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On a weekday morning before work, a pharma executive, a busy student, and a small business owner all walk into a CVS — not for toothpaste or prescriptions, but for a primary care appointment.
With a proposed partnership between Mass General Brigham and CVS that will transform CVS’s retail walk-in clinic MinuteClinics into primary care centers, the scene is not far-fetched. Proponents of the project say it will increase access to low-cost medical services throughout Massachusetts. But some experts are skeptical of the claim, citing the lack of detail in the plan’s logistics.
“If MGB is committed to better primary care access around the state and rural areas, not sure that partnering with CVS is the way to accomplish that,” said Paul Hattis, a senior fellow at the healthcare think tank The Lown Institute.
“It’s nice to have more primary care. But what price are we paying, including additional health care spending?” he added.
The preliminary plans for the MGB and CVS partnerships were filed with the Massachusetts Health Policy Commission in June, against the backdrop of a continuing primary health care crisis in Massachusetts.
Amid an ongoing shortage of primary care doctors across the state, MGB announced in November of 2023 that it would not be accepting any new primary care patients. In April, the HPC established a task force aiming to “stabilize and strengthen” primary care.
An MGB spokesperson wrote that the partnership will expand access to primary care providers “across the Commonwealth,” especially to regions with provider shortages and overwhelmed emergency departments.
“Each clinic will increase capacity and access to low-cost care for adult patients statewide,” MGB wrote.
The 37 urgent care centers currently operated by CVS would be transformed into MinuteClinic Primary Care centers, and join MGB’s Accountable Care Organization.
But the primary care affiliation will not include the hiring of additional staff, and MGB will also not be investing funds into the partnership. Since the 37 Massachusetts MinuteClinics are currently staffed largely by nurse practitioners and physician assistants, critics are concerned that there would be insufficient staffing and training to support the scope of providing primary care services.
State Senator Cindy F. Friedman, co-chair of the Health Care Financing Committee, said that primary care is more time-consuming, complex, and requires more investment from practitioners than urgent care.
“It’s early in the CMIR process and we cannot speculate about the future and if the MinuteClinic primary care model would change,” CVS wrote in a statement to the Crimson.
Friedman added that providers will have to place more referrals because “you don’t have any team system around you to look at things that aren’t straightforward urgent care.”
“The goal of this partnership is to keep care local to the patient,” MGB wrote in a statement to the Crimson, noting that referrals would align with local hospitals and healthcare systems, which need not be MGB affiliates.
“MinuteClinic affiliations with select health systems helps patients access hospitals, specialists and diagnostic facilities, when needed,” CVS wrote of the partnership.
Michael Barnett, a primary care physician at Brigham and Women’s Hospital, said that he believes the partnership doesn’t actually address any of the core issues around primary care in the state.
“I’m worried it’s a way for MGB to optically appear to be investing in primary care while actually doing very little,” Barnett said. “This does nothing to really address the fundamental workforce challenges that we have, especially in eastern Massachusetts.”
“What we need is more capacity and a more robust private care system,” he added.
MGB wrote that the partnership is “intended for MinuteClinic sites in areas that lack traditional primary care access,” particularly across Western Massachusetts. According to CVS, an electronic health system will give patients access to “MGB’s extensive resources and coordinated care.”
In May, MGB also announced a $400 million investment into primary care, which will include adding support staff, piloting AI tools for primary care physicians, and appointing a chief of primary care, but does not explicitly mention addressing the supply of primary care doctors in the state.
Other experts are skeptical about the viability of the MGB-CVS primary care clinics given the failures of similar structures in the past including the Village MD clinics at Walgreens and Walmart Health.
“Patients generally have not wanted to go there for primary care,” said Ateev Mehrotra, a professor at Brown University who researches retail clinics. “They generally have preferred to go to primary care clinics for primary care, and to go to these retail clinics for the simple stuff.”
CVS wrote that they have seen “strong” results and patient enrollment since launching MinuteClinic primary care in November of last year. The service is currently offered at MinuteClinic locations across 11 states and Washington, DC.
Mehrotra said that MinuteClinics would likely need to change the nurse practitioner model to achieve sustainable success with primary care services.
“People want to see the same clinician,” he said. “They’re going to have to do follow-up appointments and scheduling, so that’s just going to be a bit different.”
But he conceded that the retail clinic model could look different this time, as the MGB brand adds credibility to CVS MinuteClinics.
“I think that will be attractive to people being like, ‘oh, maybe this is a place I could go,’” he said.
The proposal is currently under review after the HPC voted in a meeting last Thursday to conduct a full cost and market impact analysis.
David Seltz, the HPC executive director, said the vetting process will ensure that the proposal meets the goal of delivering high quality and affordable primary care to Massachusetts residents.
—Staff writer Stephanie Dragoi can be reached at stephanie.dragoi@thecrimson.com.
—Staff writer Thamini Vijeyasingam can be reached at thamini.vijeyasingam@thecrimson.com. Follow her on X @vijeyasingam.
