When you imagine the future of healthcare, what comes to mind: an accountable care organization or a CVS HealthHUB store?
A decade into the transition to value-based care, there is general consensus that the transition has been slower than expected. Healthcare providers have been working to build capabilities and structures needed to deliver value-based care. For example, the number of accountable care organizations (ACOs) in the country has grown from 58 ACOs in 2011 to more than 1,000 today.
Yet only one in 10 Americans receives care from an ACO. In 14 of the nation’s 306 hospital referral regions (HRRs), ACOs cover less than 2% of the population, while on the other end of the scale, only 14 HRRs have 30% or more of the population covered by ACOs (Muhlestein, D., Saunders, R., Richards, R., et al., “Recent Progress in the Value Journey: Growth of ACOs and Value-based Payment Models in 2018,” Health Affairs, Aug. 14, 2018).
In June, CVS Health Corp. announced plans to open 1,500 HealthHUB stores by 2021. Within two years, there could be more CVS HealthHUBs across the nation than there are ACOs. HealthHUBs are expanded in-store clinics that focus on prevention and treatment of chronic conditions. One estimate says that if CVS expanded its 1,100 existing MinuteClinics into HealthHUBs, 75% of U.S. households would be within 10 miles of a HealthHUB (Tully, S., “CVS Wants to Make Your Drugstore Your Doctor,” Fortune, May 17, 2019).
Healthcare organizations have taken notice. In a recent Kaufman Hall survey on consumerism, 66% of respondents said that CVS Health/Aetna poses a “strong” or “extreme” competitive threat to hospitals and health systems over the next five years (see the bar graph below). A similar number saw an equally significant threat in UnitedHealth Group/Optum, which has targeted 75 markets for growth in primary and outpatient services provided outside the control of hospitals and health systems. UnitedHealth Group CEO David Wichmann recently said that it has no interest in adding hospitals to its OptumCare portfolio but would be interested in health system partnerships “in markets where there [are] maybe less assets for us to accumulate and build from” (Haefner, M., “UnitedHealth CEO: Optum Won’t Build Hospitals,” Becker’s Hospital Review, June 5, 2019).