Brown University Public Health Professor Craig Spencer, MD

Telehealth

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 Amazon.com / 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, Amazon.com 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.

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The Wire

• HIMSS Conference Shakeup: London-based B2B publisher Informa casually tucked some major news into its recent Q2 earnings report, mentioning that it obtained the right to acquire the HIMSS Conference. After about a week of increasingly nervous exhibitors, HIMSS broke the radio silence with an announcement that the transaction is now official. Informa is taking over management of the annual conference, while HIMSS will “oversee developing expert content and programming” starting with HIMSS24 in Orlando.

• Marginalized Patients Skipped in ED: Nearly 25% of marginalized patients have experienced being “jumped over” while waiting for emergency care, according to a JAMA study of over 300k ED visits. Black, Hispanic, and patients with Medicaid were 5-11% more likely to experience “queue violations” where patients who were less severe or arrived later were treated ahead of them. Patients who were skipped were also more likely to be placed in a hallway bed or leave the ED without receiving treatment.

• Love.Life Sneak Peak: A Fast Company interview with former Whole Foods founder John Mackey gave a behind-the-scenes look at the entrepreneur’s new Love.Life healthcare startup, which is apparently already delivering virtual care in all 50 states plus 27 countries around the world. Love.Live centers around what Mackey refers to as Medicine 3.0, which involves robust baseline testing for everything from genetics to the microbiome, followed by everything you might assume a wellness mogul would include: cryotherapy, infrared saunas, acupuncture, and Reiki energy healing.

• U.S. Physician Census Takeaways: The latest FSMB census of licensed physicians in the U.S. answers just about every demographic question you could have about the nation’s 1,044,734 doctors as of 2022. Some high level takeaways were that the total physician workforce grew 23% over the last decade, with women doctors now comprising 37% of the total (up from 30% in 2010). State medical boards issued a record high of 129k new licenses in 2022 (up 27% from 2020), a trend driven predominantly by expanded telehealth use throughout the pandemic. 

• RUSH + Cadence: Rush University System for Health is partnering with Cadence to roll out a new connected care program to support patients with hypertension, congestive heart failure, and type 2 diabetes. The program combines remote monitoring tech with an NP-led care team, allowing Cadence to respond to patient vitals in real-time while alerting RUSH clinicians if needed. Cadence also provides in-home medication management, labs, and coaching, which all-together has demonstrated a 21% decrease in total cost of care for CHF patients.

• The Cost of Data Breaches: The healthcare sector reclaimed its unenviable title as the “most expensive industry for data breaches” for the 13th consecutive year, with the average cost of a healthcare data breach reaching nearly $11M in 2023 (a whopping 53% jump since 2020). High profile incidents at HCA and CommonSpirit helped push up the total, with the latter system’s latest conference call revealing that the total losses due to last year’s ransomware attack have grown to over $160M. 

• Healthmap Raises $100M: Kidney-focused population health company Healthmap Solutions raised $100M to continue its expansion within Medicare, Medicaid, and commercial payors. Healthmap focuses on improving outcomes for polychronic patients through a mix of “predictive analytics, machine learning, and clinical expertise.” The nine-figure round reflects both the massive diabetes market and Healthmap’s rapid growth, with the company now serving over 160k CKD patients and managing over $3B in annual spend through risk-based arrangements.

• MAGENTIQ-COLO FDA Clearance: Israeli-based MAGENTIQ-EYE received FDA 510(k) clearance for its MAGENTIQ-COLO AI-guided colonoscopy solution that helps detect frequently-missed abnormalities, paving the way for U.S. market availability in the coming weeks. A study on the MAGENTIQ-COLO across 10 medical centers found that it increased Adenoma Detection Rate by 7%, translating to a 21% decrease in colorectal cancer occurrence and a 35% decrease in patient mortality.

• CMS Finalizes 3.1% Hospital Bump: CMS finalized a 3.1% payment increase for hospitals in 2024, a slight increase from the 2.8% bump proposed earlier this year. Despite the upwards revision, hospital groups have been outspoken against the final rule. Hospital purchasing group Premier pleaded that “CMS can and must do better to adopt new or supplemental data sources to calculate the real costs hospitals incur moving forward,” while Federation of American Hospitals CEO Chip Kahn said the increase “falls far short.”

• Heart Health by Hims: D2C powerhouse Hims & Hers announced an unexpected expansion into cardiovascular care with the launch of Heart Health by Hims. Noting that erectile dysfunction is an early sign of cardiovascular disease, Heart Health by Hims will attempt to leverage the company’s position as a leading ED treatment provider to enter the CVD market, starting with a single daily “2-in-1” pill that combines the ED medication Cialis with the CVD medication rosuvastatin.

• COVID Crushed Cancer Diagnoses: New research from the American Cancer Society in Lancet Oncology found that the number of adult cancer diagnoses fell by 15% in April 2020 due to pandemic screening disruptions. Concerning trends were also found in the stage distribution of new diagnoses, with stage 1 cancers comprising 31.4% of all diagnoses in 2020 (vs. 40% in 2019), and late-stage cancers accounting for 26.5% (vs. 20%).

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