Walmart announces ‘featured providers’ healthcare pilot in three states

Oct. 3 (UPI) — Retail giant Walmart has announced new programs it says will help its associates find better, more effective healthcare providers.

Coming in the wake of their recently announced Sam’s Club healthcare pilot, the company on Thursday said it is launching a new pilot program in three states that is designed to connect employees with “Featured Providers” — “quality, local” doctors who’ve shown a “demonstrated history” of effective care.

The company’s new effort, being rolled out in portions of Arkansas, Florida, and Texas, aims to refer participants in the company’s medical program to a select group of doctors in eight specialties.

Walmart said the pilot will be a partnership with the Nashville-based healthcare analysis firm Embold Health, which will be responsible for sorting insurance data to determine a list of providers who have consistently shown cost effectiveness in patient outcomes.

“We create data-driven objective analysis of provider performance within the local communities to shine a light on doctors who are providing quality care consistently,” Daniel Stein, Founder and CEO of Embold, told UPI.

The Institute of American Medicine has stated that an estimated $ 640 billion is wasted each year due to doctors delivering care that does not follow evidence-based guidelines.

“The process by which we do that is really first by working together with a group of clinical and methodology experts across the country,” Stein said.

“What we do with that team is we identify the factors that are shown to lead to better outcomes by reviewing the clinical evidence, and then we build those into standards looking at the quality of care, effectiveness and appropriateness of care. We use those standards to identify care that has shown to be high quality, medically appropriate, and cost effective.”

Stein said the Walmart program, focusing on eight medical specialties — primary care, cardiology, gastroenterology, endocrinology, obstetrics, oncology, orthopedics, and pulmonology — is built around the fact that those eight specialties represent Embold’s current areas of study.

“The way that we pick our specialties is by focusing on those areas where we know there’s a tremendous amount of variation in clinical performance,” he said. “That variance has a very significant impact on patient outcomes, and, in turn, it has a very significant cost impact for an employer.”

Stein, who previously worked as CMO of Walmart Care Clinics from 2015 to 2017, and as Walmart’s director of medical and clinical services from 2013 to 2015, said he founded Embold two years ago “to shine a light on doctors who are providing quality care consistently.”

Lisa Woods, Walmart’s senior director of U.S. benefits, said she’s “optimistic” that the new partnership with Embold will improve patient outcomes while lowering the program’s overall cost.

“If we get this right, we can raise the tide for all healthcare,” Woods said in a statement.

While the company has stated its employees will be encouraged to use providers within the recommended list, they will not be required to do so, being allowed instead to pay additional out of network costs to visit other providers.

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