A tweet from Rob Kornblum in response to Amazon’s growing healthcare presence.

Primary Care

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.

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The Wire

• Audio-Only Telehealth: A Health Affairs study from Harvard Medical School and RAND Corporation found that it’s difficult to predict the future of audio-only telehealth due to poor underlying data and reimbursement clarity. After attempting to estimate market share for  different telehealth modalities, the authors found wildly varying results depending on the data source, with audio-only visits comprising 25% of total visit volume in claims-based studies, 50% in survey-based studies, and 55% in EHR-based studies.

• Apple’s Health Strategy: Not to be left out of last week’s big-tech-in-healthcare newscycle, Apple released a report outlining its two-pronged approach to digital health, which includes delivering more insights through Apple Watch / iPhone features and expanding its partnerships with traditional health systems. The report marks the first time Apple has provided a comprehensive view of its healthcare strategy, and while most of the post centers on current projects, it also makes it clear that future priorities will be focused on going all-in on RPM while integrating insights into clinician workflows.

• Patient Mobile Apps: A Gozio survey of 272 health system executives found that 90% of respondents believe a consumer-facing mobile app would help their organization achieve its digital strategy goals, yet only 22% currently have a custom-built solution. As a result, 82% plan to increase mobile technology investment over the next three years, prioritizing app features such as patient note taking, support for hospital-at-home services, and wayfinding.

• UC Irvine & Luna: UC Irvine Health is teaming up with Luna to provide the health system’s patients with in-home physical therapy through Luna’s nationwide network of more than 4k licensed physical therapists. The Luna platform intelligently matches patients to therapists based on specialty, geography, and schedules, allowing the same therapist to coordinate with the patient until the end of the treatment plan to ensure consistent care.

• Patients Want Access: A new PocketHealth report (n=242 patient users) shared strong evidence that patients benefit from better access to their healthcare information, finding that 71% of patients actively research their own medical conditions, but that 52% have difficulty accessing their imaging records. Nearly 85% of respondents reported an improvement in their overall healthcare experience from being able to access their own imaging records, while 61% felt more engaged with their treatment.

• Innovaccer + Curana: Innovaccer and Curana Health are partnering to build a value-based care solution for high-risk residents in senior living communities across the country. Curana has a presence in 26 states across over 1,000 senior living communities, and will now leverage the Innovaccer Health Cloud to create a unified view of patient clinical / utilization data to help it perform risk stratification and identify proactive interventions that can prevent unnecessary hospital admissions.

• Medable and Withings Partnership: Withings Health Solutions is bringing its at-home connected health devices to Medable’s decentralized clinical trial platform. Using Withings’ solutions, Medable can now remotely capture clinical-grade measurements (temperature, heart rate, blood pressure, sleep patterns, weight) to reduce the burden on trial sponsors and sites while enabling patients to participate in trials from home.

• iRhythm FDA Clearance: iRhythm Technologies received a second FDA 510(k) approval for its ZEUS (Zio ECG Utilization Software) System that works alongside a clinical-grade Zio Watch wearable to detect and characterize AFib. Developed in partnership with Verily, the ZEUS System’s latest clearance is for an AI algorithm that provides context into how much AFib a patient is experiencing over time before generating automated reports to aid in diagnosis.

• Reintroducing GE HealthCare: GE Inc.’s separation into three independent companies reached a major milestone, with the unveiling of the companies’ new names and branding. GE Healthcare will be (slightly) renamed GE HealthCare, adopting updated corporate branding that combines its long-established cursive “GE” logo with new “compassion purple” coloring. GE HealthCare will be the first company to first spin-off in early 2023 (Nasdaq ticker: GEHC), followed by GE’s energy business portfolio (renamed GE Vernova) and its aviation business (renamed GE Aerospace) in 2024.

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