– Walmart launches 2020 annual enrollment with new pilot projects focused on transparency, virtual primary care, and helping associates fine quality physicians locally.
– The new services include a Personal Healthcare Assistant, a Personal Online Doctor, and a National Quality Provider Resource to help patients find the most qualified physicians.
– Walmart will begin offering copays next year to its most popular plan as a direct result of associate feedback to make healthcare simpler, predictable and more affordable.
Walmart today announced it is rolling out new pilots and programs designed to make it easier for its associates to access quality-healthcare by providing simpler and more transparent options. The new services include a Personal Healthcare Assistant, a Personal Online Doctor, and a National Quality Provider Resource to help patients find the most qualified physicians.
Too often, the health system can be overly complex, lack transparency and provide care that is medically unnecessary. According to the Institute of Medicine (now National Academy of Medicine), roughly 30 percent of all healthcare spending is wasted, including unnecessary care. These are real problems for everyone and, unfortunately, the health system can be very difficult for people to navigate on their own.
Walmart 2020 Pilot Programs
Featured Providers: Starting with next year’s plan (2020), Walmart, working with Embold Health, will pilot bringing physician quality information to associates’ fingertips through a program called Featured Providers. The pilot locations are Orlando/Tampa, Dallas/Fort Worth and Northwest Arkansas. Walmart will curate a group of local physicians in eight specialties based on independent medical expert analysis of data covering nearly 145 million lives to identify the factors that lead to high-quality care. The eight specialties are – primary care, cardiology, gastroenterology, endocrinology, obstetrics, oncology, orthopedics and pulmonology.
Data analytics company Embold Health, with the guidance of a scientific advisory board that includes physicians and data scientists from the country’s leading academic institutions, establish objective, scientific standards for physician performance through evaluation of the latest research, clinical guidelines and quality measures. Embold applies these measures to its data to identify the providers locally with a demonstrated history of providing the most appropriate patient care. From this data, Walmart curates the Featured Providers group.
National Quality Provider Resource: Associates have been able to receive a second opinion from an expert at no cost. Now Walmart is expanding a service provided by Grand Rounds to be the first source associates use to search for in-network physicians, regardless of which health plan they choose. Additionally, this tool will filter search results so that in-network physicians providing high-quality care will appear at the top of the search results.
Personal Healthcare Assistant: Expanding its relationship with Grand Rounds to pilot a Personal Healthcare Assistant service in North and South Carolina at no cost to associates. The service will help identify quality physicians, serve as a single go-to source for all associate’s healthcare and benefits related needs, including billing questions, making an appointment, understanding a diagnosis and supporting more complex health needs including access to clinical resources. It will also help with coordinating transportation or finding childcare during appointments.
Personal Online Doctor: Walmart currently offers telehealth to nearly everyone on its medical plans. They can see a board-certified physician, licensed psychologist or psychiatrist virtually for just $4 per visit. Through an expanded telehealth pilot, associates in Colorado, Minnesota, and Wisconsin can opt in to access a Personal Online Doctor and an entire team to manage chronic conditions, coordinate specialty care, provide nutritional and diabetic counseling, and coordinate behavioral health referrals and visits.
Associates can book an appointment with a primary care physician within one hour and a behavioral health visit within one week. This compares to the average wait time of three weeks to schedule an appointment with a mental health professional in the United States. This is the result of Walmart bringing together incumbent partners Doctor On Demand, Grand Rounds and HealthSCOPE Benefits to create a new service.
Nationwide Fitness Club Access: For as little as $9 per bi-weekly pay period, any Walmart associate 18 years and over can have access to a health club membership at any of thousands of participating locations across the country. Associates can add spouse/domestic partner and dependents aged 18-25 to the membership for no additional cost. All membership levels include unlimited visits to any of the fitness locations in that level, so associates can access multiple facilities near where they work, live and travel.
Walmart Now Offering Co-Pays
Walmart will begin offering copays next year to its most popular plan as a direct result of associate feedback to make healthcare simpler, predictable and more affordable. A primary care physician visit will be $35, specialists and urgent care visits will be $75. Centers of Excellence will also expand to include kidney transplants.
The Larger Picture
The cost of healthcare continues to rise, and Walmart is working with experts in the field to develop and implement new concepts and programs that focus on delivering quality first. The company firmly believes when quality comes first in healthcare, lower overall costs come with it. Walmart will closely monitor and learn from these pilot programs and use that data to guide its decision on improvements and potential expansion.
“We’ve learned a lot about the benefits to the individual by prioritizing quality care through our Centers of Excellence (COE) program. For example, more than half the patients on our plans who were told locally that they needed spine surgery, went to a COE only to discover they didn’t, allowing them to avoid major surgery and the potential complications that can occur from an unneeded procedure,” said Adam Stavisky, senior vice president of Walmart US health benefits. “We are building on the success and quality gains of our COEs and finding new ways to bring that quality experience to the everyday healthcare our associates receive in their local communities.”