Kristen Helton, director of Amazon Care

Telehealth

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 Amazon.com, a patient experience that the company could be uniquely positioned to pull off.

Remote Care

McKinsey Predicts More Home Healthcare

In an effort to understand healthcare’s shift from the hospital to the home, McKinsey conducted a survey of physicians who serve the Medicare population, finding that $265B of care services could switch from traditional facilities to the home by 2025.

That figure represents a nearly fourfold increase in the amount of care being delivered in the home, which McKinsey thinks could be attainable without a reduction in quality or access. This chart provides an overview of how it might be possible.

McKinsey categorizes the services that can be delivered at home into three groups:

• Services with capabilities in place that may benefit from scaling, such as primary care, outpatient-specialist consults, hospice, and outpatient behavioral-health visits. 

• Services where capabilities exist that could be stitched together into a comprehensive offering, such as dialysis, post-acute care, and long-term care, and infusions.

• Services with some capabilities but others that could be further developed, which includes a single service, acute care.

All of these services offer potential for growth within the home, although the pros and cons of transferring care outside of a traditional setting depends on the stakeholder (here’s a breakdown). Payors and providers will each have their own reasons for shifting care into homes over the next few years, but McKinsey points out that there’s one main driver behind the expected growth: more home care is good for patients.

Nuance’s Patient Engagement Must-Haves

Consumer demands are shifting, and they’re looking to get more out of their digital health technology. Nuance outlines the 5 must-haves for your patient engagement strategy here.

The Wire

• Therapy Apps Are Like Uber: A recent article from Business Insider painted a less-than-stellar picture of modern therapy apps, comparing them to Uber due to their gig-economy approach to labor. Like Uber, therapy apps promise to disrupt a broken industry through new technologies, but many existing services are now facing accusations of undercompensating their contracted therapists while offering patients “therapy stripped down to a bare-bones version of itself.”

• Volume Over Value: A study of 31 physician organizations affiliated with US health systems found that volume was a component of compensation for 83.9% of primary care physicians and 93.3% of specialists, representing 68% of total compensation. While 83.9% of primary care and 56.7% of specialist compensation arrangements included value-based components, VBC contributed less than 10% of total compensation.

• Labcorp OnDemand: After a successful direct-to-consumer COVID-19 testing pilot, Labcorp is launching a new online service that allows customers to order their own diagnostic tests without physician referrals. Labcorp OnDemand lets consumers choose from dozens of home tests including fertility, STIs, and colorectal cancer screenings, all of which use samples that can be collected at home to eliminate the need for provider middlemen.

• Home Testing, $2B by 2025: Another company with a bullish outlook on at-home testing is Quest Diagnostics, which is now projecting that the US consumer-initiated testing market will hit $2B by 2025, up from $1.3B as of the end of last year. That estimate follows the widespread adoption of at-home COVID tests, which gave many consumers their first exposure to self-ordered testing, a trend that Quest believes will spill into other areas such as digestion and heart health.

• Provider Google Business Profiles: A recent survey from consumer experience company Reputation found that 72% of patients read online reviews when searching for a new doctor, and that reviews on Google Business Profiles are as critical as those from provider websites. Over 70% of respondents trust reviews on Google over provider websites, but a majority of traffic won’t even make it that far, with 65% of organic searches for new providers resulting in a conversion from within the Google experience without visiting another website.

• Equum Expansion: Rarely a week goes by without new evidence pointing to climbing clinician burnout and staffing shortages, issues that’ve caused acute care telehealth provider Equum Medical to quickly expand its leadership team and service portfolio. Since raising $20M in growth funding late last year, Equum has strengthened its core tele-critical care and virtual specialist offerings, which allow providers to offload components of care delivery to address bandwidth bottlenecks.

• Telehealth Preferences: Most infectious disease patients were open to telehealth visits after being educated about the costs incurred by a visit to the clinic, according to a Washington University survey of 75 patients who lived 25+ miles away from their ID clinic. Although only 40.5% of patients would have preferred a telemedicine visit on the day of their visit, 77.3% were willing to complete a future visit by telemedicine after researchers informed them of their round-trip travel distance, travel time, travel expenses, and carbon dioxide emissions.

• CVS + Medable: CVS Health announced a collaboration to improve medical research by incorporating Medable’s clinical trial software at select MinuteClinic locations. Medable’s software is designed to make it easier for patients to participate in trials remotely using mobile applications and medical devices, which combined with CVS’ community reach should improve trial access for vulnerable populations frequently underrepresented in clinical research.

• X-Ray Response Team: A new Radiography study highlighted the Northumbria NHS Trust’s X-ray Response Team (a paramedic, radiographer, emergency clinician, and portable X-ray system), created to reduce unnecessary hospital visits by performing X-rays at patient homes. Over a 7-month proof-of-concept period, the XRT performed 54 calls (84% at patient homes, 80yr average age), reducing hospital visits by 50% and receiving 100% positive patient feedback.

• Kindbody Acquires Vios: Fertility startup Kindbody is now valued at $1.15B after acquiring Vios Fertility Institute, a group of brick-and-mortar fertility clinics. Kindbody’s hybrid care model focuses on providing a combination of virtual and in-person treatments, with the Vios acquisition doubling the company’s footprint to 26 clinics while underscoring the important role in-person services play in family planning.