CVS and MGB want to collaborate to provide primary care at MinuteClinic in drug stores

Boston Globe

5 days ago

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The clinics would join MGB's network of providers, which means they could refer patients to MGB hospitals, specialists, diagnostic services, and laboratories if they needed follow-up care.
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Most MinuteClinic sites currently offer limited services, such as diagnosing strep throat or urinary tract infections or providing vaccinations for COVID-19, influenza, shingles, and other preventable illnesses. But in the past year, CVS began to offer broader adult primary care to members of health insurer Aetna, a subsidiary of CVS, in nearly a dozen states.
Now MinuteClinic is poised to make its first foray into primary care in Massachusetts, assuming the state commission clears the way. The commission is reviewing the proposal to ensure it wouldn't raise the cost or hurt the quality of health care.
If the commission has concerns, it can refer the matter to the state Attorney General's Office, the Department of Public Health, or another agency for further investigation.
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The filings with the commission provided few details about the collaboration, including the specific primary care services the clinics would offer.
Shannon Dillon, a CVS spokesperson, said the collaboration is still in the early stages. But she said new services could include electrocardiograms and other diagnostic tests, management of chronic diseases, and an on-call physician.
She expected the commission to issue findings near the end of the year and MinuteClinic to begin offering primary care in early 2026.
'As one of the nation's largest employers of ... nurse practitioners and physician associates, MinuteClinic is well-positioned to address gaps in comprehensive primary care access,' she said in a statement. 'Many of the patients we see at MinuteClinic either don't have a primary care provider or have not seen one in years.'
Jessica Pastore, an MGB spokesperson, said the shortage in primary care physicians has resulted in 'unprecedented volume' for doctors, prompting the health system to look for solutions. Too often, patients without primary care providers end up in hospital emergency rooms, the most expensive places to receive care.
'This affiliation will expand access across the Commonwealth with a particular focus on regions with demonstrated shortages,' she said in a statement.
A collaboration with CVS would bring the drug store chain's MinuteClinics into MassGeneral Brigham's network of providers.
Pastore said the venture wouldn't require any financial investment by MGB. CVS would join MGB's 'accountable care organization,' or ACO.
The ACO contracts with government or commercial insurers to provide integrated care, earning bonuses for meeting cost and quality targets or getting penalized if it doesn't. The MinuteClinic sites would be owned, operated, and paid for by CVS, she said.
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Although Massachusetts has some of the most sought-after doctors in the world, primary care is badly broken for patients and physicians, according to a report issued in January by the commission.
More patients are reporting difficulty finding doctors. Physicians are struggling with overwhelming workloads. The corps of primary care providers is aging, and the medical education system isn't producing enough doctors to replace them.
Pay and work-life balance are reasons why many young doctors opt not to pursue careers in primary care. Primary care physicians typically earn less than specialists and often work longer hours, reviewing lab results, fielding questions from patients on the phone or on portals, and dealing with insurers.
Although the shortage in primary care doctors is a nationwide problem, it is particularly acute in Massachusetts. A
from Atlanta to Washington, D.C., at 69 days.
David E. Williams, president of the Boston consulting firm Health Business Group, said both CVS Health and MGB likely see different benefits to the partnership.
MinuteClinic, as part of MGB, would gain cachet. 'They're not just a drug store clinic,' Williams said.
MGB, meanwhile, would benefit from MinuteClinic referring patients to the health system for other treatments and services, Williams said.
MGB, however, hasn't discussed the collaboration with its primary care physicians,
local chapter of SEIU's Doctors Council. He added that he welcomes any effort to make primary care more accessible.
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'What I would want to see is more transparency around how the partnership is going to impact primary care access across the whole MGB system, including in Eastern Massachusetts,' Barnett said. 'We know there are lots of unaddressed problems in the MGB system as it currently stands.
'They're proposing expanding the network with a completely new model.'
MGB got feedback from clinicians in the fall of 2023 'about the need for new solutions and exploring new models of care,' said Pastore, the MGB spokesperson. In May of this year, Dr. Anne Klibanski, chief executive of MGB, also pledged to
Primary care doctors from Brigham and Massachusetts General Hospital picket outside the Brigham in 2024. Among the many questions left unanswered by the potential MGB-CVS collaboration is whether patients who need primary care would be satisfied receiving it from less highly trained nurse practitioners or physician associates instead of physicians. Among the many questions left unanswered by the potential MGB-CVS collaboration is whether patients who need primary care would be satisfied receiving it from nurse practitioners or physician associates instead of physicians.
David L. Ryan/Globe Staff
Among the many questions left unanswered by the potential MGB-CVS collaboration is whether patients who need primary care would be satisfied receiving it from less highly trained nurse practitioners or physician associates instead of physicians.
After completing college, doctors typically attend medical school for four years and then spend three to seven years in residency, depending on the specialty.
Nurse practitioners typically attend college for four years to earn a nursing degree and spend two to three years in an advanced practitioner program, depending on whether they earn a master's or a doctoral degree.
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CVS, headquartered in Woonsocket, R.I., is hardly the only retail giant that has sought to get into primary care.
In recent years, Walgreens and Walmart set up scores of clinics in their stores, with the goal of making health care as convenient as picking up prescription drugs or groceries. But the retail giants soon scrapped or scaled back their efforts, which proved financially challenging.
'It hasn't been too successful,' Williams, the health care consultant, said of the business model. 'The theory is good, but in practice, people don't want to get their medical care the same place they're picking up dog food.'
Jonathan Saltzman can be reached at