, yet more money for telemedicine with MDLive adding $50m, and get.health sponsoring a few tickets to health2con. All in 2 minutes, with a bit of filler!–Matthew Holt

 

Consider this Speculative Scenario on Walmart & Humana

Walmart (WMT) is in talks with Humana (HUM) about a relationship enhancement, possibly an acquisition. The two already know how to work together in alliances (narrow pharmacy network, marketing collaborations, points programs). If a new structure is needed, WMT and HUM must be considering a major expansion of scope or a set of operating models where contributions are difficult to attribute and reward (e.g. joint asset builds). What is on their minds? Beyond any interim incremental moves, what could be the endgame?

Catching convergence fever

Horizontal combinations among the top five health plans have arguably reached the regulatory “permissible envelope.” But provider combinations continue apace, enhancing ability to execute on value-based care to be sure, but also increasing negotiation leverage relative to payers. Further, Amazon’s (AMZN) interest in healthcare is gaining momentum but the specific goals are still mysterious, leaving many incumbents to imagine red laser dots are on their foreheads.

Accordingly, health plans are seeking defensible terrain in convergence combinations: CS & Aetna (CVS-AET), Cigna & Express Scripts (CI-ESRX), Anthem’s PBM insourcing and growing attention to CareMore (United Healthgroup [UNH] has been ahead of the curve as usual: but their recent SCA and DaVita medical group acquisitions have clarified for the market the scope of its ambitions for OptumCare). Of course, each of these moves just contributes to the uncertainty about the new competitive paradigm, driving more land grabs in response. I view the WMT-HUM discussions as part of these developments.

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Health in 2 point 00, Episode 15

Jessica DaMassa asks me about digital health funding, Walmart and PillPack, Blockchain and my sweater — not in that order, but all in less than 2 minutes. Bonus–Farzad Mostashari’s bow tie makes a twitter appearance! — Matthew Holt

Health in 2 point 00, Episode 14

For Episode 14, Jessica DaMassa asks me all the questions she can about health & technology in 2 minutes. On the docket today, Walmart & Humana, MyFitnessPal’s huge data breach, and Apple in health tech (again!)–Matthew Holt

Wal-Mart Could Transform Care–But Does It Want To?

“Why is Wal-Mart speaking at a health care summit?” the company’s vice president for health and wellness, Marcus Osborne, rhetorically offered up at a conference back in January.

“Wal-Mart’s in retail, we’re not in health care.”

But as analysts, researchers, and other experts who spoke with me. took care to point out, Wal-Mart is in health care, and getting further entrenched by the year. In the past six months alone, Wal-Mart launched a major contracting initiative with half-a-dozen major hospitals, and dropped hints — since retracted — that the company is exploring new services like a health insurance exchange.

Notably, Osborne teased a broader health care strategy for Wal-Mart that would include “full primary care services over the next five to seven years,” in a Q&A at that January conference captured by the Orlando Business Journal.

Wal-Mart has since denied Osborne’s comments — the second time in about 18 months that the company has had to walk back stories about its planned primary care services — and Osborne subsequently stopped talking to the press. (Wal-Mart declined to comment, and Osborne did not respond to an interview request for this story.)
But Osborne’s remarks from that January conference, and his other archived speeches, are still readily accessible. And they paint a vivid picture of a company that’s not just a potential market-mover and disruptive innovator, but an organization that could do a lot to positively reform health care.

Background: Wal-Mart’s Growing Role in U.S. Health Care System

In many ways, this isn’t a new story. Back in 2007, Princeton University’s Uwe Reinhardt suggested to NPR that Wal-Mart could be “taking aim at the entire health care system” by expanding its new discount drug program.

“I think it’s a really fascinating way to come out of the corner and really slug the system,” Reinhardt said at the time. “At the moment, the body blows don’t hurt. But they add up. I’m watching this with great fascination, and expect more from them.”

And in subsequent years, Wal-Mart did grow its health care footprint, from launching retail clinics based within its stores to advocating for national health reform. Considering its history — as recently as 2005, Wal-Mart had little involvement in the health care market and was being pilloried for skimping on its own employees’ benefits — it’s been a significant turnaround for the firm, and has positioned Wal-Mart as one of the leading disruptive innovators in health care.Continue reading…

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