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HL20: Kermit Crawford—Creating an Entry Point for Healthcare Access

 |  By jfellows@healthleadersmedia.com  
   January 08, 2014

Kermit Crawford always knew he wanted to be a pharmacist. Now he's President of Walgreens' pharmacy, health and wellness division, and throughout his time at the drugstore giant, he's changed the company from a prescription filler to an important entity in serving medically underserved communities.

This profile was published in the December, 2013 issue of HealthLeaders magazine.

As a child, Kermit Crawford knew he wanted to be a pharmacist. He says he looked up to the man who ran the corner drugstore and knew Kermit and his family by name.

"He knew I was Harry Crawford's son, and I grew up saying, 'That's who I want to be,' " says Crawford, adding that his dream was to run his own drugstore someday.

Mission accomplished. As president of Walgreens' pharmacy, health, and wellness division, Crawford runs more than 8,000 drugstores, with sales last fiscal year of more than $72 billion. And they're not just drugstores—there are nearly 400 walk-in clinics integrated into the stores, which can administer healthcare services, such as vaccines, minor acute care, and back-to-school physicals.

Crawford's rise to be a top executive at one of the country's largest companies by revenue started in 1983, as a pharmacy intern at a Walgreens store in Houston. His subsequent roles as pharmacist, store manager, vice president of store operations, as well as his leadership as executive vice president of the company's pharmacy benefit management services gave him a broad view of a pharmacy during a fundamental shift in healthcare. The experience positioned him to transform Walgreens from prescription filler to now filling a void for medically underserved communities.

"There's clearly a shortage of physicians," says Crawford. "In the communities where we have our healthcare clinics, approximately 40% of the people who come in don't have a primary care physician. Our objective is to support and complement the traditional healthcare system. We believe we're well positioned to serve as an entry point."

Crawford's earliest attempt to modify Walgreens' value position to consumers and patients was in 2006 when the pharmacy chain started offering flu shots at its stores. His confidence was initially shaky.

"When we first began to think about really transforming the role of community pharmacists, our question was, 'Will the American consumer allow pharmacists do more than put pills in a bottle?' "

The other unanswered question Crawford faced at the time was getting pharmacists on board because they needed additional training to become certified immunizers.

"You don't graduate from pharmacy school as a certified immunizer," he says.

Crawford says the additional training appealed only to the early adopters, but two things happened that turned doubters into believers: No.1, consumers responded overwhelmingly to the convenience of getting a flu shot at a store they trusted and shopped; No. 2, the appearance of the H1N1 virus in the United States in 2009.

When the World Health Organization declared H1N1 a pandemic, the need for that vaccine spiked and production was rushed into high gear. Crawford says Walgreens' previous internal buildup to offer more flu shots and the immediate need for the H1N1 vaccine was "luck" that he leveraged into opportunity after the virus threat lessened.

In 2009, Walgreens had 17,000 certified immunizers, a retail footprint big enough to reach a signification portion of the population, and an electronic and logistics system that gave up-to-minute information on H1N1 vaccine inventory. The pandemic that scared consumers and health officials led Crawford to believe Walgreens could successfully expand its reach into healthcare even further, and today, all Walgreens pharmacists (27,000) are certified immunizers and they offer all 17 CDC-approved immunizations in approximately 40 states.

Walgreens also helped change the business side of flu shots with health insurers that didn't always include the flu vaccine as a covered benefit.

"When we first started, about 90% of all flu shots were paid for by cash," says Crawford. "Today, almost 90% are paid for by third-party payers. It's providing access to care that people didn't have before."

Crawford has also helped build a bridge with physicians, hospitals, and health systems so that the pharmacy chain would be viewed as a partner and not a threat. Among its clinical affiliations, Walgreens has collaborative care relations with Orlando Health, a nonprofit system of physician practices and hospitals that serves 1.6 million area residents; Community Health Network, another nonprofit system in central Indiana, and most notably Johns Hopkins Medicine in Baltimore.

Those collaborations build on Crawford's vision for Walgreens' newest strategy, which is managing chronic conditions, such as diabetes, hypertension, high cholesterol, and asthma. As a partner in those systems, Crawford says the objective is population health management and the role is to increase medication adherence, provide testing, and share information with patients' primary care physicians. To him, including chronic care in the business strategy is a "natural extension" of Walgreens' ever-expanding move beyond the pharmacy counter.

"Those patients are coming into our stores significantly more than they are seeing their physicians," says Crawford. "We don't see ourselves as owning that particular patient. We see it as enhancing the experience with a physician. We're helping manage it consistently, versus a patient who has diabetes and goes to their doctor every six months."

Crawford's goal of owning a single community pharmacy in a neighborhood where he can greet patients by name seems quaint and simple now, but he believes that Walgreens' strategy is returning pharmacists back to being the face of what he sees as a front door to healthcare.

"Our real purpose is not putting pills in a bottle. It's the outcome that you get from adherence to your medication," he says. "We've freed up our pharmacists to be out front interacting with patients, and they love it. Pharmacists are at the intersection of all healthcare relationships, and now with more than 70,000 healthcare professionals between our pharmacists and nurse practitioners, we are in a real sweet spot when it comes to healthcare reform and having convenient access to quality, affordable care."

Jacqueline Fellows is a contributing writer at HealthLeaders Media.

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