Matt McGuire
CVS Health is expanding MinuteClinic’s primary care capabilities by working with payors and health systems to offer MinuteClinic as an in-network primary care provider. MinuteClinic recently began offering in-network primary care services to select Aetna members in Houston, San Antonio and the greater Atlanta area, and it has plans to include more markets and payors in the future.
The MinuteClinic locations we’re familiar with already offer many of the services that are typically found in a primary care office — everything from annual exams to chronic condition management and health screenings.
To deliver primary care, MinuteClinic is building on these capabilities, and in certain markets, MinuteClinic nurse practitioners have been credentialed as primary care providers. This gives patients accessible, end-to-end and preventive care where and when they need it.
On today’s episode, we’ll learn why it’s important for MinuteClinic to move into primary care, the strategy behind this move and what the early reaction has been from patients.
Welcome to Big Questions Answered, a podcast that helps us understand the important initiatives at CVS Health. I’m Matt McGuire from the Enterprise Communications team. I’ll be your host as we take a closer look at new products, powerful innovations and the big changes we’re making to achieve our strategic imperatives and build a world of health around every consumer. Thanks for joining me today as we get our big questions answered.
I’m here today with Dr. Creagh Milford, the president of retail health. As a third-generation physician, Dr. Milford has a natural passion for creating trusted relationships between patients and providers. And he continues to see patients in Denver, where he lives with his wife and two daughters.
In his role as president of retail health, Dr. Milford oversees MinuteClinic and CVS Virtual Care, which includes virtual primary care, on-demand care and mental health services.
Dr. Milford, you are a busy guy! I’m happy we found some time to talk. Thanks for joining me today.
Dr. Creagh Milford
Hey, thank you for having me, Matt.
Matt McGuire
So, this next step in the evolution of MinuteClinic is really interesting. Can you talk about why MinuteClinic is expanding its primary care services and what the overall strategy is?
Dr. Creagh Milford
Yeah, perfect. Happy to. And thank you again for having me. You know, as we all know, there is a significant access problem in the US healthcare system. We have an aging population and more and more people need primary care services. At the same time, you'll hear us talk about this today, the costs of care for health care in U.S. health care system continue to rise. And we believe that primary care is a key part of addressing both the access components as well as, over time, the cost component. Yeah, to be more specific, you've heard about, you know, the average stats in America is that it takes three weeks to get a primary care appointment. In my travels with local communities in our clinics, I often hear it's six months, nine months, even more, a year, to get into a primary care appointment. And, so, we're really focused on how we can transition MinuteClinic to actually be the last mile here for primary care. We've been on that journey for two decades, frankly, to improve our number of services and the things that we do related to primary care. That includes things like wellness visits, chronic care condition management, as well as behavioral health. And we are really proud to announce that over the last several months we've actually launched. We have now of 76 clinics out of our entire fleet that are performing primary care. That's today in Houston, San Antonio and in Atlanta, and we're eager to continue our journey here. Yeah, we believe that at the end of the day it's our obligation and privilege to serve the communities and deliver better, more comprehensive primary care for those patients that are coming into MinuteClinic.
Matt McGuire
Absolutely. And, so, I know part of the approach that we're taking, and part of what you're interested in doing, is making these primary care services an omnichannel model. Can you tell me about this a little bit more, and what you mean by omnichannel model?
Dr. Creagh Milford
Yeah, I mean, we use these terms I think in the corporate world. What this means for real life people is patients who want to get care when and where they want to receive care. That could be in our brick and mortar in our actual physical clinics. It could be online, virtually or it could be as simple as chatting with your doctor. And how we think about it as MinuteClinic and CVS, connected with all the digital assets that we have and apps, we believe there's a really unbelievable use case to combine all those. So, that, you know, for example, Matt, you could get primary care services through MinuteClinic in person, virtually or be able to, overtime, chat with your provider. So, we believe that's the way that primary care is advancing. And we're going to be by, I hope, on the leading edge of that.
Matt McGuire
Yeah, that's nice. That's kind of really embracing the future and technology as we know it today. So I'm curious, how does the MinuteClinic primary care strategy align with the company's larger health care delivery strategy?
Dr. Creagh Milford
Great question. And there's been a lot of headlines. Obviously, CVS acquired Oak Street Health and Signify Health. Oak Street Health is CVS's Medicare Advantage and Medicare focused primary care company. It does an amazing job of delivering really unbelievable patient experience, provider experience, and has proven reducing, kind of, the cost of care by better managing patients to frankly keep them out of the ER and the hospital. You'll find the same storyline for what we're going to be achieving for MinuteClinic, which is how do we leverage MinuteClinic and all the patients that we serve today to deliver an industry-leading patient experience, deliver on a longitudinal relationship with our providers. And over time, be able to participate in value-based, even risk-based care to manage patients more holistically and ideally reduce unnecessary costs within the U.S. health care system. There are several examples of today, our management teams, myself and our peer group, colleagues, that lead Signify and Oak Street Health, that are working on how we're going to manage patients across the spectrum, whether they're Medicare, Medicaid, commercial using our set of Oak Street and MinuteClinic and also Signify company. So, we're really excited and we've been on a journey since they joined us to connect those businesses to a larger CVS, Aetna, obviously, and Caremark.
Matt McGuire
Nice. So, MinuteClinic is one of the CVS Health services that my family is very aware of. We've used it many times. We've had a lot of appointments. Sometimes it's for vaccines, you know, sometimes it's for those last minute. Well, I mean, even this summer it was like, you know, right before, yeah, jumping on a plane for vacation, one of us caught a cold and we headed over to a MinuteClinic. And we're kind of curious, like, how will the services at MinuteClinic primary care locations be different from the MinuteClinic locations that you were familiar with. The family, you know, and others who go to MinuteClinic kind of regularly. Will traditional MinuteClinic services continue to be available?
Dr. Creagh Milford
Yeah. So, I think we're known from a patient perception view around, you know, acute care visits, vaccinations. exactly to your point, but in the backdrop for, you know, several years, we've been advancing the number of services that we performed. These are things like wellness visits, chronic condition visits, also known as diabetes, hypertension and so forth, behavioral health services, all of which are available today. If you go on the website, those are available for customers across the country and the markets we serve. And what I tell folks is that, you know, if you look at the set and the range of services MinuteClinic provides today, it's roughly 85 to 90% of the services that you would find in a traditional primary care office. So what our goal is, is to change that patient perception to your family's example, where you guys look at us as a longitudinal provider that can help you not just for, you know, cough, cold and flu, but also to manage your wellness visit and to manage other chronic conditions, hypertension and so forth that you might have. I think it's important to note we do leverage our nurse practitioner and physician assistant-led model. We hire really unbelievable providers. I've had the privilege of meeting hundreds and if not thousands of our providers through the course of my tenure here. And what we're working on is getting them credentialed with the health plan, so that in the eyes of the health plan, you, that or your family and your example, can actually have MinuteClinic be your primary care of record. And we're finding in our data, both surveying patients as well as in our current models that we've launched, that, you know, we are actually meeting this access gap that we talked about earlier. And we're finding a lot of patients are very interested and engaging in our primary care models where we've stood them up.
Matt McGuire
Gotcha. You know, earlier in this conversation, you mentioned that three weeks stat that patients, you know, typically have to wait about three weeks to line up an appointment with their primary care physician. I've seen that, too. But speaking from experience, again, that's, you know, sometimes it's three weeks, sometimes it's a couple months, sometimes it's a bit longer or shorter. It kind of depends on the provider and the service, but, you know, those long wait times come sometimes can have a negative effect on a patient’s health. Can you kind of talk about the potential risks of those long wait times that they pose, and, you know, from a health standpoint, how will MinuteClinic primary care help address those?
Dr. Creagh Milford
Yeah, great. We get this question a lot, And I believe, both as a primary care provider and then also leading retail health and MinuteClinic, this is a really important conversation to be had because what I hear from patients, from our own providers, in most of the communities that I travel to, is that it is not three weeks to get an appointment with a new primary care. Often, as we said, it's several months. And that creates two problems. First problem is, if a patient has an acute need. they're going to go to the urgent care. There's no longitudinal care plan for that individual to be followed by in this, what we're setting up as a primary care provider. And then the second one is that the patients, if they're waiting six months, nine months, you know, several weeks, that delay is preventative care. And what we've seen clearly in the post pandemic era, which is probably the most clear example in modern history of patients, you know, forsake of primary care offices and a lot of other offices being closed or having limited hours due to COVID that care was delayed for providing services. And we're now seeing many examples where because of that delay in prevention, you're seeing unfortunate new diagnosis for patients, whether it's a chronic condition or cancer or otherwise. And so I strongly believe that, yeah, we have a big role to play to deliver an accessible model for patients to receive primary care. And, you know, to put the stats together, you can go on today, and get a visit today, in the day, in one of our primary care locations. And so that's very different from waiting several weeks or months to be seen by a new primary care provider.
Matt McGuire
Yeah, that's great. So, we're kind of early in the process of launching these new MinuteClinic primary care locations. But, what would you say are some of the early successes that you see?
Dr. Creagh Milford
Yeah, I am really, really excited and proud of all the work our team has done. As we mentioned, we've got about 76 clinics live. Those are in Houston, San Antonio and Atlanta. We're seeing a really unbelievable results. The first one is, we're seeing a lot of growth in patients that are signing up for our primary care model. Those numbers are growing. I look at them daily and weekly, and we're really proud to see that we are changing that perception of patients, number one. And number two, we're meeting a real need for access by virtue of these patients signing up with us because they have access challenges within their own community. The second thing that I'm really, really proud of is just MinuteClinic overall has an unbelievable Net Promoter Score. It's been over 80 for several years. That is industry leading for health care. And within our primary care model, we're seeing patient satisfaction even exceed that, which we're incredibly proud of. And I think it speaks to the relationships in many examples that our providers have already developed with patients. And now we're just formalizing that relationship as a PCP with those patients. And then the other one, we track very closely is our provider experience. Our providers really finding joy in their practice of medicine. This is probably a whole other topic around, you know, provider burnout and what we're doing to help our providers. But our provider experience is over 90% satisfaction. Within primary care and in MinuteClinic, and so we're really proud of the infrastructure education training that we put forward, including the collaborative providers that we have, the positions that oversee our clinicians and providers.
And so just to give you a quick story around this, I get the privilege of traveling to lots of these sites that we've transformed to primary care. And this is, you know, a unique example that I'll share with you, but it's also one that I've heard several times. And this is a, you know, one of our nurse practitioners was seeing a patient. And he was in his 50s. He had a sinus infection. And during the visit, our nurse practitioner discovered that he had high blood pressure. That's pretty common. That happens all the time within MinuteClinic and generally what would happen in just MinuteClinic is referring over to a primary care. This particular individual stated to us that he had really struggled finding a primary care, and hadn't seen a primary care in several years in the exam. And in that interaction, our NP asked the patient, would he want us MinuteClinic and that provider to be his primary care, to which he said, yes, and they established the relationship. He was brought back to help manage his blood pressure, and pleased to say that he's doing well. So that's one little example of how I think this kind of innovative, access and convenient model, I think, will begin to start changing the way that we deliver primary care through MinuteClinic and be a really important differentiator for CVS Health.
Matt McGuire
Oh, wow, that's a great story. Thanks for sharing that, Dr. Milford. It has been great talking with you today. I really appreciate you sharing that story, and, you know, all the insights that you shared previously, it's been a pleasure talking with you. Thanks for joining me today.
Dr. Creagh Milford
Thank you, Matt. Pleasure.
Matt McGuire
And a big thanks to you for tuning in to this episode. Until next time, I'm Matt McGuire. I look forward to joining you again to get more big questions answered.
