Exclusive Q&A: Walmart Health SVP David Carmouche, MD

Expert InterviewsFuture of the Industry

In late 2021, we had the opportunity to sit down with Dr. David Carmouche, Walmart Health SVP of omnichannel care offerings. Today, The Scope is excited to bring Dr. Carmouche back for a follow up on Walmart Health’s growth as well as his unique perspective as a provider and leader on the changing state of value-based and ambulatory care.

What has been your biggest accomplishment in your first year at Walmart?

2022 was a big year for Walmart Health. We continued to increase the physical and virtual footprint to bring quality and affordable healthcare to the communities we serve. In my first year, my incredible team opened 8 new Walmart Health locations across Arkansas and Florida, integrated Epic’s EHR system into our centers, and we began a 10-year collaboration with UnitedHealth Group and Optum to deliver value-based care to select senior populations.

This momentum continues, with 17 new Walmart Health Centers set to open this year in the Sunshine state. We’ve just announced that we’ll grow again in 2024 with 28 new locations, deepening our presence in Texas and expanding into Arizona and Missouri.

More important than the headline-grabbing physical location growth announcements, I’m proud of the growth in the associates and providers on our Walmart Health teams – both in our Home Office and at our health centers. We have recruited excellent talent and nearly every day I hear stories about the ways our team members go above and beyond to help our patients live better and healthier lives.

What surprised you the most about the transition from a health system to the largest retailer in the world?

I came to Walmart after having spent my career working in a variety of different parts of healthcare – on the frontlines in clinic, at a hospital system, within an insurance company. In each role I saw well-intentioned teams working hard but making marginal progress at best when it came to tackling the thorniest issues that plague American healthcare – affordability, access, coordination, and social determinants of health.

90% of the U.S. population lives within 10 miles of a Walmart and for many rural communities, we can serve as an entry point to care. It was my great hope that coming to Walmart would enable me to be a part of a larger shift in transforming care delivery. And I’m seeing it come true!

On the local and daily level, we’re delivering longitudinal care in our centers and opening up avenues to care for populations who have long-needed access to affordable dental, behavioral health, and primary health care. And through our Social Determinants of Health work, we’re working on true solutions to make care more equitable for everyone who needs it. I’m truly energized by my work in a way that I haven’t been in quite some time.

What do you see as the greatest benefit to providers under Walmart’s approach?

I’m so glad you asked this, because as a former practitioner, I know that without well-trained, compassionate healthcare providers, there is no way to deliver true value. Our compensation structure is competitive, but the two aspects of working at Walmart Health that are especially rewarding are the modern equipment and technology in each of our centers and our team-based approach to care. We don’t just talk about working in a team, it’s how our centers are designed – getting doctors out of individual offices and in with the care team.

At Walmart, we can offer unique patient experiences, and our providers see this come to life on a daily basis. A patient with diabetes can see the provider in the morning, walk out of the Walmart Health center with a community health worker over to the grocery area to learn how to make healthier food choices, and stop by the pharmacy to fill prescriptions…all in a single visit. This environment enables providers to manage chronic disease, as an example, in very different ways.

Where are you spending the majority of your time right now given all the different opportunities available?

The greatest innovation we need in healthcare right now is finding new ways to help people access quality healthcare in an equitable manner, which is where I am focusing my efforts. My biggest goal is to grow our true omnichannel capabilities, both in-person and virtual care. We are hyper focused on providing more communities with affordable, quality healthcare.

Can you tell us a little about how value-based care is at the foundation of Walmart’s healthcare strategy?

We believe that value-based reimbursement aligns the interests of patients, providers, and payers. At Walmart Health, we view our job as helping patients achieve their maximal health and well-being. In lieu of being reimbursed transactionally, we prefer to use global payments to create the incentives we need to deliver the right amount of care required at the right place and time. We started this journey through a collaboration with Optum to deliver value-based care to Medicare Advantage members, and we will look to expand this care model and payment model to many more customers over time.

Follow up: Has the announcement of ACO REACH and its opportunities and limitations shaped your long-term planning?

We are excited to see the changes announced to the ACO REACH model given our strong belief that attention to health equity and under-served populations should be part of any governmental payment model. Value-based care models need to take equity-focused approaches to reduce and eliminate disparities in health care. Walmart focuses on whole person health which requires us to help solve health equity challenges and influence social determinants of health to assist patients in achieving their health goals.

What will change the most in healthcare as we know it in the next few years?

I’m biased, but I think you’ll see retailers like Walmart becoming a go-to source of care in the community. I believe we have the right strategy, tools, and resources to win if we continue to do what we’ve always done: listen to what our patients and customers ask of us and deliver – rapidly. It’s this intense focus on our customer’s problems that will allow Walmart and Walmart Health to continue to craft solutions that deepen the trust our patients have in us.

On a local level, I think we’ll see true focus on better supporting underserved communities. Last year, Walmart and Medscape released the Healthcare Providers (HCPs) Perspectives on Health Care in Rural America. The survey showed that rural healthcare professionals are more likely to say healthcare in their communities is low quality than they are to say it is hard to access. This is notable as access is typically considered the biggest barrier for rural healthcare. Walmart is committed to innovating community by community to become the front door to access healthcare and to help make quality healthcare more accessible and affordable.

Finally, I think technology and data will facilitate the continued transformation of care delivery in this company – not only disrupting the traditional sites for and methods of care, but also allowing for increasingly personalized and lower cost care options.

Even though Walmart is the largest retailer in the world with vast resources, what challenges has it faced entering the healthcare industry?

It seems obvious to say, but healthcare is hard! It’s also local, and we are determined to ensure we’re meeting the varying needs across communities while keeping costs down for patients. That’s why you’ve seen us grow in a smart way. Walmart Health is going into communities at an intentional pace where we know we have a strong presence, strong community ties, care gaps or a growing population.

One final thing that is always top of mind for me is recruiting and retaining the best providers and care teams. You can’t deliver high quality care with a team that suffers from burnout. That has not been a challenge, but it could be if we ever take our eye off the ball. Bringing in and keeping a talented team is the foundation of delivering the level of care our patients demand and deserve.

Our thanks to Dr. Carmouche and Walmart Health for the opportunity to reconnect and discuss the changing state of healthcare across the country.