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CINCINNATI — While Kroger Co. is best known as the nation’s grocer, the company is also a potent force in health care, with 2,255 pharmacies and 226 clinics across the U.S. The drive is under way to maximize synergies between the two sides of the business, positioning “food as medicine” as a means to keep customers healthy and enable them to more effectively address health problems when they do occur. That effort is spearheaded by Kroger Health, which champions the link between nutrition and health — together with efforts to carve out a bigger role in patient care for community pharmacists and secure fair reimbursement for the services they provide — has earned it MMR’s Retailer of the Year Award.
Colleen Lindholz
“We’re much more than just pharmacy,” says Colleen Lindholz, president of Kroger Health. “When you walk into most of our stores, the first thing that you see is the produce department, and I would argue that it is actually the front door of health care, because you are what you eat.
“By positioning food as medicine, we’re creating a perfect complement to our other health care assets. We have pharmacies, we have specialty pharmacies, we have mail order, we have our own PBM — Kroger Prescription Plans — and we have the Little Clinic, our nurse practitioner-led care model. What’s next for Kroger is collaborating with more primary care providers so that we can become more relevant in value-based care models.”
Kroger’s OptUP nutrition rating system is the centerpiece of the Food as Medicine initiative. Developed with input from the company’s dietitians, the science-based program gives shoppers on Kroger.com and the Kroger app instant access to scores for more than 49,000 food and beverage items, empowering them to make informed decisions about what they eat. The idea behind the initiative is that small dietary changes can have a significant impact on a person’s long-term health.
“At Kroger, we’re taking a more holistic view of patients and customers,” Lindholz explains. “Behavior change is hard, even when it’s in someone’s own self-interest. No one in this country has been able to figure it out. I’m super excited about the food score, how it will enable shoppers to make better choices, and the insights it can give health care providers. We’re building the capabilities to be able to — with the patient’s permission — give a nutrition score back to their physician.”
Armed with that data, doctors — and by extension, other members of the health care team — will be able to help people recover from an illness and stay healthy.
“That’s the innovation piece when it comes to truly taking care of people,” Lindholz says. “Because right now physicians can’t measure the nutritional security of their patients. Food scores will help them prevent chronic diseases from taking an adverse trajectory, but also preventing disease before it starts.
If we can get in on the prevention side — delaying the onset of type 2 diabetes by five years, for example — it will be worth billions to the overall health care system.”
In addition to the health implications of OptUP, the program will boost the company’s business. Lindholz indicates that Kroger aspires to be the first nutrition benefit manager, establishing food formulary protocols for specific health conditions. She says the retailer is developing its own food benefit card, which government programs and payers in the private sector can leverage to encourage beneficiaries to purchase specific products.
“Greater personalization around food fits into our go-to-market strategy from a total company perspective,” notes Lindholz. “Personalization is one of the four areas we’re really focused on; the others are fresh, owned brands, and delivering a seamless customer experience.”
Those elements are brought together in a new Kroger Health marketing campaign. Currently available on various digital platforms, A World of Care Is In-Store was created to highlight the breadth of the company’s health and wellness offerings as well as the expertise of its pharmacists, dietitians and clinicians.
A new marketing effort highlights Kroger’s food as medicine offerings, along with its breadth of health and wellness services.
“What we are attempting to do is increase consumer awareness about what’s available inside of a traditional grocery store,” Lindholz says. “And having people understand not only the advantages of the one-stop shop but the advantages of connecting the health care side to the food side — the whole prevention piece.”
Food as Medicine is just one aspect of the company’s health and wellness strategy. Lindholz and her Kroger Health colleagues, four of whom — chief commercial officer Jim Kirby, chief financial officer Jessica Paul, vice president of health and wellness operations Bill Shinton, and innovation leader Margaret Lewis — share their insights on the pages that follow, are working to ensure that the company stays ahead of changes in the health care system.
“When you think about the consumerization of health care and how health care is going to people versus people going to health care, it opens up a lot of opportunities for us,” says Lindholz. “A big factor is establishing a place where people feel good, and our grocery stores are very familiar to them. People like to go where somebody knows their name, and where they know the store manager and the pharmacist. The magic is in delivering essential pieces of health care inside a place that’s right there in the community staffed by professionals who consumers trust.
“We are really trying to take that relationship piece to the next level. The technology that we’re utilizing will help eliminate some of the redundant tasks that in the past pharmacists had to deal with in order to do their jobs. At the end of our mission statement, it says that we want to connect with people on an emotional and personal basis. Once we do that, customers are likely to stay with us. Some of the changes we’re making will create more of those times when our pharmacists can forge connections with people.”
In order for pharmacists to establish those bonds and provide such services as immunizations and diagnostic testing, the profession must receive adequate compensation, and Kroger Health has moved aggressively to see that it does. Last year, the company ended its pharmacy provider agreement for commercial patients with Express Scripts Inc. — one of the nation’s big pharmacy benefits managers — because under the plan it was filling prescriptions at a loss.
“We have to do what’s right for our customers, what’s right for our company and what’s right for our profession overall,” comments Lindholz. “What bothers me the most is the impact this has on patients. Because we’re not receiving fair and reasonable reimbursement, we can’t fill their prescriptions, give them their vaccinations and help them solve their health problems. It’s very tough.”
In addition, Kroger remains a forceful advocate for DIR reform and the expanded scope of practice that pharmacy was given during the pandemic. It also has taken a hard look at pharmacy discount cards, narrowing its focus to a select group of offerings.
“Instead of taking 40-plus cards at our prescription counters, we streamlined that and went and picked what we call strategic service providers,” Lindholz says. “We were able to drive down not only the cost for the patient, but the overall fee to the pharmacy. The change was also good for our pharmacists and technicians, who were often trying to process 10 different cards for a single patient. When we altered the discount card strategy, it was a beautiful thing because patients won, our associates won and Kroger won.”
Lindholz is optimistic that the economic hurdles facing community pharmacy can be cleared.
The high level of public support for the profession coming out of the pandemic, coupled with bold action by Kroger and other retailers, bodes well.
Kroger Health, and other retailers, account for two of every three COVID vaccines administered.
“With pharmacies giving two out of every three COVID vaccines, that should tell people something,” she says. “The country wouldn’t be where it is today if pharmacists hadn’t stepped up. I’m so proud of what Kroger and the pharmacy profession as a whole were able to do. We’ve demonstrated that we can close gaps in care, prevent side effects and keep patients from ending up in the hospital.”
Whenever legislators and regulators unlock the full potential of pharmacy and related services, Kroger Health is standing at the ready to help the nation solve chronic problems of access, quality and cost that have long plagued the health care system — and also bring the added dimension of nutrition into the equation.
“America’s sick. The U.S. spent $4.1 trillion in 2020 on health care, but ranked 30th in quality,” says Lindholz. “That’s not OK. There’s a lot of waste in the health care system. I know that Kroger can deliver high-quality care and lower overall health care costs.”
