Walking into a big-box store and getting an eye exam or picking up prescriptions have long been amenities for shoppers. Now, women can add mammogram screenings to that list. 

Sawtelle-based diagnostic imaging company RadNet Inc. last weekend opened a mammogram screening center inside a Walmart Inc. supercenter in Delaware – one of only a handful of such screening centers thought to exist in the nation. With this pilot project, Walmart shoppers can walk in and receive a basic mammogram screening. 

“This pilot program with Walmart is an effort to bring mammograms to the people,” said Mark Stolper, RadNet’s chief financial officer.

RadNet currently has 366 diagnostic imaging centers in seven states: Arizona, California, Delaware, Florida, Maryland, New Jersey and New York. Most of these centers are separate storefronts. Patients using these centers can get mammograms, computed tomography – or CT – scans; magnetic resonance imaging scans, commonly known as MRIs; and ultrasound and other diagnostic imaging tests.

In recent years, the company also has developed and sold computerized systems to other diagnostic imaging providers. And in the past couple of years, it has integrated artificial intelligence algorithms developed at recent acquisition Deep Health Inc. into its diagnostic systems.

Superstore location

But the Walmart pilot project represents the first time RadNet has placed one of its mammogram screening centers inside a superstore. In fact, according to Stolper, nationwide, there have been only a handful of mammogram screening centers tucked into retail stores. One of those is a clinic operated by NorthShore Evanston Hospital that opened in 1995 inside a Nordstrom store in the Chicago suburb of Skokie.

Unlike its stand-alone diagnostic imaging centers, RadNet’s just-opened pilot mammography center in the Walmart supercenter in Milford in south-central Delaware offers basic mammogram screenings only, with no follow-up capabilities if the mammogram yields a positive result. In that event, the woman would need to work through her primary-care physician to schedule follow-up diagnostics, either at a center designated by her health plan or at a freestanding RadNet location.

RadNet’s Walmart mammogram screening center, while less than 1,000 square feet in size, has enough room for a separate door and lobby, private changing rooms and an exam room.

“This offers a more convenient location at a more convenient time for women,” Stolper said.

As part of this screening center opening, RadNet will promote breast health education and awareness initiatives, providing the Milford community with essential information about breast health and the critical need for regular screenings.

As for the cost of the new mammography screening center, Stolper would only provide a rough estimate of “more than $500,000,” including the physical buildout and the screening equipment. 

RadNet does not disclose its per-patient cost of providing mammograms. And whatever that cost is, most women don’t pay it. For those women who have commercial health insurance, those health plans typically include an annual free screening mammogram. The insurance plans reimburse RadNet for the screening mammograms at pre-negotiated rates, as does Medicare for women over 65. The typical insurance reimbursement rate for a single basic screening mammogram currently ranges between $200 and $250, Stolper said.

For women without health insurance, RadNet charges a cash price for the screening mammogram; that price is typically equal to or less than the aforementioned insurance reimbursement rate. He noted that this price is generally only a fraction of what a hospital would charge for a mammogram.

Recently, Stolper added, RadNet began offering women who go through the basic screening mammogram service the option of paying $40 out-of-pocket for an artificial intelligence review of their scans, which the company says can detect cancers at a much earlier stage than a traditional review from a radiologist. He said that RadNet hopes that these artificial intelligence reviews will eventually be included in insurer reimbursement rates.

Stolper declined to detail the company’s financial arrangement with Walmart, except to say that Walmart is benefiting financially. He declined to comment on whether Walmart is sharing revenue or just accepting lease payments. 

Stolper said that RadNet is looking at opening two additional mammography screening centers inside Walmart stores in the next few months: one store is in Hanford and the other is in Phoenix. Beyond that, he said RadNet will wait to see how these centers fare before deciding whether to open locations at other Walmart stores.

There is plenty of opportunity: Walmart has more than 10,000 stores in 25 countries around the world. Walmart’s revenue for the fiscal year ending in January was $611 billion.

For Walmart, the opening of these mammography screening centers is part of its larger health initiative. Between 2019 and the end of last year, Walmart opened 30 health centers at store locations in Arkansas, Florida, Georgia, Illinois and Texas. Each of these health centers offers customers access to primary-care and dental-care clinics, some urgent-care services and, in some locations, mental-health services. 

Walmart has announced plans for a total of 75 health centers across the nation by the end of next year.

Beyond Walmart

RadNet’s Stolper said that the company is in discussions with operators of other “nontraditional health care locations,” but declined to say whether those included other retail superstores such as Issaquah, Washington-based Costco Wholesale Corp. or Minneapolis-based Target Corp.

But Stolper stressed that the current Walmart push is part of RadNet’s effort to increase women’s access to mammograms.

“This is all about making (mammograms) more convenient and accessible to the masses,” he said. “Increasing screenings and exams make for a healthier population.”

Of course, more mammogram screenings would also boost RadNet’s revenue. For the first nine months of this year, RadNet reported nearly $1.2 billion in revenue from its imaging centers, up 14% from the same period last year.

Net income for those nine months was $4.9 million, compared to $11.6 million for the same period last year. One reason for the drop was losses in the company’s new artificial intelligence unit as it scales up the applications it acquired through Deep Health.  

Up until this Walmart pilot program, RadNet has been focusing much of its recent growth initiatives on establishing joint ventures with hospitals and other diagnostic imaging networks.

Last month, RadNet announced it was expanding its joint-venture relationship with Beverly Grove-based Cedars-Sinai Health System that began in 2017. This includes the establishment of a new joint venture called Los Angeles Imaging Group – with three initial locations – and expansion of an existing joint venture in Santa Monica.

“The expanded relationship with Cedars-Sinai is designed to increase patient access to outpatient radiology by broadening the ambulatory network of imaging centers throughout Los Angeles, including certain underserved communities,” Howard Berger, RadNet’s chief executive, said in the company’s Nov. 8 announcement.

One analyst who follows RadNet said at that time that he expects the company to pursue more joint-venture opportunities.

“We think details on the recent JV activity highlight the company’s increasing appetite for JV partnerships and even M&A,” said John Ransom, analyst with St. Petersburg, Florida-based Raymond James & Associates.