Your Neighborhood Walgreens ACO

Two-hundred-and-fifty-nine organizations have been named Medicare accountable care organizations. Most were formed by hospitals. Some were launched by physician groups.

And three were created by a pharmacy chain.

Walgreens’ move into shared savings is many things: unusual, eye-catching, a sign of the times.

But it’s not surprising, observers say, as the pharmacy chain has been cultivating a broader strategy to ramp up its role in frontline care.

And through a handful of new programs, Walgreens already has “demonstrated … the valuable role our pharmacists can play working with physicians to meet the triple aim” of improving patient outcomes and satisfaction while cutting health costs, spokesperson Jim Cohn told me. “ACOs are the next step.”

Walgreens’ path toward frontline health services began in 2006, when the chain launched its first in-store health clinics, staffed by nurse practitioners who treated walk-in patients for the common cold and other ailments. Walgreens now has more than 700 of these clinics.

Walgreens subsequently began redesigning its stores to bring pharmacists out from behind the counter to sit at open desks and offer medication consults. Last year, Walgreens launched WellTransitions, a program designed to reduce hospitals’ readmissions rates by sending medication lists to a patient’s primary care provider, performing medication reviews for partner health systems and delivering other services related to drug therapy.

Meanwhile, the perception of pharmacists has been changing — partly because of Walgreens’ efforts, partly because of underlying changes in healthcare.

Increasingly, pharmacists are being deployed at the point of care at integrated health systems like Kaiser Permanente, to perform medication therapy management — assessing a patient’s current drugs and interactions — and personalize a medication care plan.

But for all of their advancements in supporting care delivery, pharmacists can’t offer diagnoses or actually prescribe medicine. And they are not recognized as providers under current law.

Given these limitations, Walgreens — which was eying opportunities to have a foothold in the ACA’s shared savings program — needed partners to actually launch its ACOs.

The chain will partner with a physician group in New Jersey to create Advocare Walgreens Well Network and a Florida-based clinic to launch the Diagnostic Clinic Walgreens Well Network. The company also has teamed up with a Texas-based health system to launch Scott & White Healthcare Walgreens Well Network.

The new ACOs will draw on Walgreens’ accessibility: Unlike doctors’ offices, the chain’s pharmacies are open every day of the year and some of its locations are around-the-clock. Walgreens locations also can provide basic services such as transitions of care, medication adherence management, immunizations, and health screenings, Cohn told me.

It’s telling that most of Walgreens’ coordinated-care efforts, to this point, haven’t been expected to produce much revenue for the chain. And given the ACA’s restrictions, it’s still unclear how or if pharmacists can be financial participants in ACOs.

So why is Walgreens getting into this new market?

There’s some speculation that it wants to move away from traditional retail pharmacy distribution. And the chain had an occasionally difficult 2012. In one troubled period, its haggling with Express Scripts, one of the nation’s largest pharmacy benefit managers, prompted Express Scripts to send its customers to CVS and other Walgreens’ competitors for nine months.

Regardless, the Affordable Care Act means that there will be new opportunities for the chain to participate in the nation’s health system.

Dan DIamond is a contributing editor for California Healthline, where a longer version of this article originally appeared here.