Walmart to close Health Care Clinics

[buckguy]

Amazon bought an entire chain of doctor's offices called One Medical. Wall Street wanted Walmart to copy Amazon since Amazon seems to be all into the idea of opening doctor's offices.

Amazon is losing money on those clinics and is too afraid to admit it. The company is still pushing the subscription plan of adding $9 onto your Prime Membership.

I work in a pharmacy and have to deal with One Medical. It is a hodgepodge of clinics all over the country with a bunch of inexperienced doctors who can't seem to run their own doctor's office. It is the huge inconsistencies that come from a huge chain spread all over. They recruit young doctors who can't find work at other places and market themselves as internet savvy or with fancy looking offices. It is all very superficial and appeals to Gen Z or Millennials. In reality, contacting One Medical is like dealing with an outsourced call center somewhere.

I think Amazon thinks they can use this as a loss leader to make people keep paying a fee on top of their Prime Memberships.

One Medical started out with high levels of satisfaction and they worked out deals with large insurers to cover their annual membership fees---if you can accept BC/BS customers in the DC area, you shouldn't have cash flow problems. Unfortunately, they seem to have grown too quickly and people who liked them initially haven't renewed.

The concierge model works for small practices and has been around since the 90s. It seems to be growing among private practices in DC. The practices who make it work have their own referral networks, know their communities and the most common health plans, etc., especially if they had been around well before they adopted this model. You might be able to build some local networks but this model doesn't viable on a large scale.

I don't think One Medical is going to survive the next inevitable round of Amazon cost cutting and all the clinics will be closed. They have spent way too much on high rent, high cost offices in the most expensive shopping centers when there are ample vacancies at cheaper medical plazas everywhere. Many complaints about surprise bills for hundreds/thousands because at the last minute the provider was changed and the new one is not under the patient's insurance but nobody checked prior to initiating the visit. I don't think Amazon is losing anything based on the countless Yelp reviews where the high 3 digits/low 4 digits surprise bills are widespread. I don't think they're making any money either though and the rapid turnover of providers, many of whom are not MD but rather NP level, will lead patients to not renew. The good reviews are really good but also few and far between. The bad reviews are very bad and seem to align with all the same problems of Amazon; when you have a problem it's impossible to reach anyone who knows how to solve it.

[jamcool]

Shall we talk about Walgreens and Village Medical?

[Alpha8472]

Walgreens realized that those clinics were losing money and shut them down. Originally Walgreens thought that doctor's offices like those would bring in tons of prescriptions to Walgreens.

That is not the case as many customers hate Walgreens. Walgreens is so understaffed that it is difficult to even talk to anyone at Walgreens. You stand in a long line only to find out that your prescription is not ready and you have to wait again. Customers are requesting prescriptions to be sent to other pharmacies besides Walgreens.

Customers are fed up with Walgreens and CVS understaffing. If you have a choice, you would go to any other pharmacy that gives better service. That is why pharmacies at places such as supermarkets or retail stores appeal to customers. Those lower volume pharmacies have better staffing and better customer service.

[veteran+]

Amazon bought an entire chain of doctor's offices called One Medical. Wall Street wanted Walmart to copy Amazon since Amazon seems to be all into the idea of opening doctor's offices.

Amazon is losing money on those clinics and is too afraid to admit it. The company is still pushing the subscription plan of adding $9 onto your Prime Membership.

I work in a pharmacy and have to deal with One Medical. It is a hodgepodge of clinics all over the country with a bunch of inexperienced doctors who can't seem to run their own doctor's office. It is the huge inconsistencies that come from a huge chain spread all over. They recruit young doctors who can't find work at other places and market themselves as internet savvy or with fancy looking offices. It is all very superficial and appeals to Gen Z or Millennials. In reality, contacting One Medical is like dealing with an outsourced call center somewhere.

I think Amazon thinks they can use this as a loss leader to make people keep paying a fee on top of their Prime Memberships.

One Medical started out with high levels of satisfaction and they worked out deals with large insurers to cover their annual membership fees---if you can accept BC/BS customers in the DC area, you shouldn't have cash flow problems. Unfortunately, they seem to have grown too quickly and people who liked them initially haven't renewed.

The concierge model works for small practices and has been around since the 90s. It seems to be growing among private practices in DC. The practices who make it work have their own referral networks, know their communities and the most common health plans, etc., especially if they had been around well before they adopted this model. You might be able to build some local networks but this model doesn't viable on a large scale.

I don't think One Medical is going to survive the next inevitable round of Amazon cost cutting and all the clinics will be closed. They have spent way too much on high rent, high cost offices in the most expensive shopping centers when there are ample vacancies at cheaper medical plazas everywhere. Many complaints about surprise bills for hundreds/thousands because at the last minute the provider was changed and the new one is not under the patient's insurance but nobody checked prior to initiating the visit. I don't think Amazon is losing anything based on the countless Yelp reviews where the high 3 digits/low 4 digits surprise bills are widespread. I don't think they're making any money either though and the rapid turnover of providers, many of whom are not MD but rather NP level, will lead patients to not renew. The good reviews are really good but also few and far between. The bad reviews are very bad and seem to align with all the same problems of Amazon; when you have a problem it's impossible to reach anyone who knows how to solve it.

I agree with the Amazon thing. They took over the OTC benefits program at my United Health Care insurance and it is a disaster from day ONE!

[ClownLoach]

Walgreens realized that those clinics were losing money and shut them down. Originally Walgreens thought that doctor's offices like those would bring in tons of prescriptions to Walgreens.

That is not the case as many customers hate Walgreens. Walgreens is so understaffed that it is difficult to even talk to anyone at Walgreens. You stand in a long line only to find out that your prescription is not ready and you have to wait again. Customers are requesting prescriptions to be sent to other pharmacies besides Walgreens.

Customers are fed up with Walgreens and CVS understaffing. If you have a choice, you would go to any other pharmacy that gives better service. That is why pharmacies at places such as supermarkets or retail stores appeal to customers. Those lower volume pharmacies have better staffing and better customer service.

I'm going to say it again, I keep seeing little neighborhood pharmacies popping up. It's quiet but it's happening. Somehow these little neighborhood places are able to tolerate the "bad" reimbursement rates. My guess is they're not going to carry the drugs with bad rates, nor are they going to accept Medi-CAL or other public benefits that leave them losing money. But this is a real thing. There are "experts" here who may disagree with me but I think the allegations of low reimbursements and pharmacy losses are overblown. The billions of dollars in profits CVS keeps reporting are a perfect example. They are one of the most profitable companies in the world and cry about not making even more money. They could in my eyes double staffing chain wide and not make a sizeable dent in their obscene earnings reports. Point blank, if everyone was losing money on pharmacy then why are independent people opening new businesses? Certainly can't be to lose money...

My Costco that is fairly new just had to reorganize the holding area for prescriptions and expand the racks again. Their lines just keep getting longer but they also have staff so they can speed up the process when a crowd arrives. I noticed the long sleepy Sam's pharmacy operation is starting to get business too, one of the areas they've never realized their full potential in. Walmart pharmacy lines are very long now, but they seem to have upset many customers with their shortened hours.

The only Rite Aid left is a train wreck inside but you wouldn't know it from the long line of cars outside that probably drove past multiple CVS and Walgreens to get there.

Nobody wants to go to CVS or Walgreens. CVS is still in the green, but we have all seen how Walgreens is going to hell in a handbasket financially. I wonder how long it will take for CVS to follow... Probably more difficult because of all their integrated businesses, but I cannot imagine that shrink alone isn't up five fold in the last couple of years for them because they are so obscenely under staffed. And I think more governmental agencies are going to recognize their unsafe working conditions which in most stores resemble dollar stores.

[Alpha8472]

Pharmacies can be very profitable, but it requires pharmacies to say "no." If insurances don't cover a certain medication, you have say make a tough decision. Why order a medication and give it away at a loss? CVS and Walgreens will do this. Sorry, we don't have Ozempic in stock. Of course this is all lies. They know it is a loss of $300 to $400 for one box of Ozempic. The insurance companies are deadbeats. They force pharmacies to fill prescriptions for medications and reimburse at a loss.

The insurance companies do this out of greed. They don't care if pharmacies are losing money on medications. Meanwhile patients with diabetes are running around try to find a pharmacy that will dispense Ozempic. A kind pharmacist might make an exception and fill Ozempic, but at a loss.

The insurance companies including CVS Caremark are responsible for this.

You can run a profitable independent pharmacy. You just have to lie to your customers. Sorry, we don't have any Ozempic. In reality, you save Ozempic for those few private insurance plans that actually reimburse you so you make a profit on Ozempic. This is true for many other expensive weight loss or diabetic medications such as Mounjaro, Zepbound, etc.

It is a cruel thing to lie, but that is how you keep the pharmacy profitable.

Another major loss is GoodRX. GoodRX gives out online prescription discount coupons on their website. Pharmacies lose money on these discounts coupons from GoodRX and similar companies. CVS will say, "Sorry, we don't have that medication in stock. Try another pharmacy."

That is how CVS and Walgreens stay profitable. They lie to avoid accepting money losing discount coupons and money losing insurance plans.

Mom and pop pharmacies have gone out of business for this reason. If they are honest they will fill those Ozempic prescriptions at a loss. They care about their diabetic patients and give the medication out knowing they lose money.

I know of some ruthless independent pharmacies run by greedy people. They do stay in business, but they don't take money losing Medicaid and they don't fill any prescriptions that lose money. They will tell one patient that they are out of stock and then fill it for the next patient who has profitable insurance. You have be cold hearted to stay profitable. My pharmacist friend worked for such an independent pharmacy in Fremont.

[ClownLoach]

Pharmacies can be very profitable, but it requires pharmacies to say "no." If insurances don't cover a certain medication, you have say make a tough decision. Why order a medication and give it away at a loss? CVS and Walgreens will do this. Sorry, we don't have Ozempic in stock. Of course this is all lies. They know it is loss of $300 to $400 for one box of Ozempic. The insurance companies are deadbeats. They force pharmacies to fill prescriptions for medications and reimburse at a loss.

The insurance companies do this out of greed. They don't care if pharmacies are losing money on medications. Meanwhile patients with diabetes are running around try to find a pharmacy that will dispense Ozempic. A kind pharmacist might make an exception and fill Ozempic, but at a loss.

The insurance companies including CVS Caremark are responsible for this.

You can run a profitable independent pharmacy. You just have to lie to your customers. Sorry, we don't have any Ozempic. In reality, you save Ozempic for those few private insurance plans that actually reimburse you so you make a profit on Ozempic. This is true for many other expensive weight loss or diabetic medications such as Mounjaro, Zepbound, etc.

It is a cruel thing to lie, but that is how you keep the pharmacy profitable.

Another major loss is GoodRX. GoodRX gives out online prescription discount coupons on their website. Pharmacies lose money on these discounts coupons from GoodRX and similar companies. CVS will say, "Sorry, we don't have that medication in stock. Try another pharmacy."

That is how CVS and Walgreens stay profitable. They lie to avoid accepting money losing discount coupons and money losing insurance plans.

Mom and pop pharmacies have gone out of business for this reason. If they are honest they will fill those Ozempic prescriptions at a loss. They care about their diabetic patients and give the medication out knowing they lose money.

I know of some ruthless independent pharmacies run by greedy people. They do stay in business, but they don't take money losing Medicaid and they don't fill any prescriptions that lose money. They will tell one patient that they are out of stock and then fill it for the next patient who has profitable insurance. You have be cold hearted to stay profitable. My pharmacist friend worked for such an independent pharmacy in Fremont.

Those ruthless pharmacies are probably what's popping up here and there. Makes a lot of sense. For those with good insurance they save them from the headache of CVS or Walgreens. For the money losing customers they send them their way. Probably pharmacists who worked for the duopoly and had enough.

[storewanderer]

Pharmacies can be very profitable, but it requires pharmacies to say "no." If insurances don't cover a certain medication, you have say make a tough decision. Why order a medication and give it away at a loss? CVS and Walgreens will do this. Sorry, we don't have Ozempic in stock. Of course this is all lies. They know it is loss of $300 to $400 for one box of Ozempic. The insurance companies are deadbeats. They force pharmacies to fill prescriptions for medications and reimburse at a loss.

The insurance companies do this out of greed. They don't care if pharmacies are losing money on medications. Meanwhile patients with diabetes are running around try to find a pharmacy that will dispense Ozempic. A kind pharmacist might make an exception and fill Ozempic, but at a loss.

The insurance companies including CVS Caremark are responsible for this.

You can run a profitable independent pharmacy. You just have to lie to your customers. Sorry, we don't have any Ozempic. In reality, you save Ozempic for those few private insurance plans that actually reimburse you so you make a profit on Ozempic. This is true for many other expensive weight loss or diabetic medications such as Mounjaro, Zepbound, etc.

It is a cruel thing to lie, but that is how you keep the pharmacy profitable.

Another major loss is GoodRX. GoodRX gives out online prescription discount coupons on their website. Pharmacies lose money on these discounts coupons from GoodRX and similar companies. CVS will say, "Sorry, we don't have that medication in stock. Try another pharmacy."

That is how CVS and Walgreens stay profitable. They lie to avoid accepting money losing discount coupons and money losing insurance plans.

Mom and pop pharmacies have gone out of business for this reason. If they are honest they will fill those Ozempic prescriptions at a loss. They care about their diabetic patients and give the medication out knowing they lose money.

I know of some ruthless independent pharmacies run by greedy people. They do stay in business, but they don't take money losing Medicaid and they don't fill any prescriptions that lose money. They will tell one patient that they are out of stock and then fill it for the next patient who has profitable insurance. You have be cold hearted to stay profitable. My pharmacist friend worked for such an independent pharmacy in Fremont.

Those ruthless pharmacies are probably what's popping up here and there. Makes a lot of sense. For those with good insurance they save them from the headache of CVS or Walgreens. For the money losing customers they send them their way. Probably pharmacists who worked for the duopoly and had enough.

That is exactly what is happening. There are many pharmacists out there who would love to start their own pharmacy. There are various networks/distributors they can sign on with and get a pharmacy system, etc. The problem is these insurance reimbursements.

The other problem is you have customer 1 who maybe has given you 3 "profitable" prescriptions but shows up today with a 4th prescription and you deem that unprofitable. But if you refuse to fill it, you may lose those 3 "profitable" prescriptions too.

But looking at the financials lately for CVS, Walgreens, and Rite Aid, it feels like it is a lot more than independent pharmacies losing money... these major chains seem to be losing a lot of money too. It is clear the insurances and drug companies are squeezing the pharmacies.

[Alpha8472]

When people are on Ozempic, it is usually not just 4 prescriptions, it is more like 8 prescriptions. These people are on blood pressure medications, cholesterol medications, pain medications, blood thinners, vitamins, supplements, antidepressants, etc. Customers are very easily upset. Of you deny an Ozempic prescription, they will move all of their prescriptions to another pharmacy. There are mail order pharmacies that deliver, and they are actively poaching customers away from brick and mortar pharmacies.

Every time a customer comes in to pick up a prescription the store gets a basket of merchandise. Customers come in several times a month. If pharmacies lose customers to those mail order chains, then the store will lose tons of sales.

Those insurance companies have built up entire networks of mail order pharmacies designed to put brick and mortar pharmacies out of business. Amazon is actively pushing customers to mail order with free delivery with Prime. Medications arrive in a day or two and people don't even need to set foot in a store.

Drugstores are losing so many potential sales on the front end.

Many people go to doctor's offices and then tell their doctors to send prescriptions to mail order pharmacies. These Walmart Health Centers were supposed to bring more prescriptions to Walmart, but many patients just used the doctor's office and then had prescriptions sent by mail. Then Walmart would lose out on sales at the store.

[veteran+]

I know that my independent pharmacy (top rated in West Hollywood) struggles with reimbursements.

He showed me the numbers. He is 1/4 of million dollars behind in reimbursements.

Like WOW!!!!!!!!!!!!!!!!!!!!!!!