How You Can Profit From Reversing A Walmart Healthcare Strategy
Attention medical group and physician-owned facility leaders: You can reap significant profits from reversing a multi-million dollar Walmart healthcare strategy.
Walmart spends many hundreds of millions of dollars each year insuring more than 2 million workers. So when it found that many of its employees’ health issues were being misdiagnosed it took drastic action: pay more for higher quality care.
As reported by Kaiser Health News, Walmart discovered that about half its workers who were treated at specialized hospitals, including the Mayo Clinic, for back surgery didn’t actually need surgery. The patients had been misdiagnosed or simply required non-surgical treatment.
The culprit: Very high diagnostic imaging error rates that drove patients into the O.R.
While that background is shocking in itself, the major takeaway for you centers in reversing the flow of the strategy that Walmart adopted to both cut its overall healthcare expenditures and protect its employees from unnecessary surgery: It took action to urge its employees to obtain their imaging studies from a relatively small number of imaging centers, about 800 across the country, that were identified by quality, i.e., diagnostic accuracy, not by cost.
The Flip
Just as Walmart flipped the focus from initial cost to quality, medical groups and physician-owned facilities such as ASCs and, quite obviously, imaging centers, can flip their usual contracting strategy.
Most physician-owned facilities focus their payor contracting efforts on being in-network with the same plans in which their physician owners (and other physicians with privileges) participate. Many medical groups have a variant of that same strategy: They focus on contracting with the same plans accepted by the facilities with which they regularly practice.
I’m not at all suggesting that medical groups and physician-owned facilities should abandon that strategy.
But, the Walmart story shows that you should have an additional strategy.
First, if you’re not already there (come on, tell the truth – Walmart found that most facilities were sorely lacking), do whatever you can do to improve and then track and collect the data that demonstrates the quality of care delivered by your group or at your facility. Take that data and combine it with branding to develop a true center of excellence.
Then develop a strategy of using that data and center of excellence reputation to pitch your medical group and/or facility to large, self-insured employers in your area. Just like the lucky 800 imaging centers of excellence who’ll receive an outsized bite of Walmart’s hundreds of millions, sell them on including your physicians and/or your facility as a preferred provider for their employees.
Again, as Walmart proves, even those whose entire fortune has been based on lower prices can see the value of paying more for demonstrably better care.
Doesn't being paid more sound like a good contracting strategy for you? | 
