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In Fort Wayne, CVS is well known for its MinuteClinics, filling prescriptions, not selling tobacco, and being next door to Walgreen’s. But according to The Economist (…/21730906-vertical-integration-c…), the pharmacy world is suddenly in a froth because of Amazon’s proposed entry, because Anthem sued Express Scripts unveiling plans to start its own PBM (Pharmacy Benefit Manager,) and because a proposed CVS/Aetna pairing would offer, by way of the vertical merger, increased data analytics–a combination medical file and pharmacy records that would allow for tracking of how medications are taken and whether they work well. But, would the consolidation benefit patients or merely fatten profits?

What this means in Northeast Indiana:

– CVS has 14 locations in Fort Wayne; three with Minute Clinics. At least 154 Indiana towns have a CVS pharmacy. It is not difficult to see how walk-in clinics would spread.

– With a shortage of primary care, in particular in rural areas, will the Minute Clinic model take the place of the family physician?

– Nurse practitioners and physicians may be the choke point; CVS is hiring nurse practitioners for 27 openings in Indiana.

– Minute Clinics are likely to get a boost from recent insurer refusals to pay for an Emergency Room visit. This article was featured locally in Fort Wayne:…/emergency-insurer-makes-patients-qu…

– What’s in a name? Both Parkview and Lutheran systems offer freestanding emergency rooms. The ER designation allows for greater facility charges per encounter than walk-in clinics. For many problems involving a variety of discomforts, treatment at either location may be the same, but without knowing the diagnosis, how is a patient to know which is insured?

– Patients will become educated about the financial risks of assuming that ER services will be paid by their insurer. It is likely to be a painful process that favors the growth of Minute Clinics and walk-in clinics offered also by groups of independent or hospital-contracted physicians. But the greatest benefit will accrue to those clinics that can integrate electronic medical records with pharmacy management while offering convenient care.