The Retailization of Mental Health in Urgent Care Has Begun

The creation of urgent mental health care in retail locations isn’t coming, it’s already underway.

Huge players in the retail and health care space have already built a foundation for themselves to make mental health care more accessible. Over the last 20 years or so, urgent care blazed a new retail-like trail for physical health care access — and these same players have mental health in their sights.

“Those with mental health challenges can’t wait,” Dr. David Kim, co-founder and general partner of Regal Healthcare Capital Partners, told Behavioral Health Business in an interview. “If you have an acute break, you don’t have 24 days to wait for a clinician.”

Pre-pandemic, one study found that the wait time to see a therapist for an initial assessment was 25 days. The problem of access to mental health care has been a defining feature for years and an alluring problem for innovators to solve.

Kim, an operational engineer turned emergency room physician turned entrepreneur and investor, made his career in building new levels of access and convenience into health care settings.

In 2007, he founded Premier Care Urgent Care in New York, an early entrant in urgent care in the Northeast, which merged with CityMD in 2013 and grew from 600,000 annual visits to about just under 1.4 million when he left the company in 2017. He also helped found the seven-day-a-week, walk-in friendly dental practice Dental365 in 2014: It now has over 70 locations.

Most recently, Regal Healthcare Capital Partners invested $20 million into MIND 24-7. Founded in May 2021, MIND 24-7 provides urgent behavioral health care at all times and accepts all patients. The company recently opened its third location in the Phoenix area.

MIND 24-7 is an urgent care location for behavioral health services that include express care, crisis services, 23-hour observation, intensive outpatient and partial hospitalization programs.

“As you start to step back and say, ‘Okay, what really is needed now? Where’s there limited access?’ You would say, ‘You know what, mental health is one of those areas where there’s just such limited access.’”

MIND 24-7 embraces the access element of retailers and urgent care. The company even operates out of a former Walgreens for one of its three locations. Kim contends that companies like MIND 24-7 have a bright future given the demonstrated success of the urgent care model.

Kim was optimistic about the future of any provider that’s able to bring retail-like access and ease to behavioral health and that this segment of the industry is several years away from reaching maturity.

Retailers cemented retail-like walk-in urgent cares

The key driver behind urgent care is the retail-like access to care. In doing so, they opened up a level of care between the doctor’s office and the emergency room.

Retailers jumped on the urgent care model as a means of integrating more into customers’ lives. Retail pharmacy chain and insurer CVS Health Inc. (NYSE: CVS) got into providing express-access clinics through a partnership with a company called MinuteClinic in 2006. Today, CVS operates just fewer than 1,200 MinuteClinics in its 9,900 retail locations. And the company plans to convert about 300 existing locations into CVS HealthHUB, a more sophisticated primary care offering than MinuteClinic.

HealthHUBs, which launched in 2019, offer mental health services through regular in-person or telehealth visits with therapists. CVS said that it had planned to have 1,500 HealthHUB locations in operation by the end of 2021.

In March, Behavioral Health Business reported that CVS was rolling out a behavioral health pilot program in HealthHUBs in 34 markets. The company also saw 8 million virtual behavioral visits in 2021 according to an investor presentation last year.

“Right now, this is an in-person service, but we are building out the exact care to be virtual as well because, with the pandemic, not everybody wants to come into a HealthHUB,” said Cara McNulty, the president of the Aetna Behavioral Health and Employee Assistance Program last year. “We’ve had an unbelievable increase in the utilization of our virtual care offerings. So we’re building this both for brick and mortar, in-person care and virtual care, to meet the needs of the consumers and patients.”

Cincinnati-based Kroger Inc. (NYSE: KR), which made the jump six years ago, offers mental health services through its in-store Little Clinic locations. Walgreens is in on the game too by partnering with telehealth providers and national nonprofit Mental Health America.

Another retail titan, Walmart announced in February 2020 that it’s partnering with Beacon Care Services, a subsidiary of Boston-based behavioral health provider Beacon Health Options and planned to offer counseling services for $1 a minute. A little over a year later, Walmart Health also announced it was buying multi-specialty telehealth provider MeMD to provide, among several other things, a seamless experience for mental health services.

Walmart runs locations in Arkansas, Georgia and Illinois and staff at these sites include behavioral health professionals, according to the company’s website.

Retailers massive branding power may expand mental health’s reach

Still, new entrants into the nascent urgent behavioral health movement, or even traditional providers, have to contend with the retail and its incredible reach within communities.

CVS alone accounts for about 9% of all of the stores among the nation’s 50 largest retailers, according to trade publication Super Market News. The combined footprint of CVS, Walgreens and Kroger — retailers mentioned here — accounts for over 27,000 stores or 24% of all locations.

While retailers have made moves, it’s the response by consumers that makes the case for these organizations to do it.

“I think the awareness can just not be understated — of consumers knowing that they have options in behavioral health … Another major change is the ability of CVS or Walgreens or others to push the service or create that awareness,” Tim Epple, managing director of advisory services for Avalere Health, said during an interview with Behavioral Health Business.

Retail pharmacy retailers like CVS and Walgreens already have high visibility and interaction with a health care-seeking public through their pharmacy businesses. They also have reach into people’s lives as mini-grocers as well. All of which points to meeting consumers’ daily needs.

And that’s what CVS wants. Speaking during the company’s 2021 annual earnings call, CVS CEO Karen Lynch said: “CVS Health is becoming a bigger part of their everyday health.”

The deeper intrusion of big retailers in behavioral has the capacity to expand the base of people seeking behavioral health in the first place, generating even greater demand for behavioral health services.

However, the model still needs to be proven as a way of increasing access, improving care or diverting and lowering costs.

“I think it has started to solve some of the problems of breaking the seal or tearing off the Band-Aid for just introducing people to an option to get therapy easily that they may not have realized or had access to previously,” Epple said. “I think the retail component is very, very important for just getting someone in the door … I don’t know that we’ve necessarily seen the result or impact of that model as you compare like a point-of-care, same day [model] to the more traditional establish-a-relationship, go-once-every-week-or-two of what behavioral health tends to look like.”