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Forward-looking supermarkets are taking the next step toward turning their stores into whole health destinations.Health clinics, usually run by outside companies and staffed by nurse practitioners, are finding a place alongside the pharmacy in more stores across the country. Besides adding traffic and contributing to sales in the pharmacy and over-the-counter categories, such clinics directly contribute

Forward-looking supermarkets are taking the next step toward turning their stores into whole health destinations.

Health clinics, usually run by outside companies and staffed by nurse practitioners, are finding a place alongside the pharmacy in more stores across the country. Besides adding traffic and contributing to sales in the pharmacy and over-the-counter categories, such clinics directly contribute to the environment of whole health, tying together wellness and food as only a supermarket can do, retailers and other experts told SN.

"We don't have year-round in-store medical clinics yet, but we are looking into that," said Martha Johnson, director of clinical services and marketing, Ahold USA, Braintree, Mass.

"Whole health is a huge trend, particularly for the grocery store model. We have food, which is such a strong component of wellness, along with pharmacy, which more obviously plays a big part," she said.

"This is a deeper penetration into the health care market, and it certainly fits in with the concept of whole health that we have been talking about over the last several years," said Roy White, New York-based vice president, education, for the GMDC Educational Foundation, Colorado Springs.

"What we have here is something that I am assuming not only has the opportunity for disease state management, but also to work actively with pharmacy customers in helping them maintain their health. Long term, I see this as something that might help make the store much more of a whole health center than was ever the case before," White said.

Still in the earliest stages of development, the clinics have been embraced by a number of major drug chains, including CVS, Rite Aid, Longs, Duane Reade and Albertsons' Osco, as well as mass merchandisers Target and Wal-Mart. Supermarkets with the clinics include Giant Eagle, Kroger, H.E. Butt Grocery, Albrecht, Supervalu's Cub and Scott's stores, and a Fresh Brands Piggly Wiggly.

Although some of these health clinics have existed for several years -- Cub Food stores in Minneapolis were among the first more than five years ago -- most have been added in the last year.

Giant Eagle, Pittsburgh, has one Family Express Care clinic, which opened in February in a South Euclid, Ohio, store. "This facility allows us to offer customers a convenient means to get quality health services -- evaluations, diagnosis, treatment -- related to common everyday ailments," said Brian Frey, a spokesman for the retailer. "Medical referrals to physicians are made for all patients requiring additional care."

Frey would not disclose whether Giant Eagle plans to expand the concept, saying that the chain is monitoring its performance and customer demand.

Most of the executives interviewed by SN for this story -- many at the recent HBC Marketing Conference of GMDC in Orlando, Fla. -- either praised the concept or said their companies were actively looking at it.

"Those clinics provide a major advantage to our shopper," said a nonfood executive with a major Southeastern chain. "We have been looking at it for the last six to nine months and we think it has great opportunity and promise."

"There is potential and opportunity because I see the health care dollar growing as time goes on," said Gary Crawford, director of nonfood operations, United Supermarkets, Lubbock, Texas. United already runs screening programs for conditions like blood pressure and cancer, "so why not get involved in something like [the in-store health clinics]," he said.

Wild Oats Markets, Boulder, Colo., has its own version of these health clinics in three Oregon stores, noted Steve Davis, vice president, holistic health. Those stores have licensed naturopaths, an official designation for a practitioner qualified to assist patients through the application of natural remedies. This is a long-established program in Oregon, where there is demand for naturopaths, he said, but the company has no plans to implement the program elsewhere.

One issue that can impact the success of the nurse-staffed clinics is location. Ideally, they should be positioned near the pharmacy, but store configurations can work against that. Some have been relegated to remote areas of the store or poorly signed offices, while others have elaborate kiosk-style designs.

Stores with a high pharmacy volume and available space are best suited for the clinics, said Curtis Maki, vice president, program management, HBC/GM/Rx, Topco Associates, Skokie, Ill., a private-label distributor. "Those chains that are willing to delve into it and be ahead of the curve are going to have an advantage in the marketplace. It is when stores do major remodels, or when they are building new stores, and they can plan on having the space in there, that it makes sense," he said.

Acceptance of the clinics also will vary by store location. "It makes sense for retailers to have clinics and to become a place for health information and products," said Curtis Hartin, director of pharmacy, Schnuck Markets, St. Louis. "However, it does not make sense for every store. I'm sure there are certain neighborhoods where it won't go over."

Another issue is promotion. The supermarket clinics opened so far have been limited to a handful of stores, making wide-scale advertising unfeasible. Like many other supermarket tests, the clinics may not be promoted heavily enough to be very successful, and then not expanded because of that lack of success.

Some Ahold USA chains have promoted health screenings as gift-giving opportunities for an older family member, noted Jim Wisner, president, Wisner Marketing Group, Libertyville, Ill. For instance, breast cancer screenings have been promoted with free greeting cards indicating the prepaid test.

The same thing could be done with health clinics, especially at times like Mother's Day, Father's Day and Christmas. "What you have in terms of this service is

a different form of a consumer good, but one that really is more significant and as a gift item, says something far more important than the typical kinds of things that you buy in a store," Wisner said.

Providers of services for these nurse-staffed health clinics range from established health care providers to companies that have been starting to address this new market opportunity. For example, Family Express Care is based in the Cleveland area and the Giant Eagle location was its first location. The RediClinics in five H-E-B stores and two Wal-Mart Supercenters, are part of another company called InterFit Health in Houston. The Little Clinic, Louisville, Ky., is so far opening clinics in the local Kroger division, while MinuteClinic, Minneapolis, has 40 locations in Cub, Target and CVS stores.

The leased in-store space will vary, ranging from 100 square feet or less to over 500 square feet. Fees for typical visits are usually $40 to $50, with some screenings or vaccinations costing more. The nurse practitioners usually treat common ailments like strep throat, do health screenings, or provide physical exams such as those children would need for sports programs.

Research done by MinuteClinic has proved the value of the clinics to the host retailer, said Linda Hall Whitman, chief operating officer. In a poll of 3,000 patients, 100% said they came specifically for the clinic, and 95% filled their prescription at the store pharmacy. In addition, 50% of the patients said they bought general merchandise while in the store and 30% to 40% purchased an OTC product, she said.

"This kind of clinic brings additional foot traffic to any retail host. No one is shopping and all of a sudden remembers they might have a bladder infection," Whitman said.

Kroger Adding Health Clinics

CINCINNATI -- The Kroger Co. here is increasing the number of in-store health clinics staffed by nurse practitioners and run by the Little Clinic, Louisville, Ky.

The chain had two such clinics at the beginning of the year, has added three more since then -- two last month -- and plans two more by the end of the year, according to a spokesman for the Little Clinic. Kroger did not respond to calls for comment.

So far, three of the clinics are in Louisville, one is in Lexington, Ky., and another in Richmond, Ky. Clinics in Jefferson, Ill., and Carbondale, Ill., will open in the next two months, the spokesman said.

"Currently, we are in one of Kroger's divisions," Bruce Peacock, chief executive officer, the Little Clinic, told SN. "A year or two from now, we'd like to be in stores in all of their divisions and providing a positive experience to their customers as part of the continuum of health."

The clinics treat common family illnesses, he said. "We also provide family wellness care, meaning health screenings, physicals and vaccinations."

Peacock does not see the clinics as taking the place of a patient's regular doctor, and the clinics cannot require patients to use the in-store pharmacy. "Our arrangement is an arm's length, fair market value lease arrangement. If the customer chooses to get their prescription filled at Kroger, that's terrific, because we certainly think the pharmacies in the Kroger stores are first class. But there is no requirement for the customer to have their script filled within the host retailer's store," he said. -- Dan Alaimo

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