Jennifer Whalen, MBA

Industry pundits are going to analyze the heck out of this, but it’s really not that complicated. One. Can’t make money if the payor is your competitor and they pay you less than cost. How exactly do you downsize your way out of that? You don’t…just sticking fingers in the dam to hold it together a little bit longer... maybe until the FTC lawsuit works itself out? Everything else below is a subpoint. Pre-PBM monopoly this was a 23% gross margin business. Hard to believe today. Two. No one wants to go to a damn Walgreens for their medical care. Stop with the primary care destination garbage. It’s the one part of medical care that’s reimbursed even worse than pharmacy, only a pharmacy business would think it looks lucrative. Three. Non-pharmacy sales are a matter of convenience, end of story. Anyone including Walgreens current CEO who thinks they’re going to be a shopping destination is in fantasyland. People go there for convenience or out of necessity, that’s it. Before e-commerce this side was a 35% gross margin business. Not anymore. They don’t even let their store managers make any merchandising decisions today. Which brings me to my next point… Four. Quality of leadership has taken a nose dive because they don’t let the front line do anything anymore or make any decisions. Extremely unfulfilling job I’d imagine. People are surprised to hear this, but the quality of the general managers used to be superb. Five. Walgreens didn’t go after the PBM market 20 years ago when they had the chance because they thought the FTC would never allow it… Boy were they wrong. But I think they’ll be on the right side of history when the PBMs get broken up. At least I hope so.

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With Walmart’s recent announcement – closing all 51 of its retail primary care clinics – those of us in value-based care can breathe a sigh of relief. Just because a commerce giant can deliver goods to appease the needs of our instant consumerism doesn’t mean that they can successfully launch and maintain a sustainable healthcare delivery model. Those of us in the industry recognize that our system needs improvement; however, witnessing the closure of clinics like these highlights a healthcare reality: achieving positive outcomes requires patient and provider engagement, a collaborative partnership and commitment. Unfortunately, this announcement shows that once again those in most need of intervention will be the ones that suffer. Clearly mega retailers underestimated the complexities of health care delivery. Recognizing this lesson, we as healthcare leaders are called to serve our communities holistically and meet them where they are. We at CareNu are committed to the communities we serve, addressing healthcare disparities and inequities while continually innovating to make a difference and transform the current system. #CareNuCares #CareNuIsNow #ValueBasedCare #Innovation

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Walgreens has described ~25% of its 8,600 stores as underperforming and under review for permanent closing, due to them either being unprofitable or being too close to each other. Walgreens CEO Tim Wentworth: "Everything has been on the table. We are at a point where the current pharmacy model is unsustainable." The reasons why these Walgreens stores are currently unprofitable, from: https://lnkd.in/eyNwRpV6 "All are being squeezed by lower reimbursements for prescription drugs from pharmacy benefit managers, as well as the loss of snack and staple sales to online and discount retailers — and an increase in theft since the pandemic. The closures impact low-income neighborhoods most because more customers there are on public health insurance, which reimburses drug stores at a lower rate than private plans, notes CNN." Additional reading: https://lnkd.in/e82Fs55G https://lnkd.in/ekRqqnGr

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Just wanted to share that my blog on retail strategy just got published by the University of Wisconsin’s Center for Professional and Executive Development! Please take a minute to read and let me know what you think! Best, Dennis https://lnkd.in/d8Zfk5Kr

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Yep! It really isn't that complicated... Directed patient care through Preferred Provider Networks (PPNs) affect patients' choice to choose their pharmacy. The lessons learned from the actual examples in the U.S. speak loudly to the impact of PPNs on patient choice...patient care...and creation of pharmacy deserts. Over-complicating...over-researching...and over-analyzing this matter may simply be a sign of reluctance to seriously tackle it. #BanPPN #PatientChoice #PatientCare

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The closure of independent pharmacies is not just a business issue—it's an equity issue. These pharmacies often serve as critical access points for healthcare in underserved communities. Their loss means fewer opportunities for preventive care, medication management, and personalized health services. We must move towards a payment model that reimburses pharmacies for the full range of services they provide beyond just dispensing medications. This includes preventive care, medication therapy management, and other essential services that improve health outcomes. Let's advocate for policies that support and sustain independent pharmacies, ensuring that everyone, regardless of their zip code, has access to quality healthcare.

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One aspect that’s extremely rewarding about leading DE&I at VSP Vision is that we offer tangible opportunities to embed programming that improves outcomes for our patients, doctors and members across varying cultural identities, ages, and socio-economic backgrounds.   This is why I’m pleased to share that VSP Vision Care recently announced our partnership with HUED, a learning and development company that creates equitable and inclusive healthcare content, setting the stage for inclusive patient communication and improved treatment in healthcare settings – especially for communities in need.   Following the no-cost training Cultural Competency and Humility Training with HUED, 97% of attendees said they gained valuable insights on how to better interact with their patients and there was a 94% increase in learners who strongly agree they can actively implement and articulate the strategies to help close the health equity gap.   Now being rolled-out network wide, offering this customized training isn’t just the right thing to do, but an essential that has been proven* to achieve an increase in patient satisfaction, and just as importantly, help reduce health disparities.    #DEI #WeCare #VSPVision #OneTeam #Juneteenth #WeEmpowerDiversity https://lnkd.in/g4effPwV *Improving Cultural Competence to Reduce Health Disparities for Priority Populations | Effective Health Care (EHC) Program (ahrq.gov)

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Walgreens' stock surged 27% following fiscal Q1 earnings that beat expectations, signaling early recovery signs. Despite a $265M quarterly loss, revenue rose 7.5%, driven by gains in its healthcare segment, including 12% growth in VillageMD, CareCentrix, and Shields Health Solutions, which focus on primary care, home-based healthcare, and specialty pharmacy solutions. Walgreens plans to close 450 stores in 2025 and is exploring selling VillageMD to reduce debt. CEO Tim Wentworth emphasized progress in the retail pharmacy-led turnaround through cost control, reimbursement improvements, and optimized store operations. Analysts see these results as a sign of stabilization, though challenges persist.

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Walgreens is looking to close 1,200 stores by 2027 in response to continued financial difficulties. With similar challenges to what Riteaid faced last year, most of this impact appears to be coming from online competitors in the space. The common theme for success in pharmacy operations revolves around a 3C (convenience/care/cost) approach for the patient. People like to either have their medications mailed to them, or to pick up their prescriptions at a place where they already need to go. Integrated pharmacies within the oncology environment are well positioned to meet these needs for the patient, bringing a convenient and cost-effective solution while improving visibility to the importance of adherence. https://lnkd.in/en6RaEVg

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Walmart can change the entire tortilla industry, but struggles with health care? Amazon buys One Medical, but will it succeed where others failed? The health care landscape is littered with the wreckage of good intentions from non-healthcare companies. Why? This isn't your typical market. Here's a few reasons businesses struggle in health care: Transaction vs. Relationship: Health care thrives on trust and empathy, not just efficiency (though that matters, too). Can a business built on transactions truly foster healing? Data Chaos: Fragmented data and privacy concerns make it hard to get the insights businesses crave (and often need) to succeed. Treating Diseases, not People: Health care isn't fixing a broken appliance. It's about the whole person, with unique needs and complexities. Algorithms can't replace that human touch. There's a future for businesses in health care, but it requires a fundamental shift. Can they prioritize people over profit? Can they navigate the complexities? We'll see if Amazon or others can crack the code. But one thing's for sure: the current approach isn't working. Let's see who gets it right this time. More here (and make sure you have the right song playing in the background when you read - there's a hint of what song in the title and at the end of the post): https://lnkd.in/gmTMtsPV #mentalhealth #business

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More than 300 independent pharmacies closed in 2023, creating pharmacy deserts in rural communities. PBMs have become key pieces of mega-health care companies that control the market from top to bottom. The three largest PBMs are each connected to a major health insurer. CVS Caremark owns Aetna and is number 6 on the Fortune 500 list. In 2023, CVS Health expanded into yet another health care space, creating a subsidiary that manufactures drugs. The 2nd largest PBM, Express Scripts, is owned by Cigna Group (number 16 on the Fortune 500). The 3rd, OptumRx, is owned by UnitedHealth Group, which is number four on the Fortune 500 list, and is the nation’s largest private health insurer and the largest employer of physicians. Per Becker's.....On Aug. 28, Rep. James Comer, chair of the House Committee on Oversight and Accountability, called on three PBM executives "to correct the record" regarding testimonies they made during a hearing about how the PBM industry influences prescription drug markets. "At our hearing, the witnesses claimed they do not steer patients to PBM-owned pharmacies," the committee wrote on X. "The executives also made claims contradicting the committee's and FTC's findings regarding contract negotiations, contract opt outs, and payments to pharmacies." Mr. Comer is asking David Joyner, president of CVS Caremark; Adam Kautzner, PharmD, president of Cigna's Express Scripts; and Patrick Conway, MD, CEO of UnitedHealth's OptumRx, to provide any necessary corrections to the record by Sept. 11. In his letter to the three executives, Mr. Comer highlighted the potential consequences of making false statements to Congress, including fines and imprisonment of up to five years. #pbms #fraud #spreadpricing #drugs #prescriptiondrugs #prescriptions #employers #middlemen #brokers #advisors #consultants #erisa #patients #employees #selffunding #carriers #medications #pharmacies #pharmacist

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My all-time favorite interview as the hiring manager… The role would be tough. Most akin to business development, but less focused on retail and far more wholesale. It also included key accountable areas “post-sale” in implementation and account management. In many ways, it would be harder to decipher success than failure. What I needed was someone that understood the long game; Willing to put in time for a longer sales cycle. Someone with keen intuition. Someone with grit. She, along with 2 others well qualified candidates, made it through the assigned recruiter, 2 department leaders, and was scheduled with me for a final interview. I perused her CV, looked through the stock interview questions, kept the feedback from recruiter/dept leads temporarily blinded as to avoid sway (I always took their thoughts into consideration after my interview). Then the virtual Webex interview began. Intro’s, nice get to know one another banter, some geographic reference points r/t where home is and weather, were followed by she and I briefly describing roles (my current and her most recent). She clearly met the requirements of the role, and had a track record of business development success. But I had yet to know how she would tackle this first of it’s kind role on my team. I decided to reprioritizate my questions and call an audible. “Tell me about this Franchise Owner past experience. It says here you bought a Dairy Queen and still own it.” For the final 40 minutes of our 60 minute interview, she told me everything I needed to know about the person and professional she was. Far from a lawyer, she know when and where to bring in counsel. Far from a CFO, she knew her unit economics, AR, payroll, and how to develop a sound business. Far from a marketing wiz, she knew how to storytell, create buzz, and use brand to her advantage. She knew customer experience. She knew how to lead people. She knew when to ‘phone a friend’ and call in the franchise mgmt team. My guess is she left the call feeling as though we missed the opportunity to discuss more recent BD roles she had been successful in. Either that or I may call her after asking for tips on how to open my own DQ:) She was offered and accepted the role. She crushed it. Her career has blossomed to new heights and I’d be happy to call her my boss these days. The summary here is not to overlook the early career experiences or the experience that may not match the others. That’s often the one that taught you the most about yourself. I wonder upon reading this post, if she will know she is the subject:) #snickersblizzard

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Walgreens is reportedly in discussions with Sycamore Partners about a potential sale that could take the pharmacy giant private. Sycamore, known for its investments in the retail and consumer sectors, may explore selling parts of Walgreens or partnering with other firms as part of the deal. Operating over 12,000 stores worldwide, Walgreens has faced significant financial challenges, including plans to close 1,200 underperforming locations over the next three years. Broader pressures in the retail pharmacy sector, reimbursement challenges, and losses tied to its VillageMD acquisition have further strained the company’s performance. 

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In February, Walgreens announced its "profit margin" had fallen to negative 15.95%. In other words, for every $1 in revenue, it lost 16 cents. A month later, it announced the closing 160 VillageMD locations, up 100 from the 60 previously announced. The company then announced it would be taking a $6B impairment charge on its financials related to its #primarycare endeavors. Ouch! What happened? Primary care, like #urgentcare and other #healthcare practices, is volume-driven because labor is a "fixed cost." An office can't open and accept appointments without a #primarycarephysician present. In short, the centers weren't seeing enough patients to efficiently utilize its providers, resulting in excess provider capacity. "Volume-driven" means once an office sees the minimum number of patients to cover payroll, rent, and other expenses, each additional visit accrues to the bottom line. This means a practice that sees 30 visits per day will be more profitable than one that sees 25, and one that sees 50 will be exponentially more profitable than one that sees 30. To improve its primary care profitability, Walgreens said it will be focusing on higher density markets that are capable of generating more patients per PCP. Despite these woes in health care delivery, Walgreens has one department that's contributing millions... #commercialrealestate According to ICSC, in the past three years Walgreens has executed 125 sale-leaseback transactions worth over $800,000,000 total, yielding a 21% return. How does it work? --Walgreens uses an algorithm to identify properties that are undervalued based on the current lease and market rates. --Walgreens exercises its right of first refusal to purchase the property from its landlord. --Walgreens cancels its previous lease and executes a new lease with itself on the property. --Walgreens then sells the property to another owner via a sale-leaseback. Using this tactic, Walgreens can purchase a building at the current market rate and sell it to triple-net investors at a likely lower cap rate, creating substantial value for the organization. It's significant that the company is conducting sale-leasebacks on individual properties rather than portfolio-wide. This has generated hundreds of millions in value for the company. The elephant in the room, however, is those leases are only good so long as the company generates sufficient profits by location to pay the rent.

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As part of my recent industry updates on #retail health clinics, I discovered Walgreens has introduced a new in-store clinic model..."Be Well Clinic" which offers #sexualhealth services including testing for #stds #prep and contraception. To my knowledge there is currently only one location, in Phoenix. Walgreens does have a partnership with Texas Health Action for a similar "Kind Clinic" in the Oak Lawn neighborhood of Dallas, Texas. And in a similar vein, unrelated to Walgreens, are emerging business storefront models with a sexual health focus like TBD Health in Denver and Las Vegas. The Centers for Disease Control and Prevention report sexually transmitted infections, even though retreating slightly, are still at record highs. Yet, 50% of urgent care centers do no STI testing at all. My June, 2024 feature story in JUCM: Journal of Urgent Care Medicine, the "Urgent Need for STI Testing in Urgent Care," describes the emergence of rapid, point of care testing solutions like those offered by binx health bringing peace of mind by offering near immediate results. What do you think? Is Walgreens on to something here? In my opinion, if urgent care doesn't embrace rapid point-of-care STD testing, someone else will. The time is now for urgent care to tie up this growing business and meet a community need.

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📣Sharing Important Updates for Healthcare Professionals📣 Today, I want to share something I received in the mail that I believe is crucial for all #healthcare professionals prescribing or managing opioid analgesics. My intent is to keep us all informed about updates that can help improve patient safety and address the ongoing opioid crisis. The letter, sent by the Opioid Analgesic REMS Program Companies, highlights new FDA-required measures that will take effect by March 31, 2025. These measures are part of the Risk Evaluation and Mitigation Strategy (REMS) program to reduce the risks of addiction, misuse, and overdose associated with opioid analgesics. Here are the key points: 1. Pre-Paid Mail-Back #Envelopes for #Unused #Opioids • Pharmacies and other dispensers can request pre-paid mail-back envelopes for patients to safely dispose of unused opioid analgesics. • This initiative is designed to minimize misuse and ensure unused medications don’t end up in the wrong hands. 2. Patient Counseling on #Safe #Disposal • It’s critical for us as healthcare providers to counsel patients about disposal options, including: • Take-back sites or programs. • Immediate flushing of medications, if necessary, as per FDA guidelines. 3. Drugs Covered by the #REMS Program • Affected medications include both branded and generic oral opioids like hydrocodone, oxycodone, morphine, methadone, and more. This is a proactive step to support the safe use of opioids and enhance patient education. For those who want to learn more, I recommend visiting the official Opioid Analgesic REMS website or contacting their REMS call center at 1-800-503-0784 for further details. Let’s remain committed to equipping ourselves with the #tools and #knowledge needed to navigate this complex issue and continue prioritizing #patient safety in all that we do.

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Nationally, in-store clinic operators have clinics in only 4.3% of their own stores, indicating they've not only failed to capture a meaningful share of total #healthcare spending, they've also failed to penetrate a meaningful percentage of their own stores! Take out CVS and Kroger and the number falls below 1%. For instance, after closing all 51 Walmart Health centers earlier this year, only five clinics remain in Walmart--all from previous iterations, all operated by health systems, penetrating 0.1% of the company's 4,606 US stores. Which food/drug/mass retailer do you think has achieved the greatest penetration of it's own stores, with more clinics than Walmart, Albertsons Companies and Publix? Here are some hints... --It's not #CVS with 875 MinuteClinics, down 23% from its 2023 peak of 1,150, today penetrating only 9.7% of its stores. --It's not Kroger which has remained steady with 225 Little Clinics, currently penetrating 7.6% of its stores. --It's not Walgreens, who, after retreating from its $8B investment in VillageMD over the past five years, currently has 162 in-store clinics operated by 12 health systems covering only 1.9% of its stores. The winner is one you've probably never heard of... Fruth Pharmacy, operating 21 locations in Ohio, West Virginia and Kentucky is now the 7th largest in-store clinic operator, penetrating a whopping 33% of its stores. The clinics are operated by #ruralhealth systems including WVU Medicine, Holzer Health System and Valley Health System. If you read my recent article describing "rural #urgentcare " as the fastest growing segment, maybe the success driver of in-store clinics is also rural and underserved markets? Who'd have thunk it?

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The local pharmacy is the singular place where patients need to feel like they are cared for and supported. While doctors can serve as a crucial component of the healthcare experience, the impact the doctors can have on patients is limited to the time spent in the doctor's office. However, interestingly what sets pharmacies apart in healthcare are the regular connection points made with patients. Digital transformation along these vectors, ranging from digital prescription filling to telehealth tools, allows for success in these patient arenas not previously conceptualized before the digital expansion of the industry. #Pharma #PharmacyStrategy #DigitalInnovation #Telehealth

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