Robert Glazer, MPA, CEO of ENT and Allergy Associates in New York, has, for a number of years, encouraged otolaryngologists to build relationships with local pharmacies to bolster referrals, and sees the merger as yet another sign that otolaryngology practices need to boost connections to grow and sustain their practices. Given that clinics such as Minute Clinics increasingly are providing accessible frontline care, he encouraged otolaryngologists to check in monthly with these types of clinics to cultivate referral sources.
Both Glazer and Dr. Setzen used the word “gatekeeper” to describe the role of Aetna/CVS in this new model of healthcare delivery. “I think [Aetna and CVS] are going to completely retool to be the gatekeeper of the entry level access to the healthcare system,” said Dr. Setzen.
For Glazer, this role by a major drug store is not without snags. “I think a merger where a drugstore chain is a gatekeeper for medicine will result in these companies steering patients to drug formularies that are more profitable for these companies,” he said.
Impact on Patients
How this merger and others like it will affect patients is yet to be determined; however, there is little doubt that the easier access and convenience of care offered by facilities such as Minute Clinics will be well received by patients, said Dr. Setzen.
In addition, he emphasized that moving care out of hospitals into ambulatory and outpatient settings, and now Minute Clinics, may “really open up the discussion about cost of healthcare, variation in quality, and transparency as to services provided and the cost of those services.”
Dr. Sun cited arguments in support of these discussions. “It has been proposed that the merger may make it easier for Aetna/CVS to monitor and encourage regular, appropriate use of prescription medications for chronic diseases, which in turn may lead to reduced beneficiary hospitalizations, emergency room visits, and other adverse outcomes, thus improving health and saving money.”
He was quick to point out, though, that evidence of other merged healthcare entities and integrated health networks show an ambiguous track record, at best, of cost containment. “Therefore, the positive and negative effects of such an unprecedented merger in the healthcare arena are difficult to predict,” he added.