The Battle for the Future of Healthcare, ft. James Gardner

Podcast

Retail health leaders like Walgreens, CVS Health, Walmart, Amazon, and Dollar General are remaking primary care with their ambitious plans to deliver at-scale health and wellness services. For traditional care delivery organizations, risks and opportunities are abound in this fast-changing landscape.

What is the future of the healthcare as retail health and traditional health systems battle it out? Who’s winning and what does this mean for the healthcare consumer?

Join James Gardner, Director, Healthcare Strategy, at OHO Interactive and podcast host Alan Tam as they explore and discuss the future of primary care, what’s motivating these giants, what moves they’ve already made, and what might happen next.

This conversation is brought to you by Actium Health in partnership with the Forum for Healthcare Strategists.

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james gardner battle for the future of healthcare podcast

James Gardner

Director, Healthcare Strategy
OHO Interactive

battle for the future of healthcare podcast
alan-tam

Alan Tam

Chief Marketing Officer
Actium Health

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Transcript

James Gardner (00:00):
So I think we’re on the cusp of a revolution, and I don’t think we’ve seen even a fraction of where we’ll ultimately get to. I believe it was the American Hospital Association in collaboration with the Boston Consulting Group, took a look into the future, and of course, it’s a crystal ball, so there’s all kinds of clouds in the crystal ball, but they estimated that potentially 30% of the primary care world could gravitate towards these non-traditional organizations, which I believe also included some of the payviders. So it’s not completely going to fall into the retail world, but that’s significant. That’s very significant.

Alan Tam (00:43):
Hello, Healthcare. For many of us as healthcare consumers, primary care is typically our point of entry into healthcare, especially for non-urgent, non-emergency services. From annual physicals to wellness checkups and preventive screenings, the connection to our primary care doctor is really essential for many of our care needs. Of course, retail health also knows this, Walgreens, CVS, Amazon, even Dollar General, they’re remaking primary care with their ambitious plans to deliver at scale health and wellness services. For traditional care delivery organizations, risk and opportunities are abound in this fast changing landscape. Joining me here today is James Gardner, director of Healthcare Strategy at OHO Interactive. James is a repeat guest in our podcast and has been an amazing wealth of information and insights on retail health market. James, welcome back.

James Gardner (01:38):
Thank you so much. I’m excited to be here today.

Alan Tam (01:40):
We’re excited to have you and I think in your new role at OHO Interactive, tell us a little bit about what you’re focused on and what you do.

James Gardner (01:49):
So OHO Interactive is a digital marketing agency based in Boston. We’ve got a long legacy of working in higher education, but have more recently begun to build on a foundation of strength in healthcare, working primarily with health systems, hospitals and health insurers.

Alan Tam (02:04):
Okay. And as we talk about retail health and primary care, why should we be focused on primary care?

James Gardner (02:13):
So let’s think of it from two perspectives. From a patient’s perspective, primary care is essential. Your primary care physician is the one that over the course of years, ideally, is focused on not only your health in times of illness, but also your health in times of wellness. So there’s a longitudinal aspect to primary care that makes it really, really important. More than anyone, they have an interest in keeping you healthy, keeping you out of hospitals, keeping you in a state of great health, so there’s that perspective, for patients, obviously, it’s incredibly important. It’s also, frankly, a gateway into the larger health system. It’s hard to get a specialty referral without going through a primary care physician. So for patients, that’s important, but also for health systems, it’s critically important, which is why many of them employ large physician groups as employees of the health system to maintain control over those important referrals to their specialty physicians. So it’s critically important both for patients but also for the health systems themselves.

Alan Tam (03:17):
Right. So with the convergence to value-based care, what do you anticipate the future of primary care to look like?

James Gardner (03:27):
Well, I think primary care is poised to play a critical role in value-based care. And in fact, I can’t imagine value-based care succeeding without a strong group of primary care physicians maintaining people’s health and keeping them out of expensive places of care delivery. That’s a huge value add that primary care physicians are uniquely poised to deliver.

Alan Tam (03:49):
So tell me about how fee for service organizations are. What are some challenges they face as they transition into this new world?

James Gardner (04:00):
Well, I think most people would agree fee for service, while it’s immensely popular and it has been the traditional way of operating our health system, it’s out of sync with how I think we want our system to run. Fee for service obviously encourages the over-delivery of care potentially, that’s always been the concern, so it’s not aligned with economics of reducing the cost of care. It’s also not incented necessarily to keep you healthy. So it’s no secret there’s a large movement of foot pressured by the federal government, pressured by payers to keep people healthy, keep them out of the system, and get value for the investment that we’re making in their care. And demotivate over testing the over-delivery of care and send people instead to stay healthy and keep people healthy.

Alan Tam (04:50):
That makes a ton of sense. So what are some of the things that retail health are doing, and what are some of the emerging trends that you’re seeing in retail health as they try to enter the space?

James Gardner (05:01):
Well, it might be helpful just to look at the major players in retail health. They’re all very different. It’s not a monolithic entity. Each of the large players has their own strategy, their own assets and their own path to success, which I encourage everyone to realize theirs is not going to be a winner in retail health. There’s going to be multiple winners because each of them are pursuing different strategies altogether. But do you want to walk through some of the major players and talk through what we’re seeing?

Alan Tam (05:30):
Yeah. Let’s do that and talk about the impact to healthcare consumers based on their strategies that they’ve put into place.

James Gardner (05:38):
So I usually start the narrative with a look at CVS Aetna. CVS is a $500 billion entity, one of the largest retail organizations in the country. And I’d say more so than most of the other retail health players, they’ve accumulated an incredible collection of assets. When you think of CVS, you can’t help but look at the holistic collection of things that they’ve acquired, in some cases going back 10 plus years. So most obviously we know their pharmacies, huge retail footprint across the country. They also have a large deployment of MinuteClinics, which are walk-in, non-acute care facilities where you’re going to see a nurse practitioner and get low acuity care, but we’re very familiar with those.

(06:25):
We’re also very familiar with their health hubs, which are more geared towards the needs of those with chronic diseases. So you might be able to see a dietician at a CVS if you had diabetes or whatnot. And then of course, we can’t overlook Aetna, one of the largest health insurers in the country. And Aetna alone distinguishes CVS from their peers. They’ve got a unique alignment of both delivering care and paying for care, which creates some really powerful incentives and makes them what we would call a payvider, to use that jargony term. And then more recently, they’ve acquired additional assets, $20 billion worth. So they’re poised to deliver what they would call omnichannel care, both in their stores, online and then people’s homes. So I like CVS’s positioning. I think they’re a really strong player. And Karen Lynch, their CEO has really got a clear vision, which I admire.

Alan Tam (07:27):
How do you think that pandemic has impacted their strategy? Do you think it’s accelerated it, it’s set them back? What’s the impact then?

James Gardner (07:37):
I think the pandemic was an accelerator for a lot of moves in retail health. It was just an impetus for a lot of disruption that had been bubbling along. But Obviously we’ve seen a frantic pace of M&A activity not only by CVS to major acquisitions in the last year, but others trying to seize control of primary care physicians and align them with larger organizations.

Alan Tam (07:59):
How are they competing against each other? So you talked about CVS and Aetna, but now you also have the Walgreens, Dollar General, et cetera. How do they all compete and what are the strengths of each one?

James Gardner (08:12):
Right. So CVS, as we discussed, they’re coming at it from a place of being an integrated payer provider and reducing costs of delivering care so that they can be recaptured by their health insurance arm. Let’s look at Walmart, a very different strategy. They don’t own an insurance company, so they don’t have that alignment of interest, but they’ve got other incredible assets. And in the case of Walmart, what we’re seeing is the development of what are called Walmart Health Clinics. These are standalone, six to 10,000 square foot clinics attached physically to their supercenters, of which 90% of Americans live within 10 miles of, and they’re taking advantage of foot traffic and just the accessibility of land to build these clinics where they’re delivering not only primary care, but also dentistry, mental health counseling, optometry, labs, x-rays, so a very holistic package on top of pharmacy which, of course, they’ve always had in their stores. I like the Walmart strategy too, although it’s very different from what CVS is pursuing. In the case of Walmart, they would describe their strategy as like a three-legged stool, great quality care.

(09:24):
So actually primary care physicians in these clinics supported obviously by allied health professionals, but no question, great quality care. If you need to see a doctor during a visit, you can see a doctor, which is different from a MinuteClinic. It’s different from the more walk-in models that we’ve seen to date. You’re also seeing at Walmart in their health clinics, incredible accessibility by virtue of being physically co-located beside their supercenters. You’ve got immense foot traffic with mom and dad going in some cases once, twice, three times a week for groceries and for general merchandise, and you’ve got the opportunity while mom’s shopping, perhaps, dad can see the dentist or vice versa, so there’s that convenience aspect, but also there’s more to it. There’s endless free parking, there’s extended hours, there’s walk-in appointments, so there’s a lot that goes into making that experience super convenient.

(10:21):
And everyone in a traditional health system should ask themselves, “Have we inadvertently opened the door for this to become a factor by not delivering a great patient experience?” All these retailers, as we’ll see, they have customer experience in their DNA. It’s second nature to offer things like free parking and extended hours, and the flexibility of shopping while a loved one sees a physician or a dentist. The last leg of the stool with Walmart Health to round out the three is the pricing. It’s exceptional. It’s also transparent. So their prices are posted in their clinics, they’re posted online, and I think most traditional health systems would be shocked at the cash pay pricing that’s available in these clinics. And that’s a key part of the Walmart Health strategy. They’re pursuing what we would call the uninsured, of which there’s still a shocking number of people that still don’t have health insurance, but there’s a much, much larger population of what we would call underinsured.

(11:21):
These are folks with high deductible health plans. In some cases, a thousand dollars, $2,000. I’ve seen even $5,000 where you’re essentially locked out of the health system for all but catastrophic care, which is unfortunate because you’re going to be locked out from preventative screening, tests, checkups, dentistry care, and Walmart offers a way to get those people back into the system. And that population between the uninsured and the underinsured, some estimate it to be close to a hundred million people.

Alan Tam (11:51):
Wow.

James Gardner (11:51):
So it’s a shocking problem. Walmart offers this notion of a disruptive pricing model that can get those people back into the system, getting them to take care of their bodies before it becomes a crisis and they find themselves in an emergency department or enduring a critical problem. So that I’ve simplified, but that is the Walmart Health experience. Right now, they’re hovering around 30 odd clinics, mostly in Georgia, a few in Florida, but they’ve recently announced plans to get to 75 clinics through a pretty aggressive expansion program in Texas, I believe, Missouri and Florida.

Alan Tam (12:30):
So as a healthcare consumer, I agree with you, it’s convenient, access is super easy. Booking an appointment is super easy, the price transparency is great. It’s extremely attractive. So if I’m a traditional care delivery organization in those regions, how do I compete? How do I combat the Walmart clinics?

James Gardner (12:56):
Yeah. So we usually suggest a two-pronged strategy. One is just reexamining your patient experience. And we’re all familiar with journey mapping and looking at the end-to-end experience of being a patient, whether it’s in a physician clinic or at a hospital employed physician. And you’ve got to ask yourself, “Are we delivering a competitive experience?” If you’re not, then you’re creating a window of opportunity, not just for Walmart, but for other disruptors to walk into, so there’s that. Elevate your game and compete with a great experience, whether that’s extended hours, less scheduling delays, easier scheduling. There’s infinite number of ways to improve the experience, including introducing digital tools.

(13:43):
But there’s also a partnership opportunity because as powerful as Walmart and others are, they don’t offer specialty services, and hence there’s an opportunity there, whether you’re an OB GYN or an oncologist or an orthopedic surgeon, Walmart does not, probably cannot offer those specialty services. So there’s forever going to be referrals leading from these retail health providers into the traditional system. Be smart about those, position your organization as a logical and natural partner in that community, and I think you’ll see opportunities come from that. So compete and collaborate. This is the new world.

Alan Tam (14:25):
Are you seeing that? Are health systems doing that, those partnerships?

James Gardner (14:28):
Yes, there’s talk of it, not so much in the case of Walmart Health that I’m aware of, but certainly CVS Aetna for instance, is partnering with Rush Medical in Chicago to collaborate on clinical referrals and share in cost savings that accrue from that. So there’s exciting stuff going on. The possibilities are endless, to be honest because we know these referrals have to happen. It’s just a matter of being on the receiving end of those in a smart fashion.

Alan Tam (14:56):
I think that’s game changing. So with Rush, do you think that they would eventually abandon primary care and let CVS take care of that aspect of it and focus strictly on the service lines?

James Gardner (15:08):
It’s interesting to speculate. I don’t have an answer.

Alan Tam (15:11):
Fair enough. What about Amazon? Amazon’s also a very interesting character coming into play.

James Gardner (15:16):
Right. So if we think of Walmart having a real estate based strategy, 3,500 supercenters across the country, another, I believe close to a thousand Sam’s Clubs, real estate is their greatest asset, and they’re taking advantage of the fact that care eventually has to be delivered hands-on. Amazon is obviously not a real estate play. They’re a technology powered juggernaut. So they’re leveraging their technology in a lot of cases to do a couple of things. One was an ill-fated experiment known as Amazon Care, which they launched primarily to serve the commercially insured with a premium care experience. They walked away from that in a fairly high profile move, but they’re back into healthcare with the acquisition of One Medical, which is a $4 billion acquisition.

(16:06):
It’s a subscription based model with a really strong digital element to it, but also physical clinics, not yet a national footprint, but it’s a template, and I think an example that we can look to as to how they see going to market, leveraging the technology for an amazing digital experience that even extends into the clinic experience. The scheduling is easy. The follow through post appointment is delightful. So we can see a little bit of a glimpse into that model. Where they’ll go after that, TBD. I’d say it’s still early days with Amazon, but we see in that One Medical acquisition a 4 billion glimpse into where they might be going.

Alan Tam (16:47):
So from that perspective, given where Amazon is coming from and say a CVS and Walmart, do you think they’re focused in targeting different demographics?

James Gardner (16:59):
Oh, absolutely. Most obviously, I would say Walmart is targeting a demographic that’s underinsured or uninsured, and while they do offer insurance coverage, it’s clear they’re steering people towards a cash pay model, getting people that are not in the system back into the system. I think with CVS Aetna, clearly they’re targeting those with commercial insurance, ideally Aetna Insurance, which is a large ecosystem unto itself. Amazon, I would say also pursuing an audience with commercial insurance. So there’s very different demographics, which is why when we say, winner take all? No, it’s not going to be like that. In retailing, Target and Walmart coexist and go to market against each other. There’s room for many, many different models, just given the size of the healthcare market and different demographics, different strategies, different assets, but yes. Does that answer your question?

Alan Tam (17:58):
Yeah, absolutely. So I do want to dive into Dollar General. I’m least familiar with Dollar General. So share a little bit more about what their strategy is there and what their approach is.

James Gardner (18:10):
So Dollar General is an amazing phenomena. I don’t see them in Boston. You may not see them in your local community, but in huge parts of the country, they are a dominant, dominant force by most accounts, close to 18,000 physical stores in many cases in rural and remote communities. So that’s the kernel that people saw as a path into delivering care, a huge physical footprint across the country, stores in many remote and rural communities where access to care is limited. The question was, “How, how can they do this? How will they deliver care?” And some people concluded, “Well, maybe they’ll open clinics like Walmart or they’ll offer pharmacy in their stores.” No, the stores are too small, they’re in remote locations. That’s not a viable strategy. What they are doing is a couple elements. One is just improving the assortment of health and beauty products in their stores.

(19:13):
It seems like a small thing, but actually in many of these communities, there are no other retail alternatives. So offering more women’s health products, baby care products, that actually has significance, especially if they’re delivered in an economical fashion. They’re also in many cases, making moves to deliver fresh fruit and fresh products into their stores. Notoriously Dollar General, they’re renowned for cigarettes, soda, beer, unhealthy products, but the opportunity to deliver fresh vegetables and fresh products into the stores that will also improve the health of the community. So are they as ambitious in their vision as Walmart? No, nor CVS, but nonetheless, the potential is immense, just given the footprint they have.

(20:01):
And I guess, I would conclude my thoughts about Dollar General with a pilot they have underway in Tennessee where they’re partnering with DocGo in operating mobile vans. So think of a small van outfitted to deliver primary care onsite for a day or two, then move on to another location and then move on to another location. It’s a very modest pilot. We don’t know how successful it is, but we can see that it’s a clever use of the assets they do have, these stores across the country where there might not be access to care at all for 15, 20, 30 miles and the opportunity to see a primary care physician. Even as modest as these vans are, it’s still better than the status quo for sure. So that’s the Dollar General strategy, much potential, still many questions. We can’t help but think of them as a purveyor of sin products or whatnot, but we all want them to do, be a force that delivers good in their communities, and hopefully they share that vision.

Alan Tam (21:05):
So like you said earlier, there’s definitely a lot of opportunity, and I agree with you that there doesn’t need to be a clear winner. It’s a tremendously large industry. But based on how each of these players are building out and delivering their models, if you had a crystal ball, which model do you think is going to emerge on top? Not necessarily player, but model.

James Gardner (21:31):
So I like them all in varying ways, so it’s hard for me to pick a winner. That being said, it’s hard to imagine betting against CVS Aetna. They’ve got such a collection of premium assets, and they’ve been exploring synergies between their assets for years and years and years. So it’s almost like they had a glimpse into the future five or 10 years ago as they accumulated an insurer, operated health hubs and MinuteClinics. So for them, the step into the actual hands-on delivery of primary care seems like a natural and obvious one, so I like that. I like that a lot. I would never bet against Walmart either. We famously talk about 1998 when the first super center opened in Washington, Missouri. Traditionally, Walmart obviously was a general merchandise retailer, and the notion of them being a grocery retailer struck many as absurd at the time.

(22:25):
It’s immensely difficult, probably as complex as healthcare in many ways. And they stumbled, and they stumbled, but they persisted and they iterated, and they improved their model. And within three years, they were a top 10 grocery retailer. Within 10 years, they were number one. They’ve been the number one grocery retailer ever since. So you don’t bet against Walmart without a lot of thought as to what they’re doing and whatnot. And of course, the ambitiousness of their vision just excites everyone. The idea of a holistic delivery of many, many care services under one roof, we’ve not seen anything like that. So I want to cheer for them only because what they’re doing is really exciting. And who would bet against Amazon? I don’t think they’ve struck out too many times, and when they have, they’ve picked themselves up, dusted off the dust and moved on to something more compelling and even stronger. So not a loser in the bunch, actually a really strong and compelling set of offerings from all of them.

Alan Tam (23:26):
Right. So another, I think, commonality across all these business models and what’s going on is the role of technology. Technology has been a major factor in driving force for all of retail health. What do you see the role of technology being as retail health continues to advance?

James Gardner (23:48):
You’re exactly right. Technology in many ways underpins all of the business models that we’ve talked about today, in some cases more than others. Obviously Amazon is a digital native. So for them, the notion of delivering care via digital solutions and harnessing digital to create game-changing consumer experiences, that’s second nature to them. But even at an organization like Walmart, which you don’t think of as being a technology leader, they’re surprisingly adept at their use of technology, so we mis-underestimate them sometimes. But the experience, if you were to go into a Walmart Health Clinic, it is very digitally powered, whether it’s the scheduling process or the check-in process, once you’re actually on onsite, their use of Epic as their electronic health record, they’re definitely at the forefront of using technology in exciting ways. So yes, technology is a big part of all these retail health strategies.

Alan Tam (24:41):
What do you see as some of the core gaps that a lot of these players still have in terms of emerging as a winner and over crossing that chasm, if you will, for retail health to be truly successful, embedded and part of our everyday healthcare consumer lifestyle?

James Gardner (25:02):
So each of the major players that we’ve talked about today, they’ve all got challenges. If we look at Walmart just as an example, the hands-on delivery of care, it’s still new to them despite all the experience they have. I would say with Walmart, they’re still trying to figure out their business model, although I think they’re past some of the rough edges that we saw early in the launch. But if you look at the pricing that they’re offering, there is a lot of chin scratching as to how is this possible to deliver mental health counseling at a dollar a minute?

(25:35):
And Walmart insists what they’re doing is not pro bono, it’s not for charity. They are profitable, they are cashflow positive. But figuring out the business model and managing the complexity of delivering profitable healthcare at scale, we know what a challenge that is, and they’re going to get past that, I would imagine. And then all of them are facing the staffing challenge. There’s an industry-wide shortage of clinicians from physicians to nurses to allied health professionals. The retail health community is not immune to that at all. So attracting talent and then retaining it is a challenge they all face. So those are just some of the headwinds that Walmart’s facing, and I’m sure they’re paralleled in the other organizations we’ve talked about.

Alan Tam (26:21):
Yeah. That’s very interesting because I think in some sense, retail health can probably offer better benefits and incentives potentially than a traditional care delivery organization. For example, if I worked at Walmart or Amazon and having equity, that is something that is probably very appealing to some physicians and nurses versus in a healthcare delivery system. I don’t have those particular opportunities.

James Gardner (26:49):
Yeah. Their value proposition is unique. Not every physician obviously wants to go into independent practice and become an entrepreneur. Some of them just aspire, actually many of them aspire just to deliver care, and they love this notion of, “Put me in a position where I’m not burdened by the headaches and the tribulations of running a practice,” which we know is immense. The life of a physician, especially a primary care physician is a tough one. They’re burdened by administrative overhead, the burdens of running a business. So for many, the notion of, “I show up, I deliver care and then I go home,” is quite appealing. But each of the organizations that we’ve talked about, they’re going to have strengths and weaknesses as they attract the talent that they’re looking for.

Alan Tam (27:35):
Do you have any insights in terms of between retail health and traditional care delivery systems? Who’s winning in terms of talent acquisition?

James Gardner (27:47):
That’s a good question. I don’t think I have a strong sense of whose employee value proposition is considered stronger at the moment. I’m sure they all have fans who are drawn to the different business models and the different way of servicing patients. But no, I don’t have a strong answer to that.

Alan Tam (28:06):
All right. Well, let’s look at it from the healthcare consumer perspective then. Obviously, all these businesses are growing. I’m curious to understand from your perspective, what has been the impact of retail health to these traditional care delivery systems? How much market share are they losing? How much revenue are they potentially losing?

James Gardner (28:31):
So I think we’re on the cusp of a revolution, and I don’t think we’ve seen even a fraction of where we’ll ultimately get to. I believe it was the American Hospital Association in collaboration with the Boston Consulting Group, took a look into the future and, of course, it’s a crystal ball, so there’s all kinds of clouds in the crystal ball, but they estimated that potentially 30% of the primary care world could gravitate towards these non-traditional organizations, which I believe also included some of the payviders. So it’s not completely going to fall into the retail world, but that’s significant. That’s very significant, and we can’t imagine them capturing 20, 30% without it having repercussions on the traditional care organizations themselves. In many cases, there’s going to be painful restructurings, but also efforts to boost their patient experience and make themselves competitive. So I think we’re just seeing the beginning of a revolution. All of the major retailers are making acquisition moves, they’re expanding their footprints, so I don’t see us going backwards. If anything, I see a snowball rolling down a hill, picking up both speed and size.

Alan Tam (29:39):
That makes sense. From that perspective, I think we started the conversation today, we talked about primary care and value-based care. What about population health? How does population health fit into all of this with retail health?

James Gardner (29:53):
Oh, I think it aligns very nicely. People are excited about, for instance, the opportunity for Walmart or Dollar General, given that they are grocery retailers and they have a footprint in the community. The opportunity for them to service holistically a population and keep them healthy, keep them out of the healthcare system, it’s massive. It’s massive. And I would argue CVS Aetna and Walgreens, VillageMD, they’re thinking the same way. They’re managing the population, and getting away from an emphasis on treating people when they’re ill and instead managing their health holistically.

Alan Tam (30:29):
So is retail health really knocking the ball out of the park when it comes to quality measures and star ratings?

James Gardner (30:39):
I think the jury’s out. In many cases, these organizations are still forming. I have seen data coming out of Walmart, net promoter scores and whatnot, and they claim to be delivering highly satisfactory experiences, which makes sense. Again, customer experience is in their DNA. So the fact that they’re measuring it, working aggressively to improve the experience on top of what they were delivering back in 2019 when they launched the clinics, we have to believe Walgreens, VillageMD and CVS Aetna, they’re thinking the same way of delivering not only great care, which is the traditional metric, but also great experiences on top of the delivery of care itself.

Alan Tam (31:20):
Right. So as a traditional health system, how do I compete? What should my strategy be? It seems like these guys have it figured out. They have a new model, they have less of the cultural barriers and organizational and political barriers that we deal with as a traditional healthcare system. What’s my strategy? What should my approach be?

James Gardner (31:45):
So don’t panic. As formidable as these organizations are, they’re not perfect, and we know this from the world of retailing. As formidable as they are, competitive alternatives exist. So people have learned how to coexist beside a CVS or beside a Walmart, or beside a Walgreens by offering a different experience, perhaps, a better experience, so that’s where I would start. Think through the strengths you have as an organization. Think through some of the gaps in the Walmart Health experience or the CVS Aetna experience or the VillageMD experience. Not every consumer is going to be drawn to that experience. You may have assets or you may have experiences that make you able to safely coexist. I would also encourage every organization, obviously look through your patient experience. The journey from the very beginning to the very end, and make sure you’re not inadvertently creating opportunities for one of these disruptors to walk through.

(32:46):
If you don’t offer weekend hours or evening hours, or if it’s impossible to get access to a doctor for three months, those are problems that have to be resolved, just as examples. And by looking at the patient journey holistically, you’ll surface those and hopefully make moves to address them. And then as I said earlier, collaboration is definitely a strategy I would recommend to organizations. Specialty services are never going to be something Walmart or these other providers offer, nor will they be offering really acute care. So look for those opportunities to funnel patients into your specialty practices and likewise collaborate.

Alan Tam (33:29):
That makes a ton of sense. So hopefully our audience has learned a ton from James. Some amazing insights that you’ve shared. I want to thank you again so much for your time and coming in today, James, and sharing that knowledge. If folks want to continue this conversation with you, what’s the best way for them to get ahold of you?

James Gardner (33:50):
So I would encourage people to reach out to me on LinkedIn, James A. Gardner, G-A-R-D-N-E-R. Certainly, I share a lot of information about retail health in addition to just my general work agency side. I’m also active on Twitter and would entertain email communications if people want to directly reach out, james@oho.com.

Alan Tam (34:11):
Wonderful. So definitely give James a follow on LinkedIn and on Twitter. He is a wealth of information, especially when it comes to retail health and retail health strategy. Thank you again for everything today, James. And for those of you in the audience, thank you for tuning in today. Until next time, Hello.

Outro (34:32):
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