Shopping for Healthcare: A Retailer's Foray Into Healthcare Service Delivery in the United States

Abstract

The healthcare system in the United States (US) is broken for consumers. It is built on a complex web of relationships between powerful entities that often exclude the consumer. This can translate into a poor – and at times disheartening – experience for consumers. Three problems underpin the brokenness of the healthcare system for consumers: (1) healthcare costs are high and rising; (2) access and convenience to basic healthcare services are lacking; and (3) the quality of healthcare services is often poor and variable. Walmart, the major American retailer, is interested in changing the delivery of healthcare in the US. In September 2019, Walmart opened its first Walmart Health Center in Dallas, Georgia. It offers several basic healthcare services under one roof – primary care, dental, audiology, vision, behavioral health, and others – at transparent and affordable prices. The Walmart Health Center accepts insurance and provides reasonable cash prices for consumers who may be uninsured. It operates with extended hours and is led by a team of medical professionals from the local community. With a desire to test, learn, iterate, and eventually expand, Walmart was interested in understanding the integration and optimization of primary care services at its Walmart Health Center. Integration of basic healthcare services could allow the company to reduce healthcare costs, provide an accessible and convenient healthcare experience, and offer high-quality healthcare to consumers. The project had two aims: (1) to understand existing models of primary care that integrate several services under one roof; and (2) to determine how Walmart Health could better integrate the healthcare services at its Walmart Health Center. Based on a series of qualitative interviews, this project established two major conclusions. The first is that the current landscape of primary care models is influenced by several contextual characteristics that determine the extent of integration. The second is that the Walmart Health Center has the foundational structures, operations, and workflows to support the effective integration of primary care services. Given the early stages of Walmart Health’s operational life, several recommendations are offered to provide a roadmap for effective integration of basic healthcare services.