Nontraditional Players in Health Care Highlight the Need to Balance Quality and Cost-Effectiveness With Convenience and Accessibility

Lucienne Ide, MD, PhD, Founder and CEO of Rimidi

Could you tell us a little about yourself, your background, and your journey to founding Rimidi?

Lucienne Ide, MD, PhD: I'm Dr Lucienne Ide, founder and CEO of Rimidi. A physician by training, I began my career as an academic clinician, earning an MD and PhD and completing my training in OB-GYN. However, my prior experience in technology and venture capital sparked both curiosity and frustration with the current applications of technology in health care. This led me to leave clinical practice about 12 years ago and establish Rimidi, driven by a passion to harness technology to improve health care outcomes.

Why do you believe that nontraditional players like Walmart are struggling to make a lasting impact in the health care industry?

Dr Ide: Walmart’s exit earlier this year from the health care marketplace was the latest in a long list of departures by nontraditional players. Each time, industry experts are left wondering why the industry newcomers consistently struggle to make a lasting impact in health care. Understanding the underlying reasons for these failures begins with acknowledging the fundamental mismatch between consumer expectations and the capabilities of new entrants. Health care's unique blend of trust, continuity, and personalized care cannot be replicated by retail giants focused on convenience and affordability.

A comment I heard at a conference 2 years ago, made by the head of health care at a major technology company, has proven remarkably prescient and aligns closely with recent developments. She cautioned the audience of providers, health system teams, and clinic leaders, saying “You possess the most precious asset in health care, and it’s something we all want. It’s the trust of your patients, and it’s yours to lose.” Her words served as a clear warning shot, acknowledging that nontraditional players in technology and retail want to disrupt health care delivery, but it is actually providers who hold a valuable and unique advantage: the trust and loyalty of patients.

Trust was likely the missing element in Walmart and its predecessors’ endeavors. Without it, the company struggled to attract the necessary volume of patients and drive demand, which hindered success.

Why do you think patients are hesitant to trust their health care to nontraditional providers, such as retailers?

Dr Ide: I wondered that myself, though I had a hunch about the forces at play. So, I went straight to the source and visited a few Walmart clinics in my home state of Georgia several years ago, after the health centers had been operational for some time. I spoke with Walmart employees, inquiring whether they had utilized the clinic’s services. The inherent lack of trust I detected likely gave them pause, even though the clinics’ offerings were free to employees. The staffers seemed concerned that once they visited the clinic, they would be advised to undergo additional costly tests. The underlying question posed by their concerns is one of trust: Did the clinic genuinely prioritize health care, or was it driven by revenue-generating opportunities? Trust is the single most critical factor.

How does the closure of Walmart Health impact underserved communities?

Dr Ide: Access is obviously one of the biggest issues for underserved communities, and this is where companies like Walmart, Dollar General, and others could have a major impact. Over the past 5 to 10 years, we’ve witnessed the alarming trend of rural facility closures and the decline of critical access hospitals, which has exacerbated existing concerns. Looking at my own home state of Georgia, half of our counties lack an OB-GYN. This is only getting worse because of complicating factors in the maternal health space, such as the lack of providers willing to set up a practice in certain states and regions.

In my discussions with fellow health care professionals and stakeholders following Walmart’s announcement, a common disappointment expressed was that retailers’ health care offerings haven’t helped solve the access issue. My company specializes in technology, so I’m inclined to think it can help bridge some of these access issues in underserved communities. However, that’s only part of a larger solution; we still need providers who are willing and able to serve patients in all areas.

What lessons can be learned from the failures of Microsoft HealthVault, Google Health, and now Walmart Health?

Dr Ide: Everyone involved in health care is learning to think a bit differently about the word “disruption.” It's a word that has been overused, though I agree in principle that the industry needs to be disrupted. Health care constitutes almost 20% of gross domestic product (GDP), yet the United Sates has some of the worst life expectancy numbers among developed countries. There’s a significant mismatch between what we spend and the outcomes we achieve. That is worth disrupting.

The US health care system involves 3 separate groups: those who pay for health care, those who provide care, and those who receive care. The disconnect creates a system that doesn’t function as a free market. In a typical free-market sector, big companies like Walmart or Google could disrupt the health care system by offering a better service at a better price. However, the US health care system doesn’t work that way. As a result, we must solve some of this from within. Because of the complexity of the payer system, it’s not practical to say we should scrap the current system in favor of building something new and more cost-effective.

In what ways do you think the health care industry can balance quality outcomes and cost-effectiveness with convenience and accessibility?

Dr Ide: It has to be both. The appeal of a health care offering like Walmart’s is that it is designed for the consumer. Convenience and accessibility appeal to everyone; health care must innovate into the future the way other industries have. The banking industry is a great parallel. Customers no longer have to visit banks because they can complete a variety of financial transactions on their phones. Banks have bridged the interoperability gap behind the scenes. Patients won’t stop demanding convenience and accessibility, so it’s the health care industry’s job to meet that need while achieving quality outcomes and cost reduction. The current health care system delivers quality, consumer-based models deliver convenience, and capitated models address cost. It’s time to integrate these disparate models to deliver quality, convenience, and cost-effectiveness seamlessly.

Do you believe there’s a place for nontraditional players in health care, or is it best left to established health systems?

Dr Ide: I believe nontraditional players have a vital role in health care. The industry's complexity demands diverse expertise, and fresh perspectives can drive innovation. By leveraging successes from other industries — particularly in technology, data, and artificial intelligence (AI) — we can accelerate progress. Effective partnerships, rather than disruptions, will yield the most impactful results.

While it's understandable that established health care professionals might feel frustrated when new entrants invest heavily and then exit, I choose to see the silver lining. Each attempt brings valuable lessons, and the industry benefits from these experiments. As an optimistic entrepreneur, I believe every effort moves the needle forward, even if not every model succeeds. This collaborative mindset will ultimately propel health care forward.