Episode 26: The Inside Scoop on Walmart Health

We have the inside scoop on the opening of the first Walmart Health clinic, and it’s pretty remarkable. Shawn Nason, founder, CEO, and Chief Disruptor at MOFi and a former Disney Imagineer, designed the clinic’s customer experience around cost, convenience, and care. At the same time that other retail health models are pivoting or shutting down, Walmart Health has the ability to be a unique access point. Hear how this model was built around customer and associate feedback, why they don’t consider themselves to be a competitor to community providers, and lots of other insights that are setting the stage for the next phase of retail health.

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Full Transcript

Announcer: It’s time to think differently about healthcare, but how do we keep up? The days of yesterday’s medicine are long gone and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans, and many of those humans have unbelievable stories to tell. Here, we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together and hear some amazing stories along the way. Ready for a breath of fresh air? It’s time for your Paradigm Shift.

Michael: Welcome to the “Paradigm Shift of Healthcare,” and thank you for listening. I’m Michael Roberts here today, with co-hosts, Jared Johnson and Scott Zeitzer. On today’s episode, we’re talking to Shawn Nason, the founder, CEO, and chief disruptor at MOFI, a former Disney Imagineer, and author of “The Power of Yes! in Innovation.” Shawn, thank you so much for coming on the show today.

Shawn: Thank you, guys, for having me. Excited to be here and to share a little of our story.

Michael: Absolutely

Jared: And Shawn, you are a part of some really, in my opinion, fascinating stories going on today in the types of things that you’ve been a part of. And one of those was…that I consider a very significant event in healthcare last year, towards the last year, which is the opening of the first Walmart Health clinic in Dallas, Georgia. Maybe that’s a good place for us to start. Do you wanna take us through that story of that clinic? I mean, that was a big deal when it happened. People are still talking about it. It’s pretty revolutionary thing. And so we’d love to hear just anything you’ve got there in terms of the story of that, how it even came to be, and what was the vision, to begin with?

Shawn: Yeah, it was an amazing, exciting time in our life of MOFi. And I have the privilege of working with the CEO of Walmart Wellness, Sean Slovenski, for several years. I met him in 2011 and have been on a great journey with him. And so when Sean was tapped to do this project with Walmart and lead this team, he tapped us to come in and help design experience, and innovation, and strategy with him. And yes, September 13th of last year, we were in Dallas, Georgia, and opened the very first Walmart Health. It’s a 10,000 square-foot clinic in Dallas, Georgia.

And truly, what I believe is an integrated model. We hear integration and integrated care delivery models throughout the industry, but this model is truly what I believe is integrative. It hosts primary care, diagnostic, behavioral health, x-ray, radiology, dentist, vision, pharmacy, hearing, all in one spot. And I think the powerful thing around it that we have seen and that the team has seen is that we focused on three big areas. So when you talk about the vision of it, we focused on three areas around cost, convenience, and care. And as we know, in America today, cost and transparency of pricing doesn’t exist really. Convenience and access, not really great. And then I don’t know about everyone and you guys, but sometimes, care isn’t the best either.

And so that was our focus. The team’s focus was to focus on those three areas. It’s been a powerful thing to see what’s happening. So when we talk around this whole price transparency piece, I’ll share a little bit there, that, you know, you can walk into Walmart Health today and have behavioral health, and it cost $1 a minute, so a 60-minute session, $60. That’s unheard of in America today. You can go see a dentist, have exams, x-rays, and teeth cleaning for $50. And I remember the very first week that the clinic would opened, the team shared with us, you know, a mother with four kids who had not been able to take her children and herself to the dentist, could actually pay a cash price and get all five of them taken care of for $250. I mean, that’s a pretty powerful thing happening as we are trying to focus on the cost piece.

When we look at convenience today, there are 4,800 community hospitals in America. There are a little over 5,200 Walmarts, so talk about access, access points. And I just read an article last week that the rate of bankruptcies in hospitals are rising and more hospitals are closing every year because they are going bankrupt because they can’t figure out that cost piece either. And so convenience access is getting really important, and Walmart has a huge footprint. And they were founded when Mr. Sam, as the organization called him. He went to the parts of America where access for food and retail was needed, and what a better place for healthcare to happen.

And then last, when we talk about care, I think that’s probably one of the moments we’re most proud of in this is we’ve actually created a care model using care hosts that gives what we would consider a white-glove experience. My team, along with their team, researched the leading industry experts outside of healthcare, so talked with the Disney, the Chick-fil-A’s, the Harley-Davidson’s people that really…Nordstrom, Neiman Marcus that really provides us amazing care, Apple, and created this model around care hosts where you have these interactions with the care hosts that takes you through the process and never leaves you alone. It’s been pretty incredible.

Jared: What was your role in all of that, Shawn?

Shawn: We actually call ourselves an… We are an experienced design SWAT team, so don’t look at us as a normal consulting agency. If you want pretty PowerPoints, that’s probably not what MOFI is gonna provide for you. We get in the nitty-gritty. We wanna solve big hairy problems. So our role is across so many things. We help create that care hosts experience. Even today, my team in Calhoun, Georgia, training the next staff because two weeks from now, the next Walmart Health will open in Calhoun, Georgia. So my team is on the ground right now helping with the Walmart team training associates, making sure the experience is right, making sure that everything that we envision from the beginning of those wild moments are taking place within the process.

Scott: That’s just unbelievable. It’s just great. I just see retail health clinics as a real change in healthcare. And how do the providers at these places feel? They think that they’re part of this big paradigm shift?

Shawn: Yeah. So this is another powerful thing, and I give a shoutout to Walmart for taking this on. Yes, I do believe retail health is growing. I’m not for sure any retailer has figured it out perfectly yet, because just last year, we saw where Walgreens was actually closing some of their sites.

Scott: Yeah, that’s right.

Shawn: And they were only keeping their third-party administrator sites open. And CVS is working hard at least with their health hubs. I think the big difference that I would say where Walmart, again, has focused on care, not even for the patients, but its care for the associates is we’ve alleviated a ton of the administrative burden on the providers. So, the nurse practitioners are hired associates of Walmart. And we have done as much to alleviate administrative tasks and allow them to just focus on care that we can. And so because of that, providers are loving it. Back to the reason they became a provider, a doctor, a nurse practitioner, is they get to provide care and they get to be with their patients and not be tasked with all the administrative stuff

Scott: How did the other providers feel about, you know, an in-depth analysis? Are they happy, you know, that someone’s finally come in to take care of this? Do they look at you as a major competitor? Are they working with you? How’s that working?

Shawn: Yeah, I think the big thing there, you guys, is that we are not a competitor. I say, “We.” Walmart is not looking at being a competitor, but we’re actually looking at just being another access point. And as we are studying it, again, remember the first clinic, these first few are gonna be prototypes. We’re testing, but we are pressure point release. You know, in America today, 50% to 60% of the emergency room visits don’t need to be emergency rooms.

Scott: Absolutely.

Shawn: But this isn’t an urgent care facility either. I did mention, you know, in the facility, there’s actually a well-being room, or there’s fitness class, there’s a nutrition class that’s taking place. We have someone there helping. If you don’t understand your insurance or need insurance, we have community health workers. So, what we are trying to portray to the community, and it’s going well, is that we are here to help be a relief, a pressure point relief, pressure relief, for the right people in the hospital are at the hospital. You know, I also think in this model, hospitals are starting to ask some questions like, “I don’t think. I’ve never heard.”

But I don’t think we will see Walmart branded hospitals. We need hospitals, but we need hospitals and patients in those hospitals that need to be in the hospital. So far, I think, our provider relationships in the community and our community relationships are going really well. As with anything, when this comes out, it does kind of give people some angst at first, but I think everything is on a good place with this.

Scott: Yeah, along those lines, you’re opening up in Calhoun, Georgia. You think it’s a little bit easier opening now that you’ve got some experience in your back pocket that the proprietors who were part of the system as well as working with the system, do they see…like, is it a little bit easier opening up in Calhoun now, just overall?

Shawn: I don’t know that it’s ever easier. But I think now that people have seen it and have been to see it or been through it, they get it. And I think for our side it’s been easier to open. The community is gonna be watching. The providers, they are gonna be watching to see what happens. But I don’t think there’s the angst anymore around it.

Scott: Yeah, that’s kind of interesting. Like, does Walmart have goals? Like, what they wanna see in 3, 5, or even 10 years from now?

Shawn: I think where we’re at right now is we’re opening some prototypes, testing it to see what the market is, or there’s a definitive strategy of what the 3, 5, or 10-year goal is just to see how the market is gonna take these prototypes. So far things are good but nothing definitive there yet.

Scott: Walmart is interesting in that, as you mentioned, it did have some footprint within sort of like the overall health space, right? They were already doing some vision stuff, already kind of in that realm. But obviously, this is a big leap going from…you mentioned even dental work as well.

Shawn: Yes, yes.

Michael: That’s a huge leap to go from combining…just that one thing to combining all these together. So, you’ve got a quote where you were saying that the Walmart Health team absolutely had the skills and expertise to make Walmart Health happen. They just needed the permission to dream it and then do it. Can you expand on that comment for us and tell us more what you’re looking at when you climb up?

Shawn: Well, people need to realize and remember what Walmart is. They’re not new to healthcare. This is a new area building these bigger clinics. But Walmart has today, almost 5,000 pharmacies, 2,200 or so Vision Centers. So, it’s not that they haven’t space, so lots of expertise, lots of ability to do it. I think for them was to be able to see themselves as, “I have kinda walked in and saw…” It was to see themselves that they could be an industry leader in this space.

They had previously also had 19 care clinics that they had been testing and working through that had been doing stuff in this space as well. So, I just think, in my opinion, the team just needed some unlocking and some mindsets shifted. And that’s what we’ve really had the privilege of being able to work on. But they’ve been in the space since 1978 when they opened up their first clinic, and they were already doing some really progressive things. And 2006, they launched the $4 Prescription program if you guys do remember back then.

Scott: I do.

Shawn: The industry was like, “Oh, my gosh.” Right? But they fundamentally shifted the prescription in the pharmaceutical industry then by offering that. So, I just think this is just the next big step for them and the team. So, they’ve been doing radical things and been disruptive in the industry. They just needed to, I guess, get a push to say, “Hey, we can do it here as well.” I mean, that’s what my team, I think that’s what we have been brought in to do a lot with is around that and testing and helping them think differently in some mindsets.

Michael: It’s interesting that… So our show right before this one, the last episode that we recorded, we spoke with the direct primary care provider. And so, a completely different model of someone else trying to say like, “Obviously, the system needs a ton of improvement. Let’s completely change how we’re going at this.” And there’s a growing number of direct care, primary care providers, and so, but each of them kind of seem to be tackling their own community. It’s very much like a one at a time kind of solution. Whereas, Walmart Health, obviously, has the capability of going at this in a completely different fashion.

So, I find that fascinating that both sides of the equation, both sides of the level of providers can go after this sort of experience. So, one of the things though that Walmart Health has the capacity to do at this kind of scale is really to start paying attention to things like overall customer experience and what it looks like to see that design as you were kind of mentioning, that strategy, all the way through this. I wonder if you can tell us about sort of that customer experience side of things, and what you observed, and what you’ve been able to pull out of this project so far?

Shawn: That has been the fundamental to all of this. And working with a great team there, their internal person, their lead there, Matt Perry, and then their operations lead, Amber Bynum, working with them to say, “How do we do this?” We created some fundamental principles, design principles around, “Know me, care for me, and make it easy for me.” And made sure that as we were building the experience it lined up to that.

So, again, going back to Sean Slovenski’s vision, his vision was, “We will build this model from the patient backwards, and we will always keep that patient in the middle.” The team did an amazing job. Twenty-seven thousand consumers…a little right around 27,000 consumers in 6 months before we finalized the strategy. The team did…and the Walmart team did some amazing ethnographic research to know what patients really wanted so that we could create an experience if they wanted. So, my kudos to Walmart and to the team is to say that experience at driving this, and it’s pretty powerful to see.

Michael: You mentioned that Walmart has a care-host model. Like, how much does the research that you guys were able to do lead into the role of the care host?

Shawn: A ton. It helped drive it. Again, not looking at the clinics in Walmart Health in a traditional model, has still the traditional roles, but what we call them, that they are all care hosts. We have medical assistance and they’re helping. We have people drawing blood. All the same technical things that you need to run a clinic, but just labeling them different and putting a mindset that’s different that says, “Care will be the first driver. That we will care for the patient. We will provide safety for the patient.” That has really been the transformative. In my opinion, they need to sit back and watch.

Scott: That’s really great. I can’t tell you how many hospitals we’ve interacted with. We walk into the hospital, and I’m not ill, I’m not worried about my health, and I can’t find where I need to go. There are blue lines, and yellow lines, and green lines, and they think they’re helping, and it’s like, “My goodness gracious.” And I love the idea. For anybody who hasn’t gone into an Apple Store, I might be surprised if you hadn’t, the first thing that happens is somebody comes out to you with an iPad or an iPhone and says, “Hey, what do you need today? And how can I walk you over there?” I just can’t imagine what it’s like for a patient for the first time walking into the Walmart facility and saying, “Hey, you’re not feeling well. What can we do to help you? And let me walk you to where you need to go.” Rather than, “Well, go figure it out and read.”

Shawn: Yeah, we’ve been really cautious and very precise, even the wording. You know, “How can I help care for you today? Thank you for allowing me to care for you today.” But yeah, it’s very different. You walk in and you’re greeted just like you are at an Apple Store. Someone with an iPad and starts to talk to you. Not the experience, it’s happening. And to be real, I mean, you are talking about hospitals, just before this call was with the hospital system that, in all accounts, most people in the industry would put in the top, probably, three from an experience standpoint. But they’re reaching out saying, “Well, we need to work on this. We haven’t put the patient first, like what you’re talking about here.” So, even those that are leading in the industry are starting to look and go, “Okay. How can we do this differently?”

Scott:  Yeah, it requires a different mindset on everybody’s part. You talk about the core of being cost, convenience, and care. These are fairly basic concepts outside of medicine if you were to open a business. And I’ve spoken to a lot of ortho and spine surgeons over the years, that’s kind of our niche. And we constantly tell them, I said, “Stop calling into the backline, your special phone line. Call in to the mainline. Tell me if you would be proud of how those phones are being answered, of what the wait is like, of how your patients are being treated?”

And this is what I really do like from the consumerization of healthcare side of things. It’s like, “Let’s put the patient first.” Not only from the perspective of let’s make sure that we take good care of them and get them healthy, but let’s make them feel like we care about them as well, just as individuals. So, I’m really happy that you’ve kind of dug deep into this and are helping with just the overall model for everyone, not just Walmart.

Shawn: Yeah, and I think the powerful thing there, and you said it, and it’s what we at MOFI believe in and teach is it’s not about a process, but it’s more around a mindset shift. And we teach five or six of those basic mindsets to the whole team. And it’s amazing when you said…when I talk about that they have all the expertise to do this. It was allowing and helping them shift those mindsets to unleash this huge potential.

Michael: Shawn, I’ve got one more question before we kind of wrap up for the day. But some of the different discussions that I’ve been able to have through Twitter, through the various social media account is people are really looking at all the ways that they can tackle patient literacy, helping patients to understand what real healthcare means, how they become proactive in their health, and not just wait for something bad to happen which we certainly had to deal with, for sure.

It sounds like the Walmart Health system can help patients move beyond just troubleshooting when something goes wrong. You’re talking about nutrition centers, you’re talking about having ways to go in and work out, that sort of stuff. Is that something that Walmart Health is designed for right now? And it seems like they’re very well-positioned to be able to make a dent in that space.

Shawn: Yeah, I think this is, again, we’re in the… Again, what I love about Sean Slovenski is we are in the prototyping phase. So, we’re gonna test a lot to see what’s right. But remember this one thing that these clinics, the one in Dallas, this one in Calhoun, they are…I call them the appendage built on a supercenter, right? So, they have the ability…Walmart, in my opinion, has the ability to really look at the whole person, the whole family, and begin to impact them, not only when they step into the clinic, but when they step into the retail box, when they go into the grocery. Walmart has an amazing selection of fresh food, people just don’t know about it.

So how do we start building that streamline to say, “Okay. You come into the clinic, but we’re gonna walk you and we’re gonna help you go grocery shopping to make sure you have the right things to help you with your health after you’ve been diagnosed.” I think that’s the power behind what Walmart has that no one else has. There’s not anybody else that can do that in the industry, hospital systems, no one else.

That they can really… It’s funny even in Dallas, Georgia, the day we opened Walmart Health., at the same time, Walmart had a vet clinic open. So, when you talk about taking care of your whole family, you’re really talking about your family and your pets. Like, you can take your pet to get care while you’re in there getting care. Again, no one else can do that. At least, I don’t know of anyone else and I study a lot around the industry. I don’t know anyone else that has that ability to do it.

Michael: Very, very fascinating and good stuff. Shawn, thank you so much for your time today. They’re so many more questions I could ask, but we’ll go ahead and wrap up for today. But thank you, again. I’m really excited about how many different groups are tackling the healthcare problem, right, and looking for ways to improve this. So thank you, and I look forward to seeing what Walmart Health does.

Shawn: Yeah, thank you, guys.

Announcer: Thanks, again, for tuning in to the “Paradigm Shift of Healthcare.” This program is brought to you by P3 Inbound, marketing for ortho, spine, and neural practices. Subscribe on iTunes, Google Play, or anywhere you listen to podcasts.