As the CVS + Aetna merger crosses its last regulatory hurdle at the close of 2018, we enter 2019 facing a fast-growing and -morphing retail health landscape.

I brainstormed retail health yesterday with Patrick Freuler, CEO of Audicus (developer of hearing aids sold direct-to-consumer over-the-counter) and Shai Gozani, CEO of NeuroMetrix, maker of the Quell device for pain management. The three of us will be on a panel addressing retail health disruption at CES 2019 on 9th January 2019 at the Digital Health Summit.

I explained to Shai what I’m going to say in my talk about retail health at the Summit: that once considered the purview of the pharmacy, today “retail health” broadly write covers all consumer-facing touch points for health, not just healthcare. So that includes the many so-called “front doors,” as Oliver Wyman’s team coins them, that provide on-ramps to people seeking wellness, healthcare, holistic therapies, and medical services.

Several big-companies with strong brands have announced plans to go big in retail, consumer-facing health in 2019, falling under my expansive umbrella.

On the pharmacy front, Walgreens and FedEx launched a next-day (or sooner in some markets) delivery service for prescription drugs direct-to-consumers’ homes. This works via a Walgreens mobile app where patients can opt-in to text alerts and be notified when their scrip is ready for pick-up. Instead, she can choose delivery on the app menu, for a $4.99 fee.   Patients enrolled in text alerts will receive text notification when qualifying prescriptions are ready.

Walgreens had more retail health developments, opening a new store concept with Kroger, the grocer, called Kroger Express. The pilot brings together grocery, pharmacy, health and beauty, testing out first in 13 stores in Northern Kentucky. Kroger’s chairman and CEO believes this idea, “rethinks convenience and redefines the way America shops for food,” explained in the press release for the project. The smaller-footprint stores will curate/select a fraction of the number of products sold in typical food markets. In the meantime, Kroger acquired Home Chef, the food subscription service, and offers Home Chef Express kits at Walgreens stores in metro Chicago to start.

Another grocery, Giant Eagle, is moving its pharmacies further into medical services through an agreement to channel DarioHealth’s Digital Diabetes Education and Rewards Program. Giant serves 4.6 million customers in Maryland, Ohio, Pennsylvania and West Virginia each year, who can enroll into the Dario program and receive diabetes education through a mobile app, and earn rewards as people manage the condition. This is the largest deal DarioHealth, an Israel-based company, has struck in terms of potential patient reach.

Another food-focused venture in the retail health world was announced this week: Tivity Health is acquiring Nutrisystem,  the weight-loss brand. Tivity Health has a portfolio of fitness, wellness and healthcare programs and with this acquisition, can expand its healthy living franchise along with programs like SilverSneakers, Prime Fitness, and flip50.

Walmart, already a major force in retail health through its pharmacies, retail clinics, health and beauty aisles, and groceries, is growing in telehealth. The company announced a collaboration with the Department of Veterans Affairs along with Philips and T-Mobile to expand healthcare access to veterans via telehealth. The Anywhere to Anywhere VA Health Care Initiative was launched in 2017 to build a national telehealth network to reach veterans especially in rural and remote areas. This alliance will fill in some of the gaps in the national network.

Walmart is also testing operating mental health clinics in retail stores, beginning in Carrollton, Texas. Walmart’s working with Beacon Health Options from Boston, which already serves 40 million patients across the U.S. The clinic will be staffed by at least one licensed professional and deal with anxiety, depression, grief, stress, and relationship issues, according to the announcement.

To round out these stories, we turn to Amazon, which continues to add accomplished experts from the healthcare system to various health-related projects brewing inside the ecommerce giant. You can’t get more consumer-facing that advertising on the Hallmark channel during the holidays, and I note that as I am in holiday baking mode with the kitchen TV on for background entertainment, PillPack — Amazon’s direct-to-consumer prescription service — has been frequently advertising this season.

Health Populi’s Hot Points:  As patients continue to grow their consumer muscles, retail health is playing a growing role — through the growth of services offered in the community, closer to home, to workplaces, to school, to play and entertainment, to shopping.

It’s not just about convenience but about experience and value-added services. The ventures described here are reshaping what the consumers’ health experience is, pressuring legacy healthcare providers — hospitals, doctors, pharma, health plans, et al. — to grow their own consumer-facing muscles in 2019.