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Norton Healthcare is teaming up with Walgreens to offer, for the first time, health care services in eight Louisville area retail clinics.

The clinics — five in Louisville and three in southern Indiana — will provide basic services for minor illnesses and injuries, vaccinations, physicals and screenings for high blood pressure, diabetes and other chronic illnesses.

Norton Chief Medical Officer Dr. Steven Hester told Insider that the clinics complement the nonprofit health system’s other facilities and give consumers yet more locations to access services for conditions that do not require serious interventions.

“We really want to make sure that patients are able to seek access close to home,” he said.

The venture between the health care system and the retailer aligns with a recent trend of industry consolidation and cooperation in which providers, retailers and insurance companies acquire one another or work together to provide better care at a lower cost, as government agencies and insurance companies increasingly pay for health outcomes rather than the number of services that health professionals provide to patients.

For example, CVS late last year said that it planned to acquire Aetna, and in June, Humana and Walgreens said they would open two senior-focused primary care clinics in Kansas City.

The clinics that Norton will take over early next year and rebrand as Norton Prompt Care at Walgreens, will be operated by Walgreens until then.

Dr. Steven Hester

Norton provides care in more than 250 locations in Indiana and Kentucky, including at five Louisville hospitals, seven outpatient centers and 14 immediate care centers. The system employs more than 14,000, including about 900 medical providers, which includes physicians and nurse practitioners.

The Walgreens clinics will accept most insurance plans, but patients still may incur out-of-pocket costs, depending on their plans, though, Hester said, insurance companies may lower patients’ copays as they’re seeking aid in a clinic rather than a physician office.

The clinics also welcome patients who don’t have insurance. Prices on the Walgreens website show that people without insurance can expect to pay $150 for a chickenpox vaccination, $60 for a sports physical or $69 to $150 for diabetes screening and counseling.

Norton will lease the space in the Walgreens stores and said it hopes to hire the nurse practitioners and other staff already working there.

Walgreens Chief Medical Officer Dr. Pat Carroll told Insider that it makes sense for the company to partner with Norton because if patients need referrals, they can be sent directly to another Norton facility.

“It’s really about trying to simplify a very complicated health care ecosystem for consumers,” Carroll said.

Reimbursement changes foster cooperation

The consulting firm Deloitte predicted in 2016 that because reimbursement models were changing, retail clinics and health systems would increasingly collaborate to take costs out of the U.S. health care system.

The traditional fee-for-service model, in which health care professionals are paid for the number of services they are providing, discouraged such collaboration, because “retail clinics … pose a competitive threat for lost revenue to both physicians and health systems,” Deloitte said.

However, a value-based model made cooperation between retailers and providers more likely because “incentives under value-based payment models reward physicians for delivering care more cost-effectively and for having high quality-of-care scores.”

“Retailers could benefit from increased pharmacy volume, foot traffic, and becoming a health and wellness destination, which can help them build customer loyalty,” the firm said. “For their part, health care providers could improve access to care for their existing patients, increase the size of their patient base, lower costs, and improve care quality for patients with chronic health conditions.”

Hester said that with its foray into retail clinics, Norton wants to offer patients the right place for the right care. Patients who need a vaccination or who want to have a health professional look at their sore throat may prefer visiting a walk-in clinic rather than making an appointment with their primary care physician — though the clinics, too, allow for appointments, and many primary care physicians offer same-day service. The clinics also will operate evenings and on weekends.

Hester said that Norton understands the importance of the relationship between a primary care physician and a patient. However, he said, not every ailment requires the same level of intervention, and clinics can offer services to people who otherwise may skip seeing a health professional when their symptoms are mild to moderate.

Dr. Pat Carroll

Indeed, Carroll told Insider that Walgreen’s data shows that about half the people who access its health clinics do not have a primary care physician. While that includes people who are younger and who choose to use clinics rather than doctor’s offices for their health care needs, Carroll said that clinics can offer services to people who otherwise may not seek medical help until their condition deteriorates to the point that it requires emergency intervention.

In addition, Carroll said, health care professionals at the clinics can, when they see symptoms that might indicate a more serious condition, refer the patients to primary care providers.

At the Louisville clinics that means Norton employees will be able to refer patients to other Norton facilities if more serious intervention is needed — but they also can flag chronic illnesses or potential problems early, which, in the long run, cuts costs for Norton — and improves patients’ lives.

“The bottom line,” Hester said, “is we want patients to get care in the most appropriate place.”

CORRECTION: This post was changed to update the number of medical providers Norton Healthcare employs.

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Boris Ladwig
Boris Ladwig is a reporter with more than 20 years of experience and has won awards from multiple journalism organizations in Indiana and Kentucky for feature series, news, First Amendment/community affairs, nondeadline news, criminal justice, business and investigative reporting. As part of The (Columbus, Indiana) Republic’s staff, he also won the Kent Cooper award, the top honor given by the Associated Press Managing Editors for the best overall news writing in the state. A graduate of Indiana State University, he is a soccer aficionado (Borussia Dortmund and 1. FC Köln), singer and travel enthusiast who has visited countries on five continents. He speaks fluent German, rudimentary French and bits of Spanish, Italian, Khmer and Mandarin.