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Will Amazon Care Disrupt Oncology Care?

Dawn Holcombe, MBA, FACMPE, ACHE
Editor-in-Chief
President, DGH Consulting, South Windsor, CT

Rumors about the entry of Amazon into the healthcare arena have been circulating for years. Now, it has become a reality in all 50 states. Although there is no guarantee that this venture will be successful, it is likely to become a seismic event for all healthcare providers and patients. Therefore, it is important to acknowledge and address its potential impact sooner rather than later.

What Is Amazon Care?

A recent press release stated that the goal of Amazon Care is to offer high-quality primary and urgent medical care and advice to employees of Amazon and third-party employers across the country.1 According to the official website (www.amazon.care), the following offerings will be used to help achieve this goal2:

  • Clinicians on your schedule. Connect in seconds, day or night, on weekends, and holidays;
  • Care that comes to you. At-home follow-up care for labs, tests, and treatment;
  • Prescriptions made easy. Contact-free prescriptions delivered right to your door;
  • Dedicated care teams. Quality time with your team of doctors, nurse practitioners, and registered nurses; and
  • Get the care you need in seconds, in all the moments that matter. Get treatment for nonemergency conditions with a virtual visit 24/7/365.

“We’re rebuilding the whole delivery system around the human at the center,” said Nicole Nells, a Business Development Executive with Amazon Care in a promotional video posted on the website. “You just open the app and from there, you can do a text chat with a nurse or a virtual care visit with a provider. If we can’t meet your needs in that virtual environment, we bring the healthcare system to you.”

Rapid Expansion

Amazon Care was launched in the fall of 2019 as a pilot program for Amazon employers and their family members in the Seattle, WA, area. However, by September 2020, it had expanded across the entire state. Amazon is now building the capability for further expansion. On March 17, 2021, it announced a full-blown Amazon Care model for all Washington-based employers that may want to add these services, and it plans to expand its virtual program nationwide to all Amazon employees (and other US employers) by the summer of 2021. In-person care will expand more slowly, beginning in Washington, DC, Baltimore, MD, and other cities in the coming months.1

In some markets, Amazon has assembled clinical teams by partnering with Care Medical, a fairly small private medical practice consisting of licensed clinicians.2 Care Medical, which started as the Oasis Medical Group, is the technical employer of Amazon Care providers (including physicians and nurses), creating a separation for detailed knowledge of its employees’ health for Amazon.3 In January 2021, Care Medical moved its legal headquarters from Washington to Wyoming, and it recently filed paperwork so that it can begin operations in Georgia on July 1, 2021. It has also filed paperwork to start doing business in approximately 17 other states, including Hawaii, Maine, Maryland, and Alaska.

On March 3, 2021, Amazon Care announced a partnership with Intermountain Healthcare, Landmark Health, Signify Health, Elara Caring, Home Instead, and Ascension to form a new home-based clinical care alliance named Moving Health Home.2,4 This partnership aims to support and update healthcare policy changes to designate the home as a site of clinical service.

Focus on Employers

Amazon Care is focused on employers purchasing and supplying its services as a workplace benefit. Promised deliverables include employee access to high-quality medical care within 60 seconds, with options for care around the clock through messaging or video, often without requiring patients to leave their homes. It offers instant access to a range of urgent and primary care services, including COVID-19 and flu testing; vaccinations; treatment of illnesses and injuries; preventive care; sexual health; as well as prescription requests, refills, and delivery.1

It appears that analysts in the telemedicine space believe that this offering will not pose a significant immediate threat to telehealth vendors such as Teladoc Health, Amwell, or Doctor on Demand because there is sufficient market growth opportunity to support multiple vendors5 (although they do acknowledge that smaller companies that focus on specific conditions as employer-facing virtual point solutions may face a greater risk from this new initiative). Unfortunately, these analysts do not appear to be considering the potential impact of those telehealth vendors, including Amazon, on traditional healthcare providers.

Potential Impact on Medical Practices and Providers

Our current healthcare delivery system is based primarily on patients coming to a central office for access to providers and care. During the COVID-19 pandemic, we witnessed firsthand how traditional paradigms can be upended without warning. However, despite the adaptations and innovations that arose during the pandemic, the general conversation has been about settling back into normalcy, with some modifications. Is it possible that the rise of services such as Amazon Care will affect that potential for normalcy?

Although Amazon’s other ventures in healthcare have not panned out (its much-touted Haven initiative with J.P. Morgan Chase and Berkshire Hathaway just folded), there is no denying that as a digital retail giant, it has successfully and dramatically transformed consumer behavior and expectations for purchases of goods and services.5 Every physician and healthcare provider across the country should be taking note of the service expectations that Amazon is seeking to set for healthcare through its new offering.

What Should We Be Doing?

Our healthcare customers are those who need care, and those who pay for care—for the most part, employees, employers, and Medicare. The disruption potential of Amazon Care service could pull the rug out from under traditional care delivery models, such as hospitals and medical practices, as well as intermediaries, such as major national health plans.

We should be developing a strategic analysis and review of our care models, in terms of the rubrics being offered by Amazon Care:

  • Healthcare built around patients, their life, and their schedules
  • Home-based care
  • Connection with medical advice in seconds, on a 24/7 basis
  • Contact-free prescriptions
  • Quality time (virtual as well as in person) with a team of doctors, nurse practitioners, and registered nurses.

We will be looking at this innovation model in detail over the next year, as it expands, and as our healthcare providers explore the challenges and opportunities that arise. We may think that oncology care will be exempt from such changes, but it will not be. Disruption can happen in any market, and the need for innovation will come from external influencers if it is not developed internally. Forewarned is forearmed.

References

  1. Amazon. Amazon Care to launch across U.S. this summer, offering millions of individuals and families immediate access to high-quality medical care and advice—24 hours a day, 365 days a year. March 17, 2021. www.aboutamazon.com/news/workplace/amazon-care-to-launch-across-u-s-this-summer-offering-millions-of-individuals-and-families-immediate-access-to-high-quality-medical-care-and-advice-24-hours-a-day-365-days-a-year. Accessed March 25, 2021.
  2. Padmanabhan P. Amazon Care is a big deal - here’s why. March 18, 2021. www.healthcareitnews.com/blog/amazon-care-big-deal-heres-why. Accessed March 25, 2021.
  3. Jerich K. Amazon Care’s health provider signaling potential expansion, says STAT. March 4, 2021. www.healthcareitnews.com/news/amazon-cares-health-provider-signaling-potential-expansion-says-stat. Accessed March 25, 2021.
  4. Moving Health Home. Leading health innovators form alliance to advance care in the home. March 3, 2021. https://movinghealthhome.org/leading-health-innovators-form-alliance-to-advance-care-in-the-home/. Accessed March 25, 2021.
  5. Pfifer R. Reality check: Amazon Care may not be that big of a deal. March 23, 2021. www.healthcaredive.com/news/reality-check-amazon-care-may-not-be-that-big-of-a-deal/596973/. Accessed March 25, 2021.

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