Healthcare Clinic at Walgreens Access to Care Innovations Panel March 5, 2014 Dr. Alan London Vice President, Strategic Clinical Partnerships 2014 Walgreen Co. All rights reserved.
Walgreens is Well-Positioned as a Total Population Health Solution STRATEGIC CONSIDERATIONS Traditional focus of US healthcare delivery system is on providing sick care Most Complex Complicated WALGREENS ROLE Home Infusion Medication Reconciliation (WellTransitions ) Centers of Excellence (HIV, transplant, etc.) Focus of population health solution is on keeping people well and preventing hospitalizations Stable Chronic Healthy Medication Adherence Biometric testing (eventually lab testing) Chronic Condition Support Acute Episodic Lifestyle Counseling Immunizations 2014 Walgreen Co. All rights reserved. 2
Walgreens Healthcare Assets National Network of Retail Pharmacies Specialty Pharmacy 8200+ pharmacies and over 70,000 trusted health care professionals Located within 3 miles of 2/3 of Americans 6.2 Million Customers visit stores daily #3 in the Industry, Largest Independent Specialty Pharmacy 850+ Specialized pharmacy facilities (HIV, Hepatitis C, Transplant, Fertility) Infusion Services #1 infusion provider in the nation with 100 sites in 40 states 1400+ licensed, specially trained clinicians Hospital System Solutions ~200 outpatient pharmacies in major institutions WellTransitions sm improves adherence and reduces hospital readmissions Retail Clinics 400+ Healthcare Clinic at select Walgreens in 21 states + DC 1800 NPs and PAs; every clinic has a collaborating physician Employer Health Centers 350+ Worksite health centers at employer locations 160+ employer clients in 45 states 2014 Walgreen Co. All rights reserved. 3
Coordinated Care Across The Medical Neighborhood Primary Care Providers Traditional Pharmacy Specialty & Infusion Pharmacy Specialty Care Providers Hospitals and Health Systems Retail Clinics Case Managers and Patient Navigators Accountable Care Organization Home and Community Based Long Term Care Our integrated services help identify, manage and control acute health issues and chronic conditions as a core component of the healthcare community 2014 Walgreen Co. All rights reserved. 4
Well Experience: Transforming the Patient Experience 2014 Walgreen Co. All rights reserved. 5
Healthcare Clinics: Quality Family Healthcare Made Easy Walk-Ins Welcome and Appointments Available Open 7 Days a Week and Weeknights, Too $ Most Insurance Accepted Board-Certified Family Nurse Practitioners and Physician Assistants* On-Site Pharmacy Physician Collaboration and Quality Overview Treatment for Patients 18 Months and Older 2014 Walgreen Co. All rights reserved. 6
Healthcare Clinics Deliver a Patient-Centric Experience 260+ square feet built into Walgreens space Two exam rooms, with exam tables Restrooms facilities nearby Most conveniently located across from the pharmacy Professionally outfitted with state of the art technology & medical equipment Electronic sign-in kiosks Patient queue, with wait time visibility Internally developed EMR LCD screen 2014 Walgreen Co. All rights reserved. 7
408 Locations in 35 Markets, 22 States - Atlanta Boulder Chicago Cincinnati Cleveland Colorado Springs Columbus Denver Ft Lauderdale Houston Indianapolis Jacksonville Kansas City Knoxville Las Vegas Lawrence Louisville Memphis Miami Milwaukee Nashville New Orleans New York City Orlando Philadelphia Phoenix Pittsburgh St. Louis Tampa Topeka Tucson Washington DC West Palm Beach Wichita 2014 8 Walgreen Co. All rights reserved.
Healthcare Clinic Drives Significant Cost Savings to Employers for Non-Emergent Patient Visits Almost one-third of emergency room visits are for non-urgent care, costing an estimated $20-32 billion annually 1 Healthcare Clinic average cost of care is 4x less than the cost of an emergency room visit 2 Healthcare Clinic offers significant advantages in the average visit cost per patient 4 $600 $500 $400 $300 $570 $58,000+ direct cost reduction for every 1,000 patient visits vs. office/er 3 $200 $100 $166 $156 $110 $- ED PCP Urgent Care Healthcare Clinic 1 Lin DQ. Convenient care clinics: opposition, and the path to health system integration. Front Health Serv Manage. 2008: 24(3)-11. New England Healthcare Institute. Emergency department overuse: providing the wrong care at the wrong time. www. Nehi.net/uploads/one_pager/ed_onepager.pdf. 2 Mehrotra A, Wang MC< Lave JR, Adams JL,,McGlynn EA, Retail clinics, primary care physicians and emergency departments: a comparison of patients visits. Health Aff (Millwood). 2008:27(5): 1272-1282 3 Thygeson. Health Aff. (Millwood). 2008: 27(5): 1283-1292 4 Mehrotra A, Liu H, Adams JL, Wang MC, Lave JR, Thygeson NM, Solberg LI, McGlynn EA. Comparing costs and quality of care at retail clinics with that of other medical settings for 3 common illnesses. Ann Intern Med. 2009 Sep 1; 151(5):321-8. 2014 Walgreen Co. All rights reserved. 9
Healthcare Clinics: Affiliates in Extending Primary Care Access Fee for Service Environment Risk-Sharing Environment Improved Access Overflow and after hours coverage Diversion of nonemergent ER visits Extension of primary care physician offices Extended Reach Connecting patients without a primary care provider Referral option for patients in need of specialty, diagnostic, and acute care Care Coordination High-quality, low-cost setting for care Screening, monitoring, and education of chronic care patients Decreasing preventable hospital admissions and re-admissions Expanding access to preventive services; impacting HEDIS & Stars measures Key Enablers EMR Appointment Scheduling PCP Visit Summary Electronic Data Transmission to Healthcare Providers 2014 Walgreen Co. All rights reserved. 10
Care Coordination for Four of the Most Prevalent Chronic Disease States Targeted Disease States DIABETES ASTHMA HYPERTENSION HYPERLIPIDEMIA Provide screening, education, ongoing monitoring, and education for patients in coordination with their physicians Support the execution of the primary physician s treatment plan Enhance patients overall well being and role in self care in order to decrease exacerbations of their illness and increase compliance Provide visit summaries and follow-up to the patients primary physician with patient consent 2014 Walgreen Co. All rights reserved. 11
Walgreens Value-Based Benefit Design Incents Usage of the Retail Clinic Service/Visit Traditional PPO Plan Co-Pays High Deductible Health Plan Out-of-pocket until deductible is met Out-of-pocket after deductible is met On-site and Healthcare Clinic $5 $5 $5 Primary Care Physician $20 $48 $89 $10 $18 Specialty Physician $35 $72 - $155 $15 $30 Urgent Care $20 - $85 $80 - $242 $16 $50 Emergency Room $150 $300 $1,500 (removing high cost diagnostics and admission fees) $60 -- $300 (removing high cost diagnostics and admission fees) Based on actual claims data for Walgreens employees enrolled in Walgreens benefit plans 2014 Walgreen Co. All rights reserved. 12
Utilization of Healthcare Clinic Increased Driving Significant Cost Savings Members who used the Healthcare Clinic increased 40% from 2011 to 2013 Total savings for the top 15 diagnoses after the co-pay incentive was just over $3 Million for the three year period 25,000 22,921 1,400,000 $1,300,700 20,000 15,000 16,311 18,599 1,200,000 1,000,000 800,000 $836,000 $874,000 10,000 600,000 400,000 5,000 200,000 0 2011 2012 2013-2011 2012 2013 2014 Walgreen Co. All rights reserved. 13
Walgreens Healthcare Vision Healthcare Vision Healthcare Mission To be a leading community healthcare provider and partner for providers and payers To offer a full range of integrated services and solutions to improve patients outcomes and satisfaction while lowering overall costs the Triple Aim 2014 Walgreen Co. All rights reserved. 14