Walgreens' Strategy Behind ACO Participation
As the number of participants in the Medicare Shared Savings Program grew in January when CMS announced 106 new accountable care organizations, the types of participants grew as well. Walgreens became the first national pharmacy chain to be approved by CMS to participate in ACOs. The national chain has a hand in three organizations: the Advocare Walgreens Well Network in New Jersey, Diagnostic Clinic Well Network in Florida and Scott & White Walgreens Well Network in Texas.
While some might find the move surprising, Jeffrey Kang, MD, senior vice president of health and wellness services and solutions for Walgreens, sees the move differently. "It's a natural evolution," he says. "Over the last five or 10 years, Walgreens has been increasingly moving into the healthcare space."
Build upA big part of being successful as an ACO is effective population health management — and that's where Walgreens says it can lend a hand to hospitals and physician groups forming ACOs.
According to Dr. Kang, Walgreens has developed five population health services that he believes add value to services offered by acute-care providers.
• Primary prevention and screening. This includes vaccinations and health screenings for chronic conditions such as diabetes and hypertension.
• Health and wellness. Walgreens stores’ programs such as weight loss and nutrition efforts.
• Medication adherence. Walgreens pharmacists can follow up with patients after a hospital discharge to make sure they are executing on physician orders to take certain medications. The chain also offers bedside medication delivery.
• Minor episodic care. In-store clinics staffed by nurse practitioners can treat simple illnesses such as colds, sore throats or urinary tract infections.
• Chronic condition management. Walgreen's pharmacists and Take Care Clinic NPs can help monitor patient adherence to a physician's treatment plan.
Walgreens began developing its population health services because it saw a nationwide gap in care due to the primary care physician shortage. "We see our nurse practitioners and pharmacists as a part of filling that primary care gap," says Dr. Kang. "We think pharmacists, working side-by-side with nurse practitioners and physicians, can essentially expand the primary care capacity of the country."
The development of the five health services above, coupled with the vision of filling the country's primary care gap, prompted Walgreens' entrance into the ACO world.
How it worksIn its three Medicare ACOs, Walgreens partnered with hospitals and physician groups in New Jersey, Florida and Texas. According to Dr. Kang, Walgreens and the partner organization are sharing governance of the ACO and also sharing in the generated savings.
"Essentially, through the governance model, we are integrating [our] clinical services with hospital clinical services," Dr. Kang explained. "The Walgreens' clinicians are essentially now a part of the…care team."
Walgreens and the partner organizations are on different electronic medical records in all three of the new ACOs. However, enabled by HIT and data transfers, they are sharing data between and among each other.
While the pharmacy chain is currently formally involved in three ACOs, Walgreens is looking to expand its presence in the ACO market. "We'd be interested in, in the long run, operating in all of our markets where we have a presence," Dr. Kang says. "We're certainly interested in participating in existing accountable care organizations."
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