Walgreens to spearhead ACO in N.J. and Pa.

Walgreen Co. is partnering with doctors in Southeastern Pennsylvania and New Jersey to become the first pharmacy to lead an accountable care organization.

 

Accountable care organizations are a health-care model outlined in the 2010 federal Affordable Care Act that provide incentives for coordinating care. Doctors — and sometimes hospitals — band together to care for a certain group of Medicare patients, and share in savings if they provide quality care while keeping costs low.

Walgreens is partnering with Marlton, N.J.-based Advocare, whose physicians serve more than half a million patients in Southeastern Pennsylvania and New Jersey.

Until now, the ACOs have been headed largely by hospitals or physician groups.  Now Walgreens, a retail pharmacy chain that many people see as a place to stock up on shampoo or gum, is stepping into the fray.

“On its surface, it might be surprising to some,” said Rick Weil, a health-care consultant with Oliver Wyman. “For those of us who are in the industry, it is not surprising.” 

Keeping track of medication

Why? Most people see their pharmacist a lot more frequently than their doctor. Because of that, and because they dispense medication, pharmacists can help address a huge driver of health-care costs: whether people take their prescription drugs consistently.

“Medication compliance is an enormous issue in health care. It’s one that’s not very well understood by most physicians,” Weil said. “The people that understand the issues around noncompliance best are pharmacists.”

By creating a system for pharmacists to access health records, and communicate more regularly with primary care physicians and specialists, Advocare and Walgreens hope to cut down on costs. Medical records also will be shared between primary doctors and nurse practitioners at the retail clinics in some Walgreens stores.

“If in fact, we do provide service in our ‘Take Care’ clinics, the primary care physician knows exactly  what happened,” said Ron Weinert, Walgreen Co.’s vice president of health-care solutions. “Which will result in less duplication of services and a higher quality of care, and lower cost.”

Medicare patients in the Advocare physician group can opt to become part of the accountable care organization.

If they do, Walgreens pharmacists will have access to their medical records, and they will get personal help from a nurse serving as a care navigator.

“We’re actually aggressively going out there and calling them,” said Advocare CEO John Tedeschi. He said they’re asking questions such as: “Did you make your appointment with the neurologist? Can we make it for you? We noticed you haven’t had a checkup in a year, can we make that appointment for you?”

Walgreens is also partnering with health providers in Texas and Florida to form three of the 106 accountable care organizations newly announced by the federal government.

In New Jersey and Pennsylvania, Walgreens ACO application has been approved by the federal government, but work still remains on records-sharing software that will allow the partnership to become operational.