Walmart Could Magnify Americans’ Access to Healthcare — With the Help of Key Startups

The world’s largest company could help “decouple healthcare from where it’s traditionally received,” says Director of Healthcare Innovation and Strategy Evan Schnur

StartUp Health Feb 4 · 7 min read

In the era of social distancing, a doctor’s appointment looks a little different than it did a year ago. But Evan Schnur, Director of Healthcare Information and Strategy at Walmart, says the experience will continue to evolve, even after in-person visits resume. Schnur trained as a pharmacist and currently leads the development of the growing range of healthcare services at Walmart Health, which now include primary care visits, diagnostics, and dentistry. The massive scale of the world’s largest company by revenue offers new avenues for prevention and treatment that could shatter the paradigm for medical care. In a recent StartUp Health Fireside Chat, Schnur explained what that future might look like and why healthcare startups might play a key role.

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Was there a moment when you were working as a pharmacy intern where you saw a pain point or problem that inspired you to take another route towards innovation and strategy?

I think it’s so many of the problems that we all see every day within healthcare, whether it’s the fact that I still sit at the computer and send tens of faxes every day, or the problem with someone’s insurance coverage. It’s one thing to impact one patient at a time at the counter — which is ultimately where a change happens — but being able to have a broader impact across many outlets is really what drove my personal passion for what I do today. I think that the turning point for me really was just the first few months of working with patients and loving that interaction, but seeing how much more impact you could have when you take it beyond the four walls of that location.

Walmart operates more than 11,000 stores, employs more than 2.2 million people, and serves hundreds of millions of people per week. Obviously the opportunity for impact there is enormous. What are some of the challenges when you’re thinking about strategy at that size?

I think some of the biggest opportunities are around the fact that there are so many different places that could try to make a difference. And so it’s really an opportunity around focus, number one. Then I think the second part is where we really value partners because sometimes we look to the outside to help find the right idea of the scale. So it’s a combination of those things. Because we could do everything. But the ability to execute on the right few is always something that our team strives to think about and to work on.

I think some of the biggest opportunities are around the fact that there are so many different places that could try to make a difference.

It’s frequently cited that 90% of Americans live within 15 miles of a Walmart. The idea of access and being able to reach individuals is a huge issue for the company and a major health moonshot that we’re focused on here at StartUp Health. Given your access and reach, how would you characterize the importance of Walmart in healthcare, and what gets you excited about your ability to reach into the community and increase that access?

Access is such a huge part of what we focus on, think about, and believe we can improve, so I’m excited about the correlation between your moonshots and that focus on our end. To me, I think about it in terms of a loyal shopper. That shopper, on average, is in the store two times a week, maybe more. Sure, that might look a little bit different right now, but generally a couple of times a week. When you think about how often someone interacts with the healthcare system, thankfully, for the most part, it’s less than two times a week. But how do you marry those things together to really bring access to, especially, preventative care, and put it in the workflow of a consumer’s life? I think that that’s the opportunity that we see and where we really think we can truly make a difference.

In the interim, as we work to get there, what are the things that we can be doing to figure out what customers really like? What are the things that make them want to do it, want to engage, want to get the screening? For example, we’re, we’re testing some stuff within the musculoskeletal space right now with a partner. Part of that is helping people measure their movement age, and we’re creating this opportunity for folks to come in and say, ‘Hey, am I getting better or not?’ Things like that make our customers want to come back, want to engage. And ultimately that really drives the access. So carrying it back to where we started: We see them two times a week, and in a small rural community, on average, we’re seeing as many unique people in that store every week as live in that town. That’s a huge impact you can have on the community.

Did COVID-19 change your thoughts or strategies around access and what that looks like in the store?

We’re continuing to learn every day as everybody is, but we learned a lot early on about folks’ comfort levels. They were coming to see us to buy their groceries, so they might’ve been more comfortable getting their healthcare from us than going into a more traditional facility. Those things are anecdotal; we’re still relatively small in the healthcare space. But we feel pretty good about what we observed and about our customers’ and patients’ willingness to come and engage. The other thing that we’re excited about is how to decouple healthcare from where it’s traditionally received. Of course, we’re all talking about that in the virtual sense. But what’s the physical nature of that? Things like diagnostics. We’re really excited to watch that over the next few months here as people start to behave differently in how they get their care.

Access is such a huge part of what we focus on, think about, and believe we can improve, so I’m excited about the correlation between your moonshots and that focus on our end.

Oftentimes when we think about health innovation, it is within the four walls of a clinic or a doctor’s office or a specialist’s office. You’ve got the Walmart Health clinic, and then you’ve got the Walmart Superstore. When you’re thinking about innovating the patient experience, how much of that has to do with the holistic experience or the things that they’re able to buy after their visit that have to do with their health?

I think that holistic health experience is really critical to what we’re trying to build. When you go to a Walmart, whether there’s a Walmart Health there or not, you make tens if not hundreds of decisions related to your health. It starts in the parking lot. How far away am I going to park? Can I get my steps in today because I’m in the back row? Obviously, it translates right up to the shelf where I’m deciding between a sugary breakfast cereal that might be a good treat or something that is a healthier option. We continue to make those choices throughout that journey. So if you think about how we might be able to influence those choices by just making people think more about their health while they’re there, I think that alone could create a lot of value. Then — putting my provider hat on — having all those resources for my patients literally within sight of where I’m delivering care is a really exciting proposition and one that our providers get pretty excited about as they take care of our patients.

Tell us about how Walmart works with innovative startups. What does that look like when you’ve got small companies and a giant retailer?

I think because we have a relatively small footprint in health right now, there is an opportunity still to think pretty small and think about partners independent of size. There are some things that are important in terms of the life cycle of a company — especially for things that need approvals and things, we’re pretty conservative on where we’re going to engage within that cycle. But generally speaking, we aren’t overly concerned. What is important to us is outcomes. If you are a company that’s delivering something on the clinical spectrum, having really good outcomes, we need to be able to see that data. We’re probably not the best partner to help you go find those outcomes for the first time, but we’re happy to engage once those results come through. Aside from that, working with any big company does take a long time and sometimes it may feel tough, but know that we’re a team of folks who are really committed to solving some of these pain problems. I think we find a lot of opportunities when we find like-minded entrepreneurs and innovators, and we can find ways to work together in the clinics.

We’re also trying to be more nimble in this space. We recognize that we’re not going to come up with every innovation that occurs in the Walmart Health center of the future. We need really smart folks like you to help us get there. And so we’re always trying to be more efficient and find ways in which we can partner.

I think we find a lot of opportunities when we find like-minded entrepreneurs and innovators, and we can find ways to work together in the clinics.