Wendy 00:11

hello, everyone. I'm Wendy Liebmann, CEO and chief shopper at WSL Strategic Retail, and this is Future Shop. This is where I talk to innovators, disruptors and iconoclasts, about the future of retail. My guest today is Kevin Host. He is the senior vice president of health and wellness, and I think there's a pharmacy thing in there. He'll tell me in a minute at Walmart. I don't normally say that somebody at that big a company is an iconoclast, but actually, I think Kevin is both that and a disruptor. So anyway, welcome to Future Shop, Kevin. Good to see you.

Kevin 00:50

Well. Thank you so much Wendy, and I think that's the first time I've officially been called an iconoclast. So thank you. I'm glad to be here

Wendy 00:57

Before we begin my conversation with Kevin. Don't forget, we need to know your behind the scenes there, so please click to subscribe any way that you receive your podcast. Spotify Apple, our website, anywhere and anyhow you get your podcast. Thanks for doing that. Now on to my conversation with Kevin. You and I have talked and in various ways on the floor at NACDS, recently at our Future of Commerce Symposium that we co-hosted with Walmart and The Emerson group a couple of months ago about this notion of the role retail can play in communities, and bringing this sense of accessible healthcare to communities every day and in crisis. I wanted to dig deeper into that conversation. So just to get started, I mean, you recently just stepped down as retired as chairman of the National Association of Chain Drugstores, and during your year there, you were pretty impassioned about the notion of accessibility and the importance of bringing that to people around this country in that role. What did you learn in this last year about the challenges of accessible health care for the for the American population?

Kevin 02:19

I would say, with NACDS, I, I, I've been there a little over three years. I've been on the executive committee, and absolute privilege and honor to serve as its chairman. This past year, I learned a lot the industry that we work in is is very dynamic. I think if you think back so many years ago, you know, 50, 100 years ago, what pharmacy was doing has changed, and it keeps changing. It keeps reforming itself to meet the needs of the community. It's the most accessible point of of healthcare for the communities that it serves, and those pharmacists are some of the most trusted individuals in those communities. So you know, I learned a lot, but what I saw is that NACDS is pushing for PBM reform. You know, pharmacies are at risk right now. We're seeing as many as four per day closing in this country, and that's in the face of a primary care doctor shortage as well. So healthcare has a lot of challenges, and communities need pharmacies now more than ever, but I think about what NACDS has done, and, you know, getting a chance to work with the team there, the advocacy is just fantastic, both at the federal level and the state level. You know, NACDS just remains very nimble and flexible. They work with either any administration that's in power. They work across both sides of the the aisle, so to say, and they've been very successful at that for 92 years now. It's it's an organization with just an absolute amazing legacy. And so I think as we continue to push forward, retail is evolving into a place where more and more people are going to gain access to healthcare, primary care, in some cases. And Wendy, I think I shared with you that at Walmart, we have our testing and treatment done by pharmacists. So when I say testing treatment, I'm talking about primary care for COVID, for flu, for strep throat, done by pharmacists in the pharmacy, where they're actually, actually prescribing treatments for customers who are diagnosed with one of those conditions. And so that happens in 21 states today, and we need that to happen in all 50 states. Beyond that, we're we're branching off into things like nutrition, nutritional support, cardio metabolic there's so many things that that our customers need us to do that the future is very bright, yeah, but it's going to require a lot of change and a lot of effort,

Wendy 04:55

yeah. What's interesting to me about all of that is, you know, here I am today. Home in the middle of Manhattan, where, of course, there are pharmacies all around us, and I have access almost at a fingertip. And yet, the more I travel across the country, and having grown up in a small country town in Australia, you understand that what happens in the big cities doesn't necessarily evolve. Is not real. Is not the real situation, I guess is the word in smaller communities around the country, smaller cities of which there are many. And that urgency around this when a pharmacy closes, the impact of that in a big city is one thing, the impact of that in a small town, a small community, is really dramatic. So how do you as Walmart, think about that when you provide, want to provide all the services that you can provide in those communities?

Kevin 05:56

You know, I think it always starts with our mission, which I think everybody knows, but we want to help help our customers live better and when with pharmacy, there's no better way to exemplify that by what our our associates do in those communities. So I would say the first thing we do is we put a pharmacy in every single super center, in every single neighborhood market that we have across the country, say for one state that doesn't allow us to do that, but we, we invest in those communities through pharmacies and through staffing those pharmacies. We, of course, you know, hope that in all cases we have a good, sustainable business model. But not all those pharmacies are as busy as they could be or should be in some cases, nevertheless, we're we're there for our customers. And I can say that in past lives when I've run pharmacy organizations. That always hasn't been true. You know, many, many organizations can't afford to run pharmacies in communities that that don't, that don't support it, if I could say it that way, and it's not that the community doesn't need it, it's that most of our reimbursement is coming from PBMs. And you know, PBM reform hasn't happened yet, and so the sustainability of pharmacies is very much in question, when we're seeing almost four pharmacies per day close in this country, that's that's critical, and we're seeing over 800 zip codes in this country now that have no pharmacies, and it's just an absolute tragedy. Yeah, yeah.

Wendy 07:37

And to your other point, not to be gloomy, because this is what gets us up at everyday. Right to get on with solving these issues, is, to your point about primary care at the same time. So those quote, unquote, health deserts, which are also often food deserts around the country, where Walmart has the opportunity to touch and support those communities become so important. The other thing I think about and all the PBM reform is, of course, where everybody talking about GLP-1s and new new formularies and new medications and all of this, which drives traffic and no very little reimbursement. So it's like the nuttiness of all that, may I be so bold, you don't have to say it. I will say the nuttiness of all of that makes it harder. So I know I'm preaching to the converted. So when you step back and think about what accessible healthcare means, you've talked about, as you have already here, the sorts of things that pharmacists can actually do, the testing, the solutions. One of the things we see in a lot of our research is that, you know, pharmacists are trusted to get me the right pills, to call my healthcare provider to give me vaccination, but the gap is where they shoppers want them to do more, and want them to provide health information and all of that, but they just don't have time. So how do you think about accessibility and freeing up the pharmacist time to be able to deliver that as well? Is that part of the challenge you have as you work around this?

Kevin 09:16

I think we've we've seen that pharmacy school admissions have been dropping in recent years, and you know, ultimately, that's led to a bit of a labor shortage in the in this play in the pharmacy space. But that aside, you know, what we're seeing is that customers need us now more than ever, and so we're trying to create not only an infrastructure where we can find an environment for our associates, our pharmacy technicians and our pharmacists to engage with our customers, but we're seeing our customers engage with us differently so and you've seen some of this Wendy, but we're the first and only retailer so far. Are to integrate prescription medications into a e commerce experience where they can get their groceries and their general merchandise all online, all in one order, all on one platform, in one experience, and they can have that delivered same day, sometimes in as little as 45 minutes. We've seen a huge response to that. There was it was our number one most requested addition to our E commerce experience from our customers. And so, like Walmart, does we meet the needs of our customers. And so we're creating a pharmacy shopping experience that our customers want online, digitally. At the same time, we're also creating and evolving our in store experience. Going back to what I was saying about testing and treatment services, we have those acute need or those acute care services in 21 states right now, at every single pharmacy in those states, every single one of those pharmacists provide that service. We also have 17 states where we can provide HIV prevention therapy. We also have about 37 or 38 states where we can prescribe birth control pills and that in store experience that one on one face to face is super critical, and so to enable that, we're investing pretty heavily in our two things, I would say, our workflow technologies, so that we can deliver prescriptions as efficiently as possible. The second thing is in central Phil. So we have a network of central Phil pharmacies that we're building out right now that will free up tremendous amount of hours for and what we're going to do at that time is enable our pharmacists to engage and connect with our customers. So there's a long way to go, but a lot of a lot of upside.

Wendy 11:51

So where this is where technology really plays, is a great supporter, right of you know, not doing away with the in person, but supporting the in person and getting the more routine things off the list, right? So they've got more time to to do that advisory role, that consulting role, that people seem desperate to have. You know, it's interesting when you said that about the E commerce piece, because we've just done a piece of work, which I'm sure I've told you about, if I haven't around understanding the Walmart plus shopper versus, you know, Amazon, Amazon Prime and others. And what was so interesting to me about that is, you know, the tendency is to think, if people have to pay more for something, they will be higher income. And yet, you know, we know from our work, and obviously yours, that that the lower income household is the person who often sees the value in that delivery to the door, because there's a cost to getting to the store otherwise, that they trade off. And I was thinking, as you were saying, that you know for that those communities where they sign up for Walmart plus and they can have access to their prescriptions, to their virtual healthcare, other things within that seems to be such an important addition to delivering accessibility to everybody, not just people with more income.

Kevin 13:17

Yeah, absolutely. I did see that piece work. It was very well done. Thank you for publishing that. Yeah, you know, we have 150 million customers that walk through the doors of a Walmart store every week. And to your point, they're all different, and the stories are endless. And I love getting a chance to read customer feedback. Just on pharmacy delivery alone, we have everybody from I saw one yesterday that was a self reported Walmart fan girl. She and she doesn't have a car, and so for her, she needs that experience and that delivery in order to have access to our stores. Yeah, you know other ones, as you might predict, are caregivers, a daughter of elderly parents who have adopt, adopted grandchildren. They have a very, very busy life and very a lot of challenges. And Walmart makes it a little bit easier with services like that.

Wendy 14:15

Yeah, and I do think about that, that aging population that we all talk about, people fitting in either formal or informal roles of caregiving for their family, friends or as a job, and the ability to access health care is so important for them to support that other role beyond their own health and wellness every day. So the the quote, unquote opportunities here, but also the complexity of the landscape, and it just feels like, as you said, the need is even stronger. You talked about nutrition programs, because that's the other piece, right? How do we help people eat healthier, afford healthier foods? So how is all that working in as you continue to develop.

Kevin 15:00

This model, I think back to pharmacy school and pharmacotherapeutics, and seems like the first step in any treatment regimen is is diet and exercise, and so, you know, that's ingrained into what pharmacists have learned. I think the beauty of that is, when we work in an environment where we're steps away from good, healthy options, we love bringing that together at Walmart, and I know NACDS is working on that as well through the foundation. So we've got a lot of research into Food is Medicine. We've created a “Nourish my Health” campaign that all retailers are able to utilize. And of course, at Walmart, we're very, very proud to be part of the “Nourish my Health” campaign. We've incorporated that into a lot of our day to day activities, as well as our well wellness days, yeah. And so those, those healthier options, making them, making customers aware of that, is one thing, but enabling them to afford it is another thing. And so, you know, Walmart's, that's one of Walmart's hallmark is, you know, nice, affordable, fresh produce

Wendy 16:06

Yeah, so for you're right, accessibility is not just logistics, as in convenience, but it is also affordability. So that's the that's the other piece. I noticed, you've opened this amazing new store in Texas. Are there things in that store, or this new evolution, revolution of future, store of the future, that talk to the work you're doing here? Is there something different in there?

Kevin 16:31

I think you'll see that, that with any new store that we open, we continue to lean into what those communities need. I'll think about the pharmacist there for just a moment. They did a absolutely fantastic job of getting into the community before those front doors even opened. One of the things, for example, that we did there is we had a fuel center out in the front parking lot that actually opened before the store did, and our pharmacists and our pharmacy teams were out there every day just meeting the community and letting them know, introducing themselves and letting them know what's what's coming. And so the day that we opened the front door, we had customers showing up to the pharmacy who already knew our pharmacists and our associates there. And so that's that's just one example. We've got over 100 stores coming up over the next five years. And of course, you know, I can't spill the beans, but I've seen some of the prototypes, and I feel, I think you'll see a lot more innovation in our stores going forward. Yeah,

Wendy 17:36

well, that makes me, that reminds me having some longevity in these discussions about the value of the parking lot, whether it's you know, sort of as a place to engage with people and pony rides and stuff I remember from the Sam days, but also the power of the parking lot, of course, during COVID, as people you know, drove in to get their COVID shots. And I think sometimes we think about that the store, physical or digital, begins at the door, whereas you've got a lot of land in the front. So I love that idea of the pharmacist being out there saying hello to everybody and and welcome them, welcoming them. That's that's exciting. You know, the other thing that that has struck me about all of this Walmart beyond the everyday accessibility in times of crisis, which we seem to have a lot of weather related ones these days. Dare I mention climate change? Oh, no, I won't mention that anyway. Dare I mention that? But you're very aggressive in a positive way about supporting communities in those times. I don't know that everybody knows about Big Blue and all of those things. Can you just tell me a bit about that?

Kevin 18:49

Yeah, I think that when you're in seemingly, virtually every community across America, you know, you you see and experience everything, and you know, when you're integrated, when you're a part of those communities, just think of our store associates. We could have anywhere from three to 500 associates in any given store, and every single one of them is is a member of that community. So when things happen, when tragedies happen, it's personal, and over the years, Walmart has used its its strengths to help those, those associates, in those communities. Our crisis response is unparalleled many cases, and it's leveraged from our supply chain strength to your point, parking lot space. We use our physical space for anything we can to help support the community. The parking lots are sort of the most evident place for that, especially in a natural disaster, where we may open up the parking lot just for first responders so that they can get all of their their equipment staged and their personnel staged. Of course, we're known for bringing in trucks full of water. Are trucks full of laundry machines so that people can do their laundry showers, that the list just goes on and on? Yeah, absolutely.

Wendy 20:11

And then that I think about, you know, somebody who's why the fire tornado floods, all of these apocalyptic things that most, many, I shouldn't say most many communities are dealing with on a regular basis now and then, somebody who's on a, you know, chronic medica medication for chronic conditions, things that people are dealing with every day, whether it's six children, caregivers, you know, anything, and the role that you play then in how do you get the prescriptions to people? How do you get the support to people in those situations? I mean, I'm

Kevin 20:47

glad you asked. We have a completely mobile pharmacy, custom made, where it's like a big 18 wheeler trailer that is a pharmacy. We keep it station, stationed here in Bentonville, but we deploy it into communities that have a need. So for example, with Hurricane Helene, we had two two communities that were severely affected. One was in Boone, North Carolina, and the other in Asheville. And so we actually deployed big blue to Boone. It was there for almost a month, and we dispense 1000s of prescriptions out of that that trailer while the store was being rebuilt, we also had associates come in from the surrounding states. Some came in, drove in from hundreds of miles away, just to help staff that pharmacy and take care of that community. And as you know that that was a pretty severe event, and roads were out and people were stranded in pretty remote areas. So in that case, we actually partnered with company called Wing as well as the Red Cross, and we actually activated pharmacy delivery via drone and dispensed a number of prescriptions by air, via drone that way as well. So that's one example. We had never done that before, but one example of how we can lean in.

Wendy 22:08

Yeah. What is it that Doug says, Doug she says... Doug, as in, aka McMillon says about "People led technology..."

Kevin 22:17

yeah, it's "People led, tech empowered"

Wendy 22:21

the power of that story, where all of a sudden the drone drops the prescription down into a water log community is is really it's really extraordinary. What can be done. It just feels to me like, as these weather related events continue, and I'm assuming they will, that becomes just a part of the organization that that that probably didn't exist 10 or 15 years ago. So is that, is that right?

Kevin 22:45

We have a emergency response team here at home office, and they're phenomenal. I know you had a chance to meet one of them a few months ago when we were together here in Bentonville, and it's it's really just amazing how our National Operations Center can monitor weather events. We if something looks like it's going to become very serious for any given community, we can have our resources already staged and ready to go in many communities. Walmart's the first one to roll in with with relief, relief goods, and so, you know, something that we're known for, the

Wendy 23:27

role of the Associate in all of this, really, in creating this healthier mental, healthier physical, healthier connection feels so even more important than it ever was. Do you you feel that that way? Do you see that as?

Kevin 23:42

Yeah, absolutely. You know, the our associates, as I mentioned, they're, they're part of that community. And in particular, if you think about our pharmacists, they're, you know, pharmacists in general, are one of the most trusted professionals out there. And so in many communities, pharmacists are just that pillar of trust. When you couple that with our pharmacies, those are the pillars of convenience. And so, you know, we're proud to be an employer of choice. In fact, we've got 15,000 pharmacists, and about half of them have been with Walmart for 10 plus years. In fact, we have one I got a chance to meet last year, and he's been with us for over 50 years now. Oh, I remember that. Yeah, yeah, yeah, Bruce Blackwell, he's, he's an he's an amazing gentleman, got an amazing story, and is just passionate about his work in his community. Yeah, you know, all they say all healthcare is local. Yeah, we say healthcare is hyper local. And so it's, it's, it's easy to see how our customers and our associates who live and work in those communities are who we're there to care for.

Wendy 24:56

Yeah, yeah, it does. It does. Certainly. Focus the thinking when we, when we realize that and and sort of step back from this notion of Walmart as, you know, the largest retailer in the world, and think about that one community, you know, one, one store at a time, and the power of all of this advocacy. You know, I always think about having grown up in a small country town and the in Australia, and the the engagement with, whether it's the local chemist or the grocer or the, you know, whatever, the guy who sold fish and chips, you know, all of those exciting, not so healthy things, but the power of that engagement, right? And on a day to day level, it's just that that's very something that I focus on a lot still in this day of E commerce, click here, show up, pick it up, or whatever. So just last thought so for you, what? What do you what's on your mind? I mean, I know the PBM issue is a massive issue, but what's on your mind as you get up every day and and tend to your proverbial knitting. What's, what's the what's on the top of your list in the next in the next year or two, as you think about accessible healthcare and everything else you work around

Kevin 26:10

absolutely Well, I'll tell you, it's my mind when I wake up. I think about what do I have to do at 8am as well as what do I need to get done today that'll set us up for the next two to 10 to 20 years, you know, and I've touched on a lot of what we need to do, as far as the investments that we're making here at Walmart. But with pharmacies closing at the rate they are, and with consumer behavior shifting, you know, we're seeing that they need, they need a pharmacy home, and they need something more than just a pharmacy at the end of the day. So we're my old team is just completely dedicated to ensuring that the investments that we're making and the technology and the infrastructure gives us the ability to meet the needs of those customers as more and more of them shop at Walmart and Walmart pharmacies, and it's something that we we need to work on with policy, you know, policy folks, with legislators, with regulators. We need to make pharmacy more sustainable. And so PBM reform is at the top of that list. And when I'm not, you know, focused on my day to day at Walmart, I'm definitely focused on things like NACDS and working with other advocates across the industry to support that. But I'll tell you, Wendy, I think 1020, years ahead, you know, and hopefully long after I'm gone, I want to have, want the ability to look back on what I'm doing right now and say that I made a difference in the profession. I graduated pharmacy school feeling like we should be doing more primary care, more more urgent care activities. And back then, we were not able to. We weren't even allowed to give shots in immunizations at that point in time. And now today, most adult immunizations, the majority, are given at pharmacies, and they're given not only by pharmacists, but by pharmacy technicians. That's reflective of the need that we have for more healthcare. And so I've actually spent some time in Canada this past year looking at what pharmacists are doing there. I've talked to folks in the UK about what pharmacists are doing there, and they face a lot of the same kind of macro issues that we do in this country, physician shortages, namely. And they've, they've leveraged their pharmacists to extend health care into their communities. You know, in UK, they call it pharmacy first. Pharmacists there can can do a level of triage that helps get people into the appropriate primary care or even specialties. In Canada, I'll point to Alberta. Alberta is very progressive, and they have a scope of practice set up now that enables pharmacists to function as as mid level practitioners. So as I come back down to the states, we don't, you know, there's, there's 21 states that allow pharmacists to do what I was talking about earlier, with testing and treatment for upper respiratory conditions. But fortunately, we have one state, Idaho, that has started to set their scope of practice language such that, you know, pharmacists can do whatever, whatever they're educated, trained and experienced in doing, so that that leaves a very broad scope. Yeah, and I hope over the next 10 years, plus that I help in some way get the the pharmacists, whether they're Walmart pharmacists or anywhere across the country, enabled to practice at the top of their license, their education, their training. So that's, that's what I think about, in a nutshell. Well, it

Wendy 29:53

sounds like you know, you've got your you've got your work cut out for you, but a huge, a huge need and that that. Vision when we think about the power of the pharmacists and and having technology at this moment, or increasingly, to free them up from the more routine things that they do into the what will be the new routines. And also, I'm assuming, by being able to practice this way, it becomes a much more engaging profession, again, as opposed to pill counting and calling the medical whatever is to make sure the insurance coverage is right. So it feels like the two things, Doug is right, as always, but Doug is right, you know, in terms of the people in the technology. So it feels like you are on a journey. Well, thank you for the work you did at NACDS, of which I was, you know, able to see some of that impact and but, you know, thank you for the passion around this story. Because I think we don't remember always about the role that retail can play in doing good, which was our topic in Bentonville, doing good for communities. And that's that feels very, very powerful and somewhat iconoclastic for me, at least. So thank you for joining me on Future Shop today. It's great to see you again, and hopefully I will see you somewhere very soon as we reinvent the future of healthcare.

Kevin 31:16

Thank you for having me. Wendy, it's always a pleasure to spend time with you.

Wendy 31:21

So here's the thing, I mean, you can hear from Kevin his passion and reflected Walmart's passion about the role of bringing accessible, affordable health care to the breadth of their communities around this country, the challenges are pretty clear for those of you who aren't necessarily in the prescription side of the medical space, you can hear from Kevin where the opportunities are, whether it's the support that comes when you think about the front store over the counter, support for health and wellness, for the tools of delivering health and wellness into communities, whether it's the OTC environment, whether it's healthy food, healthy beverages, all of those things that become so important in this journey to provide accessible healthcare to people around this country, but also in times of need. I don't think you know, Walmart's a very big company. It doesn't always get the play for some of the good work it does. And it's not just Walmart. In fact, there are most of the major retailers and minor ones in communities around this country deliver in times of need. So the power of retail at large, and the role that those of you in the manufacturer communities can play in supporting that will become even more critical as we as we move forward to the future of retail so thank you for joining me yet again to see the future. Cheers for now.