Amazon Clinic Expands to All 50 States

The same eCommerce giant that brought us one-click checkout is well on its way to bringing us one-click healthcare, with Amazon Clinic now available in all 50 states.

Amazon’s blog post sticks to the company’s roots by positioning Amazon Clinic as a “virtual health care marketplace,” allowing patients to compare treatment options for 30+ common conditions like pink eye or allergies.

The clinicians delivering the actual care appear to be from four partner networks: Curai, Hello Alpha, SteadyMD, and Wheel.

  • Users can see the cost of each provider, as well as the average wait time, although notably absent is any sort of care quality metric for the desired condition.
  • They can then select either an asynchronous chat or a live video visit delivered directly through / the Amazon app, and medications can be conveniently fulfilled by Amazon Pharmacy. Sounds great on paper.

It’s easy to picture this playing out the same way that Amazon’s eCommerce marketplace unfolded, with telehealth costs kicking off a race to the bottom that’s great for consumers and less great for margins. 

  • Amazon Clinic’s provider partners just got a massive boost to visibility (and probably volume), and we could see more traditionally B2B telehealth vendors enrolling to get the same perks.
  • Amazon also gains a treasure trove of user data, a new gateway to Amazon Pharmacy (One Medical referrals could easily be on the way), and it doesn’t seem far-fetched to think the Amazon Basics playbook of copying/acquiring outperformers is on the roadmap.

The Takeaway

Convenience is king with all consumers, and Amazon is hard at work blurring the line between patient and consumer. This probably wasn’t news that Ro or Hims loved to see, given that they offer overlapping services without the benefit of two billion website visitors every month. Case in point, publicized the Clinic expansion with a homepage banner reading “healthcare for those ‘can’t wait’ days,” possibly the single most valuable ad slot for a D2C telehealth launch of all time.

Amazon Launches RxPass For Generic Drugs

The biggest digital health news of the week was Amazon’s new RxPass offering, which sparked a ton of conversation around the tech-giant’s overall strategy and the direction of retail healthcare.

The RxPass details seem to have already been posted on every news site under the sun, but here they are in case you missed them:

  • Consumers can choose from a list of 53 generic medications for over 80 common conditions such as hypertension, anxiety, or hair loss, then have ALL of them filled for a total of $5/month, including delivery. Here’s the full list.
  • What’s the catch? You need to be a Prime member ($139/year), it’s OOP only (even Medicaid/Medicare coverage is a no-go), and residents of California, Texas, and a handful of other states need not apply… yet.

For patients taking multiple medications, RxPass has the potential to be an absolute game changer. It also seems like a great way to enroll new Prime members that don’t want to watch Jack Ryan or listen to Amazon Music, especially seniors.

  • Only a few other companies have the logistical prowess to put something similar together, such as Walmart’s generic drug service ($4/month PER medication), CVS and Walgreens’ prescription programs, and Mark Cuban Cost Plus Drug Company’s transparency-first approach.
  • What these competitors don’t have is 170M US Prime members and a website that averages two billion monthly visitors. Walmart’s probably the closest, and it last reported having about 12M Walmart+ members.

The Takeaway

Amazon’s RxPass launch is the latest link in a chain of healthcare moves that now looks something like this if you cut out the noise form Alexa / Whole Foods / Halo:

If anything, RxPass reaffirms Amazon’s commitment to compete in the healthcare arena through its core competencies, which isn’t exactly great news for D2C digital health startups or mail-order pill mills. The good news is that if anyone’s going to come out on top of all the competition, it’ll probably be the consumer.

Amazon Ends Amazon Care, Pursues Signify

What a week for Amazon. Just when you think that entering the bidding war for Signify Health would be enough excitement for one top story, the tech giant had to overshadow the news with another major announcement:

Amazon Care will shut down at the end of the year.

In an internal memo obtained by The Wall Street Journal, Amazon Health Services SVP Neil Lindsay explained that the primary care offering wasn’t “the right long-term solution” for its enterprise customers.

  • The move comes as quite the surprise given that CEO Andy Jassy recently highlighted Amazon Care in his first letter to shareholders, as well as the fact that we just covered a new partnership with Ginger that would’ve brought behavioral healthcare to the service.
  • Although Lindsay didn’t give too many details on the matter, earlier this month The Washington Post reported on a growing tension over Amazon Care’s ability to balance growth with proper medical safeguards, as well as a nursing shortage that’s been hampering expansion. 

Amazon said that its decision to pull the plug on Amazon Care was made prior to last month’s $3.9B acquisition of One Medical, but the company’s second major headline from this week might cast some light on the course correction:

Amazon is on the list of heavy hitters competing for the Signify Health acquisition.

  • Other companies vying for Signify include CVS Health and UnitedHealth Group, with the latter bringing the highest reported offer (so far) to roughly $8B – implying a 20% premium at $34 per share.
  • We covered Signify’s core home care business in our initial writeup, but Amazon’s angle could center more around the treasure troves of data that the company collects on the Medicare Advantage population that just so happens to be the same patients served by the Iora segment of One Medical.

The Takeaway

Regardless of the outcome of the Signify acquisition, Amazon’s interest in the company and the abrupt end to Amazon Care seem to signal that it’s done its diligence and has decided to hone its focus on a combination of senior care (Signify + Iora), primary care clinics (One Medical), and prescription delivery (Pillpack). 

We’ll leave further speculation alone for now since we luckily shouldn’t have to wait too long for an official update. Signify is set to have a board meeting on Monday to discuss the offers, and negotiations are expected to conclude shortly after Labor Day.

Amazon Acquires One Medical for $3.9B

If you looked at any sort of healthcare news last week it was pretty hard to miss what might end up being the biggest digital health story of the year: Amazon agreed to acquire primary care provider One Medical for $3.9B.

Should the acquisition close, it will be Amazon’s third largest of all time behind Whole Foods ($13.7B) and MGM Studios ($8.5B), and the first since the company appointed Andy Jassy as its chief executive.

One Medical is a membership-based primary care provider that offers virtual care as well as in-person visits. It operates 188 US locations across a dozen markets, boasts over 750k members, and works with more than 8k employers to offer its services as a benefit.

  • The company ended Q1 2022 with a net revenue of $254.1M and a hefty loss of $90.9M due in part to its significant customer acquisition costs. Hypothetically, these expenses could be cut down by steering Amazon’s ~160M US Prime subscribers towards One Medical’s services.
  • The acquisition also helps alleviate the scaling challenges of building a brick-and-mortar presence and staffing clinics in a tight labor market, while giving Amazon access to One Medical’s existing payor and health system relationships.

Amazon’s quickly growing list of healthcare moves ranges from launching Amazon Pharmacy on the back of its 2018 acquisition of PillPack to the nationwide rollout of its Amazon Care employer telehealth program earlier this year.

  • Some of Amazon’s initiatives have seen more success than others, and its ill-fated Haven partnership with JPMorgan and Berkshire Hathway came to a sooner-than-hoped-for ending last February.
  • That said, Amazon has never had significant in-person resources to bolster its care delivery, and its One Medical acquisition is a strong acknowledgement that Amazon views the future of healthcare as hybrid.

Industry Impact 

Although we’ll have to wait and see where Amazon’s healthcare ambitions go from here, owning the primary care “front door” to the healthcare system gives Amazon a way to disrupt the industry using the same customer-first playbook that made it an e-commerce giant in the first place.

As for what comes next, analysts were quick to speculate on everything from Amazon health plans to specialty care, but the acquisition itself might also prompt other retailers like CVS and Walgreens to ramp up their own primary care services. Amazon’s laser-focus on the customer experience reshaped how long millions of consumers were willing to wait for packages and caused its competition to either catch up or get left behind, and picking up a primary care provider seems to suggest that healthcare might be in for a similar shakeup.

Teladoc and Amazon Partner on Echo Voice Visits

Yesterday’s competitors are today’s collaborators, with Teladoc and Amazon inking a new partnership to bring voice-activated virtual visits to Alexa-equipped Echo devices.

  • “Alexa, I want to talk to a doctor” will now connect Echo users to a Teladoc call center to verify a patient’s medical history and health plan information ($0 if covered, or $75 direct-to-consumer). Within roughly 15 minutes, the patient will then get a call back from a Teladoc physician to treat mild needs such as colds, flus, or allergies.
  • The new service will initially be available in an audio-only format for supported devices such as the Echo Dot and Echo Show, but will add video functionality “soon” to make it easier to diagnose certain conditions.
  • The partnership greatly expands Teladoc’s consumer reach as part of its ongoing strategy to meet patients where they are. Amazon reports over 40M Alexa users in the US alone, and has delivered more than 200M Alexa-equipped devices globally.
  • This is the latest in a string of health-focused improvements to Amazon’s Alexa ecosystem, which have included capabilities for elder care coordination through Alexa Together, as well as medication management through the Care Hub… and those are happening outside of even bigger moves with Amazon Care.

Industry Impact

Despite the recent launch of Amazon’s own Amazon Care telehealth service, Teladoc’s virtual physician network is significantly larger, and this scale will be absolutely essential to keep up with what could be an insanely high call volume for the new service.

The Teladoc partnership marks Amazon’s first attempt at providing truly on-demand healthcare with Alexa devices, and if well executed, could go a long way towards breaking down barriers to care for many patients. Even though Amazon and Teladoc are now competing in the same arena, the collaboration shows that coordinated efforts are still on the table when there’s a clear benefit for both patients and the companies.

Amazon Expands Telehealth Services Nationwide

It’s never great to hear that a competitor with deep pockets and an army of engineers is pushing into your market, and this week Amazon gave companies in the employer telehealth space a lot to be nervous about.

After launching as an internal service in 2019, Amazon is now expanding its Amazon Care health offering to employers across the US amid “growing demand” for hybrid care.

Amazon Care’s hybrid model consists of two main elements:

  • Telehealth-based primary care delivered by a dedicated Care Medical doctor
  • Nurse practitioners dispatched to patient homes when medical needs can’t be resolved over video

Virtual services are now available nationwide to meet the needs of Amazon Care’s growing roster of employer clients, which now includes TrueBlue and Whole Foods Market (a fairly self-congratulatory announcement considering Amazon acquired the grocer in 2017).

In-person services are also expanding beyond the 8 existing locations (Seattle, Baltimore, Boston, Dallas, Austin, Los Angeles, Washington, DC, and Arlington), with Amazon planning to bring its nurse practitioner network to 20 additional cities by the end of the year, including San Francisco, Miami, Chicago, and New York City.

Industry Impact

The telehealth landscape is crowded with companies promising to improve outcomes with video visits, but Amazon Care’s in-person component could prove to be its biggest differentiator.

The hybrid model allows Amazon to keep patients within its ecosystem when in-person care is needed, building off the logistical expertise of its retail business to coordinate at-home and virtual care. Amazon is aiming to make ordering healthcare as seamless as ordering any other product off of, a patient experience that the company could be uniquely positioned to pull off.

Amazon Care is Coming to a City Near You

Amazon is expanding its in-person medical care service to 20 cities by the end of next year, causing many digital primary care providers to begin wondering how much disruption is on the way.

  • What is Amazon Care? The service offers virtual primary care through an app, connecting users to physicians with messages and video in as little as 60 seconds. For in-person care, nurses are dispatched to patients’ homes for tests and treatment, as opposed to patients travelling to an office.

Amazon Care began as an employee-only health service for the company’s own workers, but recently opened up to other US-based employers.

In-person care was originally limited to Washington state, Washington DC, and Baltimore, but is now set to reach Philadelphia, Chicago, Dallas, and Boston in 2021 – at least according to “three people familiar with the plans” speaking to Business Insider.

  • Is Amazon Care coming to your city in 2022? Yes… as long as you live in Atlanta, Denver, Detroit, Houston, Indianapolis, Kansas City, Los Angeles, Miami, Minneapolis, Nashville, Tennessee, New York, Phoenix, Pittsburgh, San Francisco, San Jose, or St. Louis.

Although the expansion announcement might seem as innocuous as a young Jeffrey Bezos telling you he’s starting to sell books on the internet, Amazon’s success in industries ranging from e-commerce to cloud computing suggests that healthcare could be next.

The $3T US healthcare market is notoriously difficult to disrupt, and Amazon Care’s unique approach of sending clinicians to patient homes is an enormous logistical problem, but that might make the company behind 2-day free shipping the best one to solve it. 

Although Amazon’s recent healthcare ventures haven’t had an industry-altering impact, the company has a long history of experimenting, learning lessons from failures, and making a better product down the road. Amazon Care might be that product.

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