Retailers take part in transition to quality-based healthcare model and get paid

Walmart's Arkansas Payment Improvement Initiative aims to create a more patient-centered and cost-efficient payment system for the retailer's home state. 

The latest move by Walmart is as sure an indication as any that health care is becoming less about fee-for-service and more about basing compensation on ratings derived from patient outcomes.

John Gorman, chairman of the Washington-based Gorman Health Group, summed up what's been happening last month at a symposium in Philadelphia sponsored by Acro Pharmaceutical Services when he said, "We've got to all collaborate to deliver better value to the member, the payer and ultimately to the customer -- the federal government."

With what Gorman predicted to be an explosion of accountable care organizations and a transition to healthcare delivery to something akin to public utilities, retailers are already starting to jump in to quality-based health care, as was also demonstrated this week when the Department of Health and Human Services announced 106 new ACOs in Medicare, including three operated by Walgreens.

Meanwhile, a PwC report this week found that more companies were likely to form partnerships to build their population health information technology infrastructures and to share responsibility for patient outcomes and satisfaction, data collection and analysis, member education and engagement, focusing on at-risk populations - in addition to Medicare's ACO and patient-centered medical home initiatives. Interestingly, the report also found a rise in the number of consumers who expressed interest in buying insurance from non-traditional sources, such as retail stores, while finding overall that consumers' rising voice on where their healthcare dollars go was prompting the healthcare industry to compete on attributes similar to retailers, showing just how deep the new focus on overall quality goes.

The United States healthcare system is undergoing its biggest change in more than a generation, developing a quality-based model that means retailers have a major interest in working as part of a team to ensure the delivery of quality care.