The Seattle-based company announced in March that it was expanding its on-demand health service, Amazon Care, from just its employees in Washington to the entire country. It also recently announced that it would be expanding mental health services to nearly a million workers, and that it is dipping its toes into diagnostics and pharmaceuticals as well. Amazon is also arguably the flagship company of the Moving Health Home coalition, which includes a slew of home-based care companies looking to advance favorable policies in Washington, D.C. And that’s not even all of it. It goes without saying, Amazon is becoming a relevant home-based care player quickly. Additionally, once it starts accelerating on an initiative, it’s unlikely to stop, Dr. Robin Gaster, the president of the data consulting company Incumetrics, told Home Health Care News.
“Amazon operates like dog years in reverse,” Gaster said. “One human year is seven dog years, right? Well, one human year is seven Amazon years too. They move quickly.” Gaster is also a visiting scholar at George Washington University and an expert on business innovation. He is the author of the book “Behemoth, Amazon Rising: Power and Seduction in the Age of Amazon.” “I think Amazon is going to be a classic disruptor in the space,” Gaster said. “Amazon has made a business out of disintermediating existing businesses and existing markets. And as far as I can see, that’s exactly what they’re going to do here. It just seems that the health care space is pretty well set up for what they want to do, … and businesses are absolutely desperate to try and find cheaper ways to address health issues.”
Amazon Care utilizes an application to help coordinate in-person care and virtual health care services for its employees — for now. The future of it could include providing services for more company’s employers or facilitating care to individuals directly. After all, Amazon has taken the same course with its other pilots in the past. “This is exactly what Amazon did with its retail marketplace, and with AWS more generally,” Gaster said. “Its model is to build stuff for itself, then see who else needs it. I would be astounded if they don’t do the same here.” Many home-based care agencies are just beginning to collect data on a greater level, and some still don’t collect data in a meaningful way at all. Amazon, on the other hand, is one of the most advanced data-collecting entities in the world. Whereas some companies segment different parts of demographics and pull data from each of those, Amazon has mastered the ability to pull data from every individual — creating segments of one.
The ability to compile specific, advanced data on each patient would put Amazon where a lot of home-based care providers strive to be. “It seems to me that health care is traditionally seen as a pyramid — you have primary care at the bottom and then you have specialists, hospitals, intensive care and brain surgeons at the top,” Gaster said. “But Amazon is working right at the bottom of that pyramid, in the basement and in the foundation. Amazon is going to eat health care from below. And I think home health care is absolutely central to that.” Amazon is no stranger to taking on brand new challenges, and it recognizes its investment in health care represents another risk.
“Let me assure you, I can guarantee you that none of these ideas are guaranteed to work,” Amazon founder Jeff Bezos acknowledged during his last shareholder meeting as CEO. “All of them are gigantic investments and they’re all risks. … The only way to get above-average returns is to take risks and many won’t pay off. Our whole history as a company is about taking risks, many of which have failed and many of which will fail, but we’ll continue to take big risks.”
How home-based care players see Amazon
Amazon has as much money, resources and data as any other company in the U.S. — and it certainly has more than any home-based care agency. But in-home care providers aren’t entirely convinced yet that they have to worry about Amazon. In some cases, they feel that Amazon’s focus on the area will force a rising tide that helps raise all boats. “I believe Amazon’s involvement sends a very strong, highly confirmatory signal to the market about the importance of the home as a site of care,” Rami Karjian, the founder and CEO of Medically Home, told HHCN. “It also sends a very strong signal about how consumer attitudes are changing towards health care, particularly in viewing the need to have health care come to them, instead of the other way around.”
Boston-based Medically Home — a member of the Moving Health Home interest group — aids hospitals in their efforts to care for patients in the home. Specifically, it arranges in-home clinician visits and any technology, medication or other supplies that are necessary for at-home care. “In the macro, that’s what Amazon has done such an amazing job at — proving to the world that decentralized models, particularly ones that are focused on the home, can simultaneously offer better service and lower costs,” Karjian said. “And so this is a good, strong sign that there’s no reason why health care should be any different.” Other providers feel the same. If Amazon is going to invest in home-based care and persuade lawmakers to form better legislation for the involved industries, it’s a win for everyone.
On the other side of the coin, if Amazon wants to get into home-based care, it’ll face the same problems everyone else does, Kerin Zuger, the chief of strategic growth at Right at Home, told HHCN. Right at Home is another member of Moving Health Home, having joined earlier this week. “They face what we all face,” Zuger said. “Amazon will need to get reimbursement to follow care into the home, but that won’t be an exclusive arrangement. Other providers will be able to get into the home for seniors with that reimbursement as well. So if Amazon gets care into the home, it will be alongside other providers. In this way, they are a great partner.” The Omaha, Nebraska-based Right at Home is a home care franchise with over 500 offices across the U.S., in addition to a footprint in seven other countries.
Zuger also believes that if anything, Amazon’s threat as a competitor will push home-based care providers to think beyond their traditional way of doing business. “Their entrance into the health care world pushes other providers, including home care ones, to think bigger and do more,” Zuger said. “They are driving convenience in health care, and seeing needs through the eyes of the consumer. We all need to do more of that. Not only for the client, but for the caregiver.” Amazon has disrupted a lot of industries, particularly the retail space.
The company’s power is undoubtedly intimidating, but some in the home-based care world still believe that disruptors will only come from within. Medically Home and Karjian subscribe to that thinking. “I don’t actually believe that Amazon is going to offer a wholesale disruption in the way health care is delivered,” Karjian said. “I think they’re going to be able to support the disruption that health care providers are leading. I think they’re going to help accelerate it, but I don’t think that they’re going to be the ones driving the disruption. Only hospitals and health providers can actually be the ones that drive a disruption to how care is delivered.”