Earlier this month, tech giant Amazon (Nasdaq: AMZN) unveiled major plans to expand its budding home-based care offering, “Amazon Care,” across the U.S.
Since then, home-based care stakeholders have been trying to make sense of the news and figure out what it means for them — and the in-home care patients they serve. Their early evaluations are thus far divided, with some excited by Amazon’s ability to bring additional attention to home-based care and others concerned about technology overshadowing the human touch.
“I would only caution that people who are integral to the building, running and supervising of this platform are those who know health care, preferably with clinicians and patients on the board,” Jinjiao Wang, a nurse scientist in New York, shared via social media. “Algorithms should only serve, not dictate, humans.”
Amazon launched Amazon Care — an initiative that uses an app to coordinate in-person care and virtual health care services — about 18 months ago. The company initially began testing the platform as part of an exclusive pilot program for employees and their family members in the Seattle area, but eventually expanded it across all of Washington by September 2020.
While not much is known about Amazon Care as far as health impacts or utilization, Amazon officials have publicly touted the offering’s accessibility, convenience and timeliness.
“[We’re now] excited to be expanding our service and offering an accessible, convenient solution to help even more employees and their families get the care they need in the moment,” a company spokesperson told Home Health Care News last week.
As part of last week’s expansion news, the full-blown Amazon Care model is now available to all Washington employees as well as other in-state employers who want to add home-based care services to their benefits packages.
Amazon expects to make Amazon Care’s virtual capabilities available to its employees and all other U.S. employers by this summer. In-person care will remain somewhat limited, with concrete expansion plans only announced for Washington, D.C., Baltimore and ‘“other cities in the coming months.”
“We’re rebuilding the whole delivery system around the human at the center,” Nicole Bell, a business development executive with Amazon Care, said in a promotional video posted to the platform’s website. “You just open the app and from there, you can do a text chat with a nurse or a virtual care visit with a provider. If we can’t meet your needs in that virtual environment, we bring the health care system to you.”
Friend or foe
In its existing markets, Amazon has enabled Amazon Care by teaming up with Care Medical, a relatively small private medical practice consisting of licensed clinicians.
As services expand across the country, it’s likely Amazon will need to partner with other home health providers, home care agencies and in-home primary care practices.
That need could, in turn, create new contracting opportunities for those traditional home-based care entities, even if Amazon Care’s patient population isn’t the exact same senior demographic that most operators are used to.
“It’s definitely something to look at and see how Amazon works this for the patient care and those who own their own home health agency,” Amit Parekh, managing director at the Texas-based QA Home Health Services Inc., told HHCN.
The nationwide expansion of Amazon Care’s virtual component is particularly encouraging for technology companies that target the home-based care space.
The use of telehealth and virtual care services has exploded in the past year due to the COVID-19 pandemic. Amazon wouldn’t invest in virtual care if it didn’t see continued upside for years to come, according to Levi Pavlovsky, COO and co-founder of real-time staffing platform Medflyt.
“While Amazon is not necessarily bringing new innovation with their offering, the entrance of the tech giant into the category definitely draws more attention from both investors and regulators and labels the virtual care space as a growing industry,” Pavlovsky told HHCN.
Yet there could be potential downsides to a broader rollout of Amazon Care, too, home-based care stakeholders note.
The most obvious downside could be loss of business, as several home care organizations — including FirstLight Home Care — have formed relationships with employee-assistance programs (EAPs) to provide similar in-home care services to U.S. employers. Amazon Care probably isn’t a big business threat on the senior care front, however.
A nationwide expansion could likewise bring more scrutiny and oversight to the virtual care arena, which is effectively a double-edged sword. More oversight could improve service, but it could also lead to more innovation-stifling red tape.
“Amazon’s move is by no means a ‘bad thing’ for existing home care operators,” Pavlovsky said. “The most drastic change I anticipate for the industry is enforced regulation and stricter guidelines by state legislatures as a result of ‘Big Tech’s’ entrance in the category. As virtual care is currently predominantly unregulated, the hope is that Amazon’s move will help to increase safe and positive virtual care experiences for patients and ensure companies in the space act accordingly.”
HHCN asked home-based care stakeholders to weigh in on Amazon Care and its potential impact on home health and home care agencies through a LinkedIn poll. Of the few dozen stakeholders to reply, 52% said Amazon Care will be “bad” for traditional providers, with 48% saying the platform will be “good.”
A new advocacy weapon
Amazon’s interest in health care was apparent as far back as 1999, when the company began investing money in Drugstore.com, with plans to bring its e-commerce model into the pharmacy space.
Those efforts eventually hit a brick wall.
But Amazon has many inherent strengths it brings to the health care sector, including its scale and existing supply-chain infrastructure. A previous report from CB Insights pointed out that it’s only a matter of time before Amazon figured out how to deliver some sort of health care product to Medicare and Medicaid beneficiaries.
“Many patients in this category have chronic diseases or mental health issues that require day-to-day lifestyle management,” the report stated. “These are groups of the population where Amazon has the most room to grow its Prime Membership.”
In terms of remote patient monitoring in the home, Amazon also has its Amazon Echo, a voice-controlled smart speaker with video capabilities.
“The Echo could be used to monitor adherence and give notifications about medications,” the CB Insights report noted. “Amazon also has patents for monitoring blood flow and heart rate through the camera, and could expand to fall detection or gait monitoring.”
As Amazon bets big on home-based care, it’s simultaneously forging alliances with well-known players. In fact, with organizations like Landmark Health, DispatchHealth, Elara Caring and Home Instead Senior Care at its side, the company helped form “Moving Health Home” at the start of March.
Moving Health Home is a new coalition dedicated to advancing home-based care policies and reimbursement models.
Having skin in the game, Amazon Care may turn into a significant advocacy powerhouse.
“In my professional opinion, Amazon Care has the potential to elevate the awareness and advocacy for our industry as a whole,” American Advantage Home Care CEO Cleamon Moorer, Jr., told HHCN. “I applaud Amazon for shifting its mindset and making steps to join us in our pursuits.”
Moving Health Home is reportedly the brainchild of Washington, D.C.-based lobbying firm Sirona Strategies, which primarily lobbies federal health agencies and has worked with other companies like Aledade and Magellan Health.
On its end, Amazon spent over $18.7 million on its lobbying efforts in 2020, according to data from the Center for Responsive Politics. The issues the company lobbied on include COVID-19 testing, the CARES Act, electronic health records and more.