DOCTOR BLAKE BORTLES completes a physical for a long time patient, and looks down his Jacksonville office hallway, through the glass door into his waiting room. He watches his patient proceed to the shelves installed in the far wall, and pick out a copy of People magazine and some Mentos. "Now that's what I'm talking about," he announces cheerfully to his nurse before heading to the next exam room to see another patient.

Doctor Bortles, a family physician, is one of a growing number of doctors responding to competition from pharmacy sponsored retail clinics such as CVS's Minute Clinic, by offering retail products in their waiting rooms that are typically offered in chain pharmacy outlets.

"It's going really well," Doctor Bortles says as he glances at a sales report prepared by his front office manager. "The cosmetics items are strong, the toiletries are doing well, and the take home snacks are off the charts." Bortles confides that the key is to keeping patients in the waiting room long enough to fully browse the shelves before being called back to an exam room. "It's like when the restaurant keeps you in the bar awhile before telling you that your table is ready. We have a captive audience out there."

Bortles shares that he went through a learning curve after introducing the retail shelves several months ago. "We don't have the kind of foot traffic and inventory turnover that pharmacies like CVS do. So we have had to adjust our mix of food item offerings to those with a longer shelf life, like Twinkies. Also, we had to discontinue some products that just weren't compatible, like Cheetos for example. Our patients were buying them while they were waiting, and then coming back to the exam rooms with orange hands, and getting orange all over everything."

Gus Bradley, head of a consulting firm that helps set up retail product offerings in physician offices, says that business is booming. "Look, these retail clinics have come after the patients that my clients have been serving. We're taking the fight to them, and coming after the products that they've been selling." Bradley adds that "it isn't practical to set up a pharmacy in each doctor's waiting room. But everyone knows that the big retail pharmacies want you to get a prescription filled there so that you'll buy a shopping cart full of their retail products while in the store. So we're hitting them where it hurts, by going after their toothpaste, chewing gum, lipstick and National Enquirer sales." 

AS THE PERCENTAGE of consumers covered by health benefit plans high deductible requirements continues to increase rapidly, the ranks continue to swell of those without a companion Health Savings Account (HSA) or Health Reimbursement Account (HRA). Now a new companions offering has been installed by numerous self-insured employers and some health insurers - lottery games with winning amounts matched to the deductible requirement.

Phillip Rivers, Head of the U.S. Health and Group Benefits Practice for the international benefits consulting firm. Minarets Holmes explains that "Account Based Plans - high deductible health plans paired with an HSA or HRA have unfortunately not been within financial reach of every client or consumer, due to the cost of funding and administering the account. So these new Lottery Based Plans provide a monthly lottery game ticket for each insured when the monthly premium invoice is sent. This gives the consumer an affordable opportunity to fund their deductible requirement."

Rivers explains that the lottery games selected aren't the high stakes, Powerball-type games with only one winning number and millions of dollars in the single payout. "The odds of winning those games are worse than getting struck by lightning twice in your lifetime." Instead, Lottery Based Plans utilize the scratcher games with much smaller payouts - with the amounts matching the deductible requirement - and therefore many winners. "The actuarial odds of winning these games can come much closer to having a catastrophic illness, so really it's a much more appropriate pairing," Rivers adds.

CEO JOHN McGINLEY WAS confounded by lower weekend occupancy rates at Saint Emperor Norton Medical Center in San Francisco. "During the week," McGinley explains, "physicians are scheduling procedures, or admitting patients after examining them in the office. But when their offices are closed over the weekends, our occupancy rates correspondingly drop."

Not content to continue simply flexing his staffing levels down on Saturdays and Sundays, McGinley signed up his facility with sharing economy powerhouse Airbnb, which is also headquartered in his city. The hospital CEO couldn't be happier with his results in increasing Emperor Norton occupancy over the weekends with Airbnb customers.

"We provide a great experience and value for Airbnb clientele," McGinley explains. "Where else can you get access to extensive parking lots, room service for three meals a day, multi-position adjustable beds equipped with a remote, your vital signs monitored throughout the day and night, and the ability to make new friends and socialize with your new roommate and their visiting family?"

McGinley notes his staff has had to help navigate some Airbnb customers through the nuances of conducting their weekend stay in a hospital setting. "Probably our biggest issue is in trying to help the customers understand their bill when they are discharged - or rather should I say, checking out. They aren't used to receiving a twenty-three page statement."

HEALTHTURNUP HAS LEARNED that one-week fantasy sports titans Draft Kings and Fan Duel are both about to unveil competing fantasy provider narrow network applications, developed in collaboration with major health plans. Sources state that the competing apps will be offered through partnering health plans, enabling consumers to build their own provider narrow networks for their health plan coverage one week at a time, with their provider draft subject to contractual payment caps, similar to salary caps imposed in fantasy sports drafts.

"Just as fantasy sports applications were built upon strategic partnerships and licensing agreements with major sports organizations, industry leaders Draft Kings and Fan Duel are leveraging their platforms in a new industry where consumers interact with rosters with much at stake, through strategic partnerships with health plans," comments longtime health insurance industry analyst Seth Rogaine of Rogaine Franko Group. "What's more, this opportunity is exciting, as the health plan season is all year long, unlike sports seasons that are limited to just part of the year."

In addition to building a provider roster, the fantasy provider networks can also be used in competitions similar to Draft Kings and Fan Duel one week sporting fantasy matchups - in which consumers can vie against their health plans with premium rates and out of pocket expenses at stake. "The matchups against sponsoring health plans just seem like a natural, given that consumers are often already going head-to-head with their health plans," Rogaine notes.