- Amazon wants to run primary care for other large employers, Business Insider has learned.
- It plans to do that through Amazon Care, which is still in pilot mode and currently serves Amazon’s own workers.
- Through a mobile app, Care offers in-person and online doctor visits. When Amazon employees are sick, they can start an appointment on the app and be visited at home by a nurse.
- It’s unclear how widely Amazon has pitched the service, but it approached Zillow, a person familiar with the matter said.
- Amazon’s continued push into healthcare is important to Jeff Bezos, its chief executive, who recently has been paying a lot of attention to telehealth.
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Amazon, the $1.6 trillion retail and technology behemoth, is plotting a major move to disrupt healthcare, building on its multiyear push into the pharmacy industry.
Amazon is planning to provide online and in-person primary care to workers at other companies, five people familiar with the matter told Business Insider. Two of them have direct knowledge of Amazon’s plans. The people asked not to be named because they were not authorized to speak publicly.
It’s still early in Amazon’s healthcare push, and the company has a long way to go before it can influence the highly regulated healthcare industry and win over employers who in many cases are also competitors.
The health service that Amazon is building would be an extension of the Amazon Care business, which publicly debuted in September 2019 and serves Amazon employees right now. Through a mobile app, it connects eligible workers in Seattle to online doctors, house visits, and prescriptions. This past September, the company expanded the virtual aspects of the pilot to the rest of Washington state. Plans for Amazon Care to work with companies beyond Amazon have not been previously reported.
In the past few years, Amazon has pushed deeper into healthcare, sending shockwaves through the industry with its acquisition of online pharmacy PillPack, in 2018, and again in November when Amazon debuted its Amazon Pharmacy service. Through Amazon’s AI assistant, Alexa, wearables like Halo, extensive data work with health systems, and secretive projects searching for a cure for the common cold, the company is attacking the industry from all sides.
Now, Amazon intends to sell the Amazon Care health service to other large companies, bypassing health plans and brokers, one person said. There are already 300 workers at Amazon dedicated to Amazon Care, a person familiar with the matter said.
Amazon wants to help those employers lower the cost of healthcare, an increasingly pressing problem for organizations that insure roughly half of all Americans and spend $880 billion on healthcare each year.
Business Insider provided Amazon with a detailed summary of the facts in this story before publication and requested a comment and interviews with executives.
“We do not comment on rumor or speculation,” an Amazon spokesperson said in an emailed response. “Amazon Care is a healthcare benefit pilot for Amazon employees in the state of Washington.”
It’s unclear how widely Amazon has pitched the idea, but conversations were initiated with Zillow, the Seattle real-estate marketplace, a person with knowledge of the talks said. Those talks are on hold, the person added.
A spokesperson for Zillow confirmed that the company was pitched by Amazon Care, and said that nothing came of it.
Amazon plans to charge employers a tech fee, plus payments based on how many employees are using the service each month, two people said. The doctor visits themselves would be run by Care Medical, a Washington doctor group that contracts exclusively with Amazon, one person told Business Insider. Care Medical currently works with Amazon on the employee pilot program.
The venture has already faced challenges.
Amazon had planned to have contracts in place with several companies that had employees in all 50 states by July 2021. But that goal has been walked back after leadership realized the “magnitude” of work involved, one person said.
Amazon Care has struggled to hire someone to lead the national expansion, with a posting for the role remaining unfilled since at least August, two people familiar with the matter said. An advisor close to Amazon said that’s because contenders have been wary of Amazon Care’s relationship with corporate and the pressures that come with it.
One now removed job posting from this fall showed Amazon Care looking for a “business development manager” who could “build and grow relationships with commercial and public sector enterprises.” CNBC’s Chrissy Farr reported on Amazon Care’s hiring efforts in October.
Amazon recently tried to recruit, unsuccessfully, three such salespeople from Doctor on Demand, a large telehealth company, a person with direct knowledge of the matter said. A Doctor on Demand spokesperson had no comment on the matter.
Amazon Care has also found itself at odds with Haven, the healthcare joint venture struck up by Amazon, JPMorgan, and Berkshire Hathaway in 2018 to lower healthcare costs and improve care for the founding companies. Over the years, Amazon has been slow to commit to Haven’s projects because some of its internal executives wanted to bring their own solution — Amazon Care — to CEO Jeff Bezos, one person told Business Insider.
Haven said that its founding companies, including Amazon, were supportive.
“Our Founders are aligned on our priorities and programs,” a spokesperson at Haven said in an email. “It’s not accurate to say that they have been slow to collaborate or commit.”
Read more: Amazon is going deeper into the prescription-drug business. Here are the 7 ways the tech giant is taking on healthcare, and why 2 analysts think doctor visits are next.
Amazon Care spun out of Amazon’s mysterious Grand Challenge program
Amazon Care is a product both of Amazon’s corporate human-resources department and of Grand Challenge, a secretive group within Amazon that takes on bold projects that can be out of step with the company’s main business, Business Insider has discovered.
The initial idea was incubated in HR before Haven came along, a person familiar with the matter said. The employee pilot, however, didn’t begin until 2019.
Amazon Care has been kept separate from other key health strategies such as AWS, Amazon Pharmacy, and Amazon Business for healthcare. Kristen Helton-Lloyd is Amazon Care’s boss, and she reports to Babak Parviz, who heads Grand Challenge, Business Insider has learned.
Internally, Care is considered one of Grand Challenge’s “flagship” products, as the clearest example insiders could point to of an idea spearheaded by the group that’s working and growing, someone close to Grand Challenge said.
For now, Amazon Care’s team does in-person and telehealth visits for people with basic health issues such as coughs and fevers, and can refer out to specialists when needed. Ideally, Amazon Care can one day make that hand-off smoother.
In a conversation with Business Insider in September, tech leader Erik Cardenas said one of his priorities is making labs, imaging centers, and doctors in the network more coordinated through the exchange of patients’ health information.
When Amazon Care contracts with other companies, the plan would be to provide the whole suite of services — including in-person visits — to employees who live near headquarters. There would be centralized offices for supplies, but not physical clinics that employees could visit, one person said. Company workers who live in other cities or states would have access only to the virtual components, they said.
Read more: How a 38-year-old who taught himself health technology is shaping a key part of Amazon’s plans to transform healthcare
Amazon is tackling a critical problem for massive employers
During this pandemic, Bezos has been paying a lot of attention to telehealth, or online care, a person close to his team told Business Insider. Remote visits and mobile apps have emerged as a commonsense way to treat people in their homes. That led, in part, to Amazon Care’s bold goals for 2021: Leadership wanted to take advantage of the pandemic-inspired trend toward virtual care.
There’s some reason to think that providing better primary care via telehealth could help employers limit their healthcare spending. Costs are rising, and more than 20% of healthcare spending in the US is considered waste — medical errors, overprescribing, missed diagnoses — estimates show.
So far, the internal Care pilot has yet to gather statistically significant data that it’s lowering Amazon’s healthcare costs, though early numbers are promising, a person with knowledge of the pilot told Business Insider. There’s a correlation, for example, between use of the app and reduced visits to urgent care, which can be costly, they added. That data could be helpful to sell other companies on Amazon Care.
Amazon has a track record of building internal tools to solve problems or lower costs, and then turning those tools into external businesses. For instance, Amazon’s cloud offering, Amazon Web Services, grew out of an effort to address the high cost of servers, Jeff Becker, a healthcare analyst at Forrester, told Business Insider in November.
“They’re solving for healthcare costs the same way they were solving for infrastructure,” Becker said. “And if they are able to do it, they will commercialize that. They would never just sit on it.”
Read more: A small but growing movement of doctors who don’t accept insurance and charge a monthly fee could be a model for big employers like Amazon and JPMorgan
An unwelcome surprise for Haven
When Amazon helped create Haven in 2018, the joint venture with JPMorgan and Berkshire Hathaway was destined to clash with Amazon Care because it focused on cutting costs and therefore infringed on HR’s turf.
In a pilot code-named “Starfield,” a Haven app gave employees access to primary-care teams, The Information’s Paris Martineau reported in July. It’s a similar approach to Amazon Care, and the announcement of Care’s Seattle pilot in September 2019 blindsided and troubled Haven employees when they read about it in news articles, Martineau reported.
Amazon Care and Haven shared a common Amazon leader in Beth Galetti, a senior vice president of HR. She’s been involved in Care’s incubation, one person said, and sits on Haven’s board of directors alongside representatives from Berkshire Hathaway, JPMorgan, and former Haven CEO Atul Gawande.
From the start, key Amazon executives were frustrated with Haven as a concept, one person said. “No one at Amazon was happy about Haven because it was a shot across the bow from Bezos that the internal team wasn’t doing its job to control costs,” they said.
Now Haven is no longer focused on primary care, the venture confirmed to Business Insider, and a recent hire suggested it might be pivoting to address the cost of prescription drugs.
Mitch Betses, a longtime CVS Health executive overseeing part of the pharmacy-benefits business, joined Haven as COO in March, the company said. After the departure of Gawande as CEO in May, Betses has been managing daily operations at Haven.
‘Why not build something new and great’
Amazon Care is learning that primary care is a complex and low-margin business. Its top brass is trying to toe the line between corporate leadership’s expectations for success and speed with what’s possible in this industry, four insiders said.
Some employees with healthcare backgrounds have had short tenures with Amazon Care.
Kristi Henderson, the former clinical operations leader, took a telehealth job at Optum after just over a year with Amazon, according to her LinkedIn. Martin Levine, who founded the medical group working with Amazon Care, left after two years for another medical-director job, his LinkedIn profile shows. One insider said that quick turnover was typical at Amazon.
Henderson had no comment. Levine did not respond to Business Insider’s requests for comment.
Amazon Care has a lot of hope to make something transformative in what it sees as a broken system, two insiders said. Its marching orders are to lower costs not just at Amazon but also at some of the world’s most powerful companies.
“If no one had what anybody wanted, and people were frustrated, why not build something new and great, just like they’ve done in other areas of retail?” a former Amazon employee said. “They’re really good at that.”
Eugene Kim contributed reporting.
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