Jim Peters

The world of duplicates seems to growing as pricing on national brands increases and consumers are always looking for "deals, bargains and savings". Check out this article - what are your thoughts??

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The healthcare industry has faced a series of challenging headlines this quarter, with major players like VillageMD, CVS Health, Optum, and Walmart announcing significant scale-backs or closures. These developments have sparked conversations about the future of healthcare in the U.S., a trillion-dollar industry that impacts every single person on the planet. Despite these setbacks, I firmly believe there is hope for transforming healthcare, particularly through smaller, agile companies like Tele911. Last summer, we embarked on an expansion into a new state. Within just four months, we secured all necessary approvals and launched, providing access to board-certified emergency room physicians for an additional 1 million lives. That quick! Our approach at Tele911 isn’t just about quick access; it’s about efficient, cost-effective care. Residents in our new service area now receive care in an average of 35 seconds. We offer this at a fraction of traditional costs, increasing value exponentially by delivering care directly to homes. It's difficult for large entities to pivot quickly, which sometimes is a misstep for these giants. While I remain a strong believer in our partners and the broader healthcare ecosystem, I am hopeful that more industry experts will join our 'rocket ship' at Tele911, bringing their knowledge and expertise to elevate healthcare delivery to new heights. Let's continue to drive change and bring healthcare into the stratosphere together! Join our team. https://lnkd.in/etP_2CHw

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Investing in companies that fill needs for health systems is a growth opportunity for both delivery organizations and start ups. Some systems are jumping in on their own, while others are partnering with like minded systems or with established VC firms. While this is a relatively new trend for systems, health plans have been making similar bets for many years. The benefits of becoming a health system portfolio company can be significant. Data, access to beta populations and real world coaching can be extremely beneficial. Start ups get mentoring and systems have to ability to leverage outside resources to solve relevant business problems. I predict a booming business!

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Recent studies suggest that mail-order pharmacy drugs come at a higher overall cost than in-person pick-up. Contrary to popular advice, margins can be up to a $65 difference for a 30 day prescription. Optimizing pharmacy benefits and costs requires consideration of this discrepancy. #pharmacy #PharmacyBenefits #MailOrderDrugs

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Walmart is exiting healthcare. This doesn’t surprise me. Walmart was never designed for healthcare, it was designed for retail. Everyone wants a piece of the $4T pie, but it’s a pie full of indigestible ingredients that would make the biggest companies choke. Especially companies that were never built for healthcare. - fee-for-service doesn’t work, especially with very low fees - relying on legacy payors doesn’t work - using insurance for primary care doesn’t work - not paying providers enough doesn’t work - having a clinic next to gardening supplies doesn’t work Throwing millions at healthcare doesn’t automatically work with a large base that comes to you for something else. I believe a properly built and well-executed healthcare startup that “thinks differently”, will eventually move the needle on improving the American healthcare experience. It’s coming, and will surprise everyone.

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Hey Vendors, Service Providers, Pharma Companies, and strategic Digital Health prospects! Members from our Executive Team, including myself, will be at the National Association of Chain Drug Stores (NACDS) #TSE #TotalStoreExpo #NACDSTSE. Seek us out to learn about our Independent Pharmacy Cooperative (IPC) strategic initiatives and values. Wondering why we invested in IPC Digital Health? Book an appt with me and find out!Interested in #PharmacySelect or how you can support our members? Government Affairs...chat, build a talking sheet, and engage meaningfully! We're excited to discuss how we can collaborate to future-proof our Independent Pharmacist and Independent Pharmacy members. Your trust and partnership are crucial for a thriving Independent Pharmacy. Join us to bridge gaps and create a healthy, future-ready environment! #pharma #digitalhealth #mobilehealth #homehealth Helpful Hints: Read About Us, think about ways we can work together. If already working with us prepare your data sheets, bring solutions and action, talk to us about where we can improve, work with our members to capture opportunities. I'm personally interested in working with strategic pharma and medical device companies to support our integrated home test kit strategy, and RPM + CCM programs. Not to mention PMS partners open to integrate #iCare+. Let us protect and secure our members success for the next 40 Years!!!! To book appointments email maureen.johnson@ipcrx.com Check us out: https://lnkd.in/gf4cvkPU

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The latest in our ongoing Q&A series with RMN leaders:

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Overall, the impact of Walmart selling its clinics will depend on how the new owners manage the transition and integrate these clinics into their existing operations. For Walmart: Refocus on Core Business: Walmart can concentrate more on its core retail operations by selling its clinics. For Buyers/Healthcare Providers: Expansion Opportunities: Healthcare providers purchasing these clinics can expand their reach and services, leveraging Walmart's existing infrastructure and customer base. Increased Market Share: Acquiring Walmart's clinics could help healthcare companies increase their market share and compete more effectively with other providers. For the Healthcare Industry: Market Dynamics: The sale could lead to increased competition among healthcare providers. Integration and Efficiency: New owners might integrate these clinics more effectively into their existing networks. Shifts in Service Models: The transition might bring changes in how services are delivered, possibly introducing new models of care that emphasize efficiency and accessibility. For Patients: This will be the main topic to track Continuity of Care: Patients might experience changes in their care providers, which could impact the continuity and quality of care initially. Access to Services: Depending on the new owners' strategies, patients might benefit from improved access to a broader range of healthcare services or face disruptions if services are restructured. Cost Implications: The cost of services might increase, either due to the new ownership or decrease if efficiencies are realized. For the Retail and Healthcare Interface: Retail-Healthcare Integration: Walmart's exit from clinic operations might indicate a shift in the retail-healthcare integration landscape, with other retailers or healthcare providers reassessing their strategies. New Partnerships: This move could lead to new partnerships or collaborations between retail and healthcare sectors, aiming to combine strengths and improve patient access to care.

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Retail health as we know it is dying. Walgreens just wrote off $6 billion in VillageMD goodwill. This week, Walmart exited healthcare completely, shutting down 51 centers. Simply put, VillageMD clinics and Walmart Health tried to bring a consumer experience to one of the lowest margin segments in healthcare, thinking there was business opportunity to be had by entering primary care. Why did their grand ambitions fall apart? Operating in standalone primary care is tough. The economics are truly unsustainable, unless you're 1️⃣ incredibly lean or  2️⃣ attached to a larger enterprise with material downstream value capture. In healthcare, primary care is a loss-leader, and that dynamic needs to change. Low reimbursement is exactly why operating an independent primary care practices is tougher than ever (a big reason why firms like Aledade exist). It's why we're seeing burnt-out physicians buck traditional pathways in favor of concierge medicine or direct primary care. And it's also why the urgent care → specialty services pipeline exists within our health systems. Coming back to Walmart, here are some working theories on what brought down the retail giant: 🏥 1: Building health clinics required significant investment and staffing. Organizationally, sounds like Walmart didn't want to devote more resources to a cash-burning operation outside of their core competency. 🏥 2: Walmart was either unable to justify the cost of standing up new clinics or couldn't quantify the downstream financial impact to pharmacy, vision, or retail sales. 🏥 3: Patients probably don’t want to get primary care at Walmart for anything other than a shot, preferring continuity of service. Finally, today's Medicare Advantage challenges likely worsened Walmart's book of business from a supplemental benefits standpoint (as some insurers are cutting benefits in a tough operating environment). It's interesting, because if the Fortune 1 company wanted to go all-in on healthcare, it could. But a lack of a cohesive strategy hamstrung its efforts to provide 'everyday low prices' in healthcare. I’d expect to see similar struggles for other retailers who, out of fear of missing out, joined the retail health bandwagon over the past several years but will likewise fail to capture downstream value. In short, this is another way to say: PCPs are saints, and we need to protect them at all costs along with finding reimbursement models that work to sustain their practices, rather than fragmenting healthcare further through poorly strategized retail health initiatives looking for a quick buck. The vision was there, but the execution...not so much. Looking for even more healthcare industry news and analysis? Subscribe to Hospitalogy, my 2x/week newsletter. Join 30K+ other investors, executives, and healthcare pros: https://lnkd.in/gJ-672sC

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I strongly believe that if independent pharmacies want to stand out amidst major pharmaceutical competitors, they need to create strong community ties. One way they can do this is by offering services that go beyond simply fulfilling patients' prescriptions. A great place to start is more digital health initiatives. These digital health services -- such as telehealth consultations, mobile app prescription management, remote patient monitoring, and electronic health records integration -- can significantly enhance patient engagement and satisfaction. It can also make healthcare more accessible for people who don't have the resources to go anywhere else. Independent pharmacies, with their personalized touch and deep community connections, are perfectly positioned to adopt these innovations that can truly transform the lives of so many people in their community. #IndependentPharmacies #DigitalHealth #PatientEngagement

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The last 10 years of minimally invasive surgery has been digital. Moving forward, surgery will be both digital, and data-driven. We will be making decisions based on objective information, not just knee-jerk reactions, intuition, or feelings. I had the pleasure of discussing this to HCA Healthcare executives from around the country with regard to dV5 and the insights it offers! #surgery #medicine #intuitivesurgical #roboticsurgery

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Unfortunately, I think many DTC virtual clinics + cash-pay, mail-order pharmacies have a tough road ahead. This is all about the mismatch between the VC investment thesis (5-10x valuation increase from latest round) and what is likely a realistic exit outcome for this archetype right now. We know what best-in-class looks like for a DTC virtual clinic + cash-pay, mail order pharmacy: Hims & Hers Health worth $4.6B. They've seen strong investor interest lately, especially related to their GLP-1 compounding initiative. Hims' full year 2024 guidance is $1.20-1.24B in revenue. That represents a 3.7x forward revenue multiple. The challenge is that many smaller DTC virtual clinic + cash pay, mail-order pharmacies raised significant funding in 2020-2022 and now have high exit expectations. Once you raise significant VC funding (series a and beyond) and dilute the cap table, it's really hard to pivot to a sustainable, cash-flowing business. For example, after an angel, pre-seed, seed, and series a round, the founders may own ~50% or less of the company. By this time, there's already a formalized board in place with $1B+ exit expectations. Now if we were talking about DTC skin care, frozen food, or clothing, there's a tried and true pathway to exit the business to a $100B+ conglomerate CPG brand for 8-9 figures like Unilever, P&G, PepsiCo, Nestle, LVMH, or Coca Cola to name a few. The problem is that unlike traditional CPG, DTC health is much smaller and younger. Instead of P&G (worth $398B) or Unilever (worth $143B), the largest acquirer may be Hims at $4.6B. And now that Hims is publicly traded, they may prefer an acquisition that is net income accretive at a reasonably low multiple (1-2x revenue). And they also would have to believe it's not a product/service they could do internally. The $100B+ players in healthcare like UnitedHealth Group, CVS, McKesson, or HCA don't appear to be interested in acquiring niche DTC virtual clinics + cash pay, mail-order pharmacies at this time. Especially hard when their cash yields 5% risk free and the market optimizes for earnings per share. DTC is not their core business and given their mature revenue scale, adding 8 figures of revenue does little. Now the holy grail for these DTC virtual clinics + cash pay, mail-order pharmacies is either a) go public; or b) get bought by a consumer juggernaut that likes healthcare (aka: Amazon). The only issue with Amazon is given the recent dept consolidation news, seems like they're still digesting PillPack and One Medical. The other option of IPO'ing is hard because bankers want to see a $1B+ valuations. If we use Him's 3.7x forward revenue multiple, another DTC virtual clinic + cash pay, mail-order pharmacy needs ~$270M annualized revenue w/ similar margins. That's brutally hard to achieve that scale when growth-stage private funding has dried up for DTC. But this is just my two cents. And I could be wrong, wouldn't be the first or the last time. Thoughts?

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Many will see Walmart’s exit from direct care as yet another indication that #healthcare is an endeavor that requires domain expertise not easily replicated by retail or technology leaders. On some level this of course is true, but I believe another less obvious, but equally important factor must be considered. Effective and highly successful #healthcare organizations and operations build on and draw from, deep community-based provider relationships that are not easily created with a big-box approach. Fierce Healthcare https://bit.ly/4bgfyaS

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🚨🚨 Thoughtful Analysis Alert 🚨🚨 Why are we seeing significant pullbacks in healthcare services from major retailers like Walmart and Walgreens. This strategic shift underscores the real challenges in healthcare delivery today. Our latest blog post talks about why these pullbacks are happening, the implications, and more. #HealthcareInnovation #RetailHealthcare #StrategicInsights #HealthcareTrends https://lnkd.in/gfW5aX3n

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Please review this important perspective from #jeffreyhogan concerning health care costs and quality of care. Worth a few minutes of your time. #ceo #chro #cpo #cfo #ericbrickermd

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I took on two different independent pharmacies as clients recently, both needing help to implement a 340B contract pharmacy relationship with a local covered identity. This relationship is not without risk for the contract pharmacy— The terms of the arrangement are important to get right. Properly implemented, these are synergistic relationships where an independent pharmacy is a true partner in caring for mutual patients. #340B #pharmacy #healthcare #340Bprogram #pharmacy #pharmacists https://lnkd.in/gQnR6imG

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There are many versions of corporate primary care. It's not the "corporatization" that distorts primary care and robs it of its inherent value. Corporations can infuse desperately needed cash into primary care and provide infrastructure and human capital that enhance and empower primary care but would otherwise be unaffordable. But the incentives absolutely have to align. If there is an upstream revenue agenda that is contradictory to or a higher priority than what's happening between the patient and their primary care team, it will be a money pit, every time. That's not what primary care is for. When corporations understand that the purpose of primary care is to improve health and wellbeing and drive down total cost of care, and they align their incentive structure to ensure everything is designed to make that primary care team and their patients successful, they can be successful too. Nice work by Sara Pastoor, MD, MHA, FAAFP and Andrew Carroll in this piece for MedCity News ⤵

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