Uncovering the Healthcare Opportunity in Grocery

Grocery chains in the United States are increasingly investing in on-site healthcare clinics, transforming their stores into hubs for both food and wellness. While grocery stores have long featured pharmacies and some basic healthcare services like vaccinations, recent years have seen a shift towards more extensive healthcare offerings. 

Today, many grocery stores offer a range of services – from primary and urgent care to dental and mental health care. In addition to providing an important community service, grocery-anchored healthcare clinics can boost foot traffic at chains, help health providers reach more patients, and allow shoppers to manage their health and home needs in one convenient trip. 

This white paper examines the impact these in-store clinics have on grocery chain visitation patterns and trade area characteristics. Are shoppers more or less likely to make repeat visits to grocery stores with healthcare services? And how does the addition of a clinic affect the demographic profile of a grocery store’s captured market? The report examines these questions and more, offering insights for stakeholders across the grocery and healthcare industries.

Health Clinics Lead to Healthy Foot Traffic Boosts

Analyzing foot traffic to grocery stores with and without in-store clinics shows the positive impact of these services: Across chains, locations with on-site healthcare offerings drew more visits in H1 2024 than their chain-wide averages.

The Kroger Co., which operates numerous regional banners as well as its own eponymous chain, has been a leader in in-store healthcare services since the early aughts. The company introduced its in-store medical center, The Little Clinic in 2003 – and today operates over 225 Little Clinic locations across its Kroger banner, as well as regional chains Dillons, Jay C Food Stores, Fry’s, and King Soopers.

And in H1 2024, the eight Dillons locations with clinics saw, on average, 93.0% more visits per location than the chain’s banner-wide average. Jay C, which offers two in-store clinics, also saw visits to these venues outpace the H1 2024 banner-wide average by 92.9%. For both chains, relatively small overall footprints may contribute to their outsize visit differences: Indiana-focused Jay C operates just 22 locations, all in the Hoosier State, while Kansas-based Dillons has some 64 locations.  

But similar patterns, if somewhat less pronounced, could be observed at Kroger (43.0%), Fry’s (19.2%), and King Soopers (16.5%) – as well as at H-E-B (14.5%), which boasts its own expanding network of in-store clinics. 

The Doctor is in (Higher HHI Areas)

Analyzing the trade areas of grocery stores with healthcare clinics shows that these services tend to draw more affluent visitors from within the stores’ trade areas. 

For some chains, including King Soopers, H-E-B, and Jay C, the clinics are positioned to begin with in areas serving higher-income communities. The median household income (HHI) of King Soopers’ in-store clinic’s potential markets, for example, came in at $92.3K in H1 2024 – significantly above the chain’s overall potential market median HHI of $88.1K. Similarly, the potential markets of H-E-B and Jay C Food Stores with clinics had higher median HHIs than the chains’ overall averages.  

And for all three chains, stores with clinics tended to attract visitors from captured markets with even higher median HHIs – showing that within these affluent communities, it is the more well-to-do customers that tend to frequent these venues. (A chain or store’s potential market is obtained by weighting each CBG in its trade area according to the size of the population – thus reflecting the general composition of the community it serves. A chain or store’s captured market, on the other hand, is obtained by weighting each CBG according to its share of visits to the business in question – and thus represents the population that actually visits it in practice.)

Other brands, including Fry’s, Kroger, and Dillons, have positioned clinics in stores with potential market median HHIs slightly below chain-wide averages. But within these markets, too, it is the more affluent consumers that are visiting these stores, pushing up the median HHI of their captured markets. 

These patterns highlight that, for now, grocery store clinics tend to attract consumers on the upper ends of local income spectrums. This information can be utilized by healthcare professionals and grocery store owners to pinpoint neighborhoods that may be open to grocery-anchored clinics, or to take steps to increase penetration in other areas. 

Kroger’s In-Store Clinics Offer Community Blueprint 

Supermarket giant Kroger is a major player in the world of grocery-anchored healthcare, offering visitors access to pharmacies, clinics, and telehealth options via its grocery stores. What impact has the company’s embrace of healthcare had on visits and loyalty? 

Convenience for All: Clinics Draw Families

An analysis of household compositions across the potential and captured markets of Kroger-owned stores with and without Little Clinic offerings suggests that families with children are extremely receptive to these services. 

In H1 2024, Kroger, King Soopers, Fry’s, Jay C, and Dillons all featured captured markets with higher shares of STI: PopStats’ “Households With Children” segment than their potential ones – highlighting the chains’ appeal for families. But the share of parental households in those stores with Little Clinics jumped significantly higher for all five banners. 

The share of families with children in King Soopers’ overall captured market stood at 28.3% in H1 2024, higher than the 27.2% in its potential one. But the households with children in the captured markets of King Soopers locations with Little Clinics was significantly higher – 30.6% – and similar patterns emerged at Jay C, Dillons, Kroger, and Fry’s. 

This special draw is likely linked to the clinics' focus on family health services like physicals, nutrition plans, and vaccines. The convenience of being able to take care of healthcare, grocery shopping, and pharmacy needs all in one go makes these stores particularly attractive to parents. And this jump in foot traffic shows the strategic advantage of incorporating healthcare services into the retail environment.

Wellness Options, Loyal Shoppers

Providing essential healthcare services at the supermarket can establish a grocery chain as a crucial part of a shopper's daily life, enhancing visitor loyalty, and helping nurture long-term customer relationships. Indeed, in-store clinics offer a unique opportunity for grocery providers to connect with customers on a level that extends beyond the transactional.

An analysis of several Kroger-branded locations in the Cincinnati metro area showcases the profound impact in-store clinics can have on customer loyalty. In H1 2024, stores with Little Clinics had significantly higher shares of repeat visitors – defined as those making six or more stops at the store during the analyzed period – than those without. 

For instance, 36.4% of visitors to a Kroger Marketplace store with an in-store clinic in Harrison, Ohio, frequented the location at least six times during the first half of 2024. But over the same period, only 29.0% of visitors stopped by at least six times to a nearby Kroger location in Cleves, Ohio – just ten miles away. Similarly, 30.7% of visitors to the Beechmont Ave. Kroger Food & Drug location with a clinic visited at least six times in H1 2024, compared to 23.0% for the nearby Ohio Pike Kroger store.

This trend was consistent across the analyzed locations, with those offering in-store clinics attracting significantly higher shares of loyal visitors. These metrics support the value of offering additional services as a draw for frequent visitors, while also providing the clinics themselves with the visitor volume needed to operate profitably.  

Texas Strong: H-E-B’s Wellness Mission

Texan grocery chain H-E-B is beloved across the state – and though the chain isn’t new to the healthcare scene, it has been doubling down on wellness. In 2022, H-E-B launched H-E-B Wellness, a healthcare platform that offers patrons a variety of medical services, including – as of today –  some 12 primary care clinics, many of them inside stores. 

Community Care at H-E-B

H-E-B stores with primary care clinics are helping to cement the grocer’s role as a convenient one-stop for local residents – allowing them to drop in to a nearby location for both daily grocery needs and wellness care. 

H-E-B has always placed a premium on community, stepping up to help local residents in times of need. And though the chain as a whole draws an overwhelming majority of its visitors from nearby areas, those with clinics do so even more effectively. In H1 2024, some 83.6% of visitors to H-E-B came from less than 10 miles away. But for locations with primary care clinics, this share increased to 88.0%. 

This suggests that wellness services are particularly appealing to nearby residents, strengthening H-E-B’s connection with local consumers even further. And for a grocery store centered on community engagement, the integration of health services into its offerings is proving to be a winning strategy.

Wellness Wins Over Middle-Class Visitors

H-E-B has been steadily expanding its primary care offerings since it launched the Wellness concept, adding two primary clinics at locations in Cypress, TX and Katy, TX in June 2023. Following the opening of these clinics – which operate Mondays through Fridays – both locations saw marked increases in the share of “Urban Cliff Dwellers” in their weekday captured markets. This STI: Landscape segment group encompasses families both with and without children, earning modest incomes and enjoying middle-class pleasantries.  

Between June 2022 - May 2023, the share of “Urban Cliff Dwellers” in the weekday captured markets of the Cypress and Katy locations stood at 9.5% and 7.2%, respectively. But once the stores had clinics in place, those numbers jumped to 12.4% and 11.0%, respectively. 

This increase in the stores’ reach among “Urban Cliff Dwellers” immediately following the clinics’ openings suggests that in addition to more affluent consumers, middle-class families also harbor considerable interest in these services. As more retailers continue making inroads into the healthcare sector, they may find similar success in attracting diverse groups of convenience-seeking shoppers.

Grocery and Health Care: A Winning Combination

As grocery stores lean into healthcare, they are transforming into multifaceted hubs that offer both essential health services and everyday shopping needs. Retailers like Kroger and H-E-B are reaping the benefits of boosted foot traffic, higher-income visitors, and strengthened community ties – while offering their shoppers convenience that helps streamline their daily routines.  

Strategies for Retail Giants

Walmart, Target, and Costco are three of the most popular retailers in the country, drawing millions of shoppers through their doors each day. Each of these retail giants boasts distinct strengths and strategies that cater to their unique customer bases, allowing them to thrive in a highly competitive market. 

This white paper takes a closer look at some of the factors that are helping the three chains flourish. How does Walmart’s positioning as a family-friendly retailer help it drive visits in its more competitive markets? How can Target leverage its reach to drive more loyal visits? And what does the increase in young shoppers frequenting membership warehouse clubs mean for Costco? 

We dove into the location analytics to explore these questions further. 

Year-Over-Year Visit Growth 

Examining monthly visitation patterns for the three retail giants shows Costco’s wholesale club model leading the way with consistent year-over-year (YoY) visit growth – ranging from 6.1% in stormy January 2024 to 13.3% in June. Family favorite Walmart followed closely behind, seeing YoY foot traffic growth during all but two months, when visits briefly trailed slightly behind 2023 levels before rebounding.

Target, meanwhile, had a slower start to the year, with visits trending below 2023 levels for most of January to April. Over this same period (the three months ending May 2024), Target reported a 3.7% decline in YoY comparable sales. But since then, things have begun to turn around for the chain, with YoY visits rising in May (2.5%), June (8.9%), and July (4.7%). This renewed visit growth into the second half of the year bodes well for the superstore – and the ongoing back-to-school season may well push visits up further as the summer winds down. 

For all three chains, Q2 2024’s visit success has likely been bolstered in part by summer deals and intensifying price wars – as the retailers slash prices to woo inflation-weary consumers back to the store.   

Changing Consumer Habits

Over the past few years, consumer behaviors have been changing rapidly in response to shifting economic conditions. This next section explores some of these changes at Walmart, Target, and Costco, to better understand what may be driving these shifts. 

Less Mission-Driven Shopping – Except at Costco

One way that consumers have traditionally responded to inflation and other headwinds has been through the adoption of mission-driven shopping – making fewer, but longer, trips to retailers, so that every visit counts. Superstores and wholesale clubs, which offer one-stop shopping experiences, have long been prime destinations for these extended shopping trips. And even during periods when visits have lagged, these retailers have often benefited from extended dwell times – leading to bigger basket sizes. 

A look at changes in average dwell times at Walmart and Target suggests that as YoY visits have picked up, dwell times have come down – perhaps reflecting a normalization of consumers’ shopping patterns. With inflation stabilizing and gas prices lower than they were in 2022 and 2023, customers may feel less pressure to consolidate shopping trips than they have in recent years. 

In contrast, Costco’s comparatively long dwell times have remained stable over the past several years. The warehouse club’s bulk offerings, plentiful free samples, and inexpensive food court encourage shoppers to spend more time browsing the aisles than they would at other retailers. And even if mission-driven shopping continues to subside, Costco customers will likely keep on making extra-long shopping trips. 

Increased Competition from Dollar Stores

While inflation is cooling faster than expected, prices remain high, and new players are stepping into the retail space occupied by Walmart, Target, and Costco – especially dollar stores. Though higher-income customers increasingly rely on the three retail giants for many of their purchases, customers of more modest means are often drawn to the rock-bottom prices offered at dollar stores. 

And analyzing the cross-shopping patterns of visitors to Walmart, Target, and Costco shows that growing shares of visitors to the three behemoths also visit Dollar Tree on a regular basis. In Q2 2019, the share of visitors to Walmart, Target, and Costco who frequented Dollar Tree at least three times ranged between 9.8% and 13.7%. But by Q2 2024, that share rose to 16.7%-21.6%.  

Dollar Tree is leaning into this increased interest among superstore shoppers. Over the past year, Dollar Tree added some 350 Dollar Tree locations, even as it shuttered nearly 400 Family Dollar stores. And the chain recently acquired the leases of some 170 99 Cents Only Stores – offering Dollar Tree access to a customer base accustomed to buying everything from groceries to household goods. As Dollar Tree continues to grow its footprint and expand its food offerings, the chain will be better positioned than ever to provide a real challenge to Walmart, Target, and Costco.

Still, the three retail giants each have unique offerings that distinguish them from dollar stores. This next section examines what sets Walmart, Target, and Costco apart – and how they can continue to strengthen their competitive edge. 

Inside the Giants’ Playbooks

With competition on the rise, Walmart, Target, and Costco must display agility in navigating an ever-evolving market landscape. This section dives into the data for each chain’s more successful metro areas to see what factors are helping them outperform nationwide averages – and what metrics the retailers can harness to try to replicate these results nationwide. 

Wealthier Visitors Drive Loyalty at Target

Target recently expanded its Target Circle Rewards program, rolling out three new tiers for its 100 million members. And this focus on loyalty has proven successful for the chain. Demographic and visitation data reveal a strong correlation between the median household incomes (HHIs) of Target locations’ captured markets across CBSAs (core-based statistical areas), and their share of loyal visitors in Q2 2024: CBSAs where Target locations’ captured markets had higher median HHIs also tended to draw more repeat monthly visitors.

Target’s captured markets in the Los Angeles-Long Beach-Anaheim, LA CBSA, for example, featured a median HHI of $89.8K in Q2 2024 – and 48.0% of the chain’s LA visitors frequented a Target at least twice a month during the quarter. Target stores in the Chicago-Naperville-Elgin, IL-IN-WI CBSA, where the chain’s captured markets had a median HHI of $88.7K in Q2 2024, also had a loyalty rate of 48.0%. 

Target generally attracts a more affluent audience than Walmart. And even as the superstore slashes prices to attract more price-conscious consumers, the retailer is also taking steps likely to enhance its popularity among higher-income households. In April 2024, Target debuted a paid membership tier within its loyalty program offering perks like same-day delivery for a fee. Maintaining and expanding these premium offerings will be key for Target as it seeks to attract more affluent  customers and replicate its high-performing results in CBSAs nationwide.

Costco’s Younger Audience 

The persistent inflation of the past few years, while challenging for some retailers, has also created new opportunities – particularly for wholesalers. Membership warehouse clubs, including Costco, are gaining popularity among younger shoppers, a cohort often looking for new ways to stretch their more limited budgets. An October 2023 survey revealed that nearly 15% of respondents aged 18 to 24 and 17% of those aged 25 to 30 shop at Costco.

A closer look at some of Costco’s best-performing CBSAs for YoY visit-per-location growth highlights the significance of these younger shoppers: In H1 2024, the company’s YoY visit-per-location growth was strongest in areas with higher-than-average shares of young urban singles.

For example, the San Diego-Chula Vista-Carlsbad, CA CBSA experienced visit-per-location growth of 10.4% YoY in H1 2024, while the nationwide average stood at 7.9%. And the CBSA’s share of Young Urban Singles, defined by the Spatial.ai: PersonaLive dataset as “singles starting their careers in trade and service jobs,” was 12.1%, well above Costco’s nationwide average of 7.3%. 

Walmart’s Family-Friendly Focus

Walmart is a one-stop shop for everything from affordable groceries to clothing to home furnishings, making it especially popular among families. The retailer actively courts this segment with baby offerings designed to meet the needs of both kids and parents, virtual offerings in the metaverse, and collectible toys.

And visitation data reveals a connection between the extent of different Walmart locations’ YoY visit growth and the share of households with children in their captured markets. 

In H1 2024, nationwide visits to Walmart increased by 4.1% YoY, while the share of households with children in the chain’s overall captured market hovered just under the nationwide baseline. But in some CBSAs where Walmart outpaced this nationwide growth, the retail giant also proved especially adept at attracting parental households – outpacing relevant statewide baselines. 

In Boston-Cambridge-Newton, MA, for example, Walmart experienced 5.0% YoY visit growth in H1 2024 – while the share of households with children in the chain’s local captured market stood 7% above the Massachusetts state average. And in Grand Rapids-Kentwood, MI, where Walmart’s share of parental households outpaced the Minnesota state average by an even wider 15% margin, the retailer saw impressive 7.3% YoY visit growth. This pattern repeated itself in other metro areas, suggesting that there may be a correlation between local Walmart locations’ visit growth and their relative ability to draw households with children.

Walmart can continue solidifying its market position by leaning into its family-oriented offerings and expanding its footprint in regions with growing populations of young families.

The Winning Retail Edge 

Walmart, Target, and Costco all experienced YoY visit growth in the final months of H1 2024, with Costco leading the way. And though the three chains still face considerable challenges, each one brings unique strengths to the table. By continuously innovating and responding to changing market conditions, Walmart, Target, and Costco can not only overcome obstacles but also leverage them to reinforce their market positions and drive continued growth.

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Lollapalooza: Energizing Chicago

The first Lollapalooza – a four-day music festival – took place in 1991. Chicago’s Grant Park became the event’s permanent home (at least in the United States) in 2005, drawing thousands of revelers and music fans to the park each year. 

This year, the festival once again demonstrated its powerful impact on the city. On August 1st, 2024, visits to Grant Park surged by 1,313.2% relative to the YTD daily average, as crowds converged on the park to see Chappell Roan’s much-anticipated performance. And during the first three days of the event, the event drew significantly more foot traffic than in 2023 – with visits up 18.9% to 35.9% compared to the first three days of last year’s festival (August 3rd to 5th, 2023).  

Change In Visitor Profile

Lollapalooza led to a dramatic spike in visits to Grant Park – and it also attracted a different type of visitor compared to the rest of the year. 

Analyzing Grant Park’s captured market with Spatial.ai’s PersonaLive dataset reveals that  Lollapalooza attendees are more likely to belong to the “Young Professionals” and “Ultra Wealthy Families” segment groups than the typical Grant Park visitor.

By contrast, the “Near-Urban Diverse Families” segment group, comprising middle-class diverse families living in or near cities, made up only 6.5% of visitors during the festival, compared to 12.0% during the rest of the year.

Additionally, visitors during Lollapalooza came from areas with higher HHIs than both the nationwide baseline of $76.1K and the average for park visitors throughout the year. Understanding the demographic profile of visitors to the park during Lollapalooza can help planners and city officials tailor future events to these segment groups – or look for ways to make the festival accessible to a wider range of music lovers.

Businesses Get Boosts

Lollapalooza’s impact on Chicago extended beyond the boundaries of Grant Park, with nearby hotels seeing remarkable surges in foot traffic. The Congress Plaza Hotel on South Michigan Avenue witnessed a staggering 249.1% rise in visits during the week of July 29, 2024, compared to the YTD visit average. And Travelodge on East Harrison Street saw an impressive 181.8% increase. These spikes reflect the festival’s draw not just for locals but for out-of-town visitors who fill hotels across the city.

The North Michigan Avenue retail corridor also enjoyed a significant increase in foot traffic during the festival, with visits on Thursday, August 1st 56.0% higher than the YTD Thursday visit average. On Friday, August 2nd, visits to the corridor were 55.7% higher than the Friday visit average. These numbers highlight Lollapalooza’s role in driving economic activity across Chicago, as festival-goers venture beyond the park to explore the city’s vibrant retail and hospitality offerings.

Queens Keeps it Cool

City parks often serve as community hubs, and Flushing Meadows Corona Park in Queens, NY, has been a major gathering point for New Yorkers. The park hosted one of New York’s most beloved summer concerts – Governors Ball – which moved from Governors Island to Flushing Meadows in 2023. 

During the festival (June 9th -11th, 2024), musicians like Post Malone and The Killers drew massive crowds to the park, with visits soaring to the highest levels seen all year. On June 9th, the opening day of the festival, foot traffic in the park was up 214.8% compared to the YTD daily average, and at its height, on June 8th, the festival drew 392.7% more visits than the YTD average. 

The park also hosted other big events this summer – a July 21st set by DMC helped boost visits to 185.1% above the YTD average. And the Hong Kong Dragon Boat Festival on August 3rd and 4th led to major visit boosts of 221.4% and 51.6%, respectively. 

These events not only draw large crowds, but also highlight the park’s role as a space where cultural and civic life can find expression, flourish, and contribute to the health of local communities.

The Reach and Resonance of Events

Analyzing changes in Flushing Meadows Corona Park’s trade area size offers insight into how far people are willing to travel for these events. During Governors Ball, for example, the park’s trade area ballooned to 254.5 square miles, showing the festival's wide appeal. On July 20th, by contrast, when the park hosted several local bands and DJs, the trade area was a much more modest 57.0 square miles.

Ready, Set, Summer

Summer events drive community engagement, economic activity, and civic pride. Cities that invest in their parks and event hubs, fostering lively and inclusive spaces, can create lasting value for both residents and visitors, enriching the cultural and social life of urban areas.

For more data-driven civic stories, visit Placer.ai.