Published October 2023

Healthcare's Changing Landscape
By Dave Jakielo

I am entering my sixth decade of involvement in the medical billing industry, and I believe that there will be a major shakeup in ways that healthcare services will be delivered.

However, independent physicians may be a dying breed. I recently read that doctors who work in physician-owned practices fell from 60.1% to 46.7% from 2012 to 2022.

What is changing is not just the fact that hospitals are employing physicians, but now major retailers are providing various healthcare services. One of the retailers that is aggressively entering the healthcare market is Walmart. They recently announced plans to open 28 new health centers, bringing their national total to over 75. Walmart's offerings are not only primary care, but include dental care, behavioral health, lab, and X-ray services, located right in their facilities. Additionally, they jumped on the telehealth bandwagon during the pandemic and have continued providing those services.

Amazon is another retailer which acquired a primary care provider, One Medical, which offers in-office and virtual services. They will have on-site labs, services for mental health, preventive care, chronic care, etc. Amazon's pharmacy offers low-cost generic medications that can be delivered directly to customers' homes.

According to the American Hospital Association, Apple is concentrating on ways to help patients live healthier lives by making greater use of the data captured through their personal devices. I wear an Apple watch which tracks my heart rate on my wrist. I can give myself an ECG, check my blood oxygen level, and save the results so they are available for my physician to review.

Like Apple, Google uses a health tracking platform to help patients collect their data in one location.

Best Buy is also involved with healthcare, and they are developing and selling wearable tech devices that allow the provider care team to remotely monitor a patient's vital signs on a 24/7 basis.

CVS Health has had its MinuteClinics open since 2006, and now that they are part of Aetna, I wonder if they will be directing people with Aetna insurance to utilize their facilities? They also purchased Oak Street Health, a primary care provider for Medicare beneficiaries.

Uber offers a ride-sharing arm, Uber Health, which offers same-day prescription deliveries and arranges for patients to be transported back and forth from their medical appointments. They launched this service in 2018 as a non-emergency medical transportation system with particular emphasis to underserved and vulnerable communities.

Walgreens recently partnered with Prothena, a late-stage clinical biotechnology company that will help patients enroll in an Alzheimer's clinical trial. Walgreens also made a big push into the primary care space when it bought Village MD, and they plan to open at least 600 co-branded primary care practices in more than 25 U.S. markets by 2025 and have 1000 locations by 2027.

Some advantages of these new retail locations are same-day appointments, convenient locations, and self-scheduling ability. If retailers offer a friendlier consumer experience relating to easy access and longer hours of operation, that may incentivize people to utilize their services.

The primary care market is about $260 billion on an annual basis right now. Traditional providers dominate the market, but some predictions are that 30% of the market will be controlled by retailers by 2030.

This delivery system is gaining traction because patients are no longer willing to wait days to see their doctors. They want quick access, to see test results sooner rather than later, and to get answers to healthcare questions as quickly as possible. Retailers are starting off with advanced technology tools that many small, privately-owned practices don't have or cannot offer.

If the retailers can gain traction, it will have a ripple effect on medical billing companies that currently bill for office-based physicians. As I mentioned, physicians who own their practices are down to 46.7%. We could see further erosion of those numbers, thereby shrinking the market for medical billing opportunities to service small practices.

The retailers will need to do medical billing, but given their scope and size, they will do it internally or look to partner with or purchase a large medical billing service. Stay tuned; as Bob Dylan sang, "The times they are a-changin."

Dave Jakielo is an International Speaker, Consultant, Executive Coach, and Author, and is president of Seminars & Consulting. Dave is past president of Healthcare Business and Management Association and the National Speakers Association Pittsburgh Chapter. Sign up for his FREE weekly Success Tips at www.Davespeaks.com. Dave can be reached via email Dave@Davespeaks.com; phone 412-921-0976.

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