Amazon had originally partnered with Berkshire Hathaway and JPMorgan Chase on a new insurance model aptly called Haven as a departure from the status quo frustration with quality, service, and high costs. That venture's future came into question after Dr. Atul Gawande stepped down as CEO in May, 2020.

In February of 2021, Haven Health officially shut down operations. The goal of making primary care easier to access, insurance benefits simpler to understand and easier to use, and prescription drugs more affordable was too difficult to accomplish despite the pooling of three multi-billion dollar companies and a potential employee pool of 1.5 million. Key staff turnover was an early warning as evidenced by the departure of Serkan Kutan former CTO and Jack Stoddard COO prior to Dr. Gawande stepping down.

Amazon accounted for 1.1 million of that 1.5 million potential employee membership and while Haven was slowly dismantling, it quickly started building its own product in its push to own a piece of that healthcare spend. Unlike Apple which in interviews hopes to be remembered in the future as a healthcare company (and also hopes to develop an electric car too), Amazon has made enough progress to actually be considered a healthcare company.

Let's review:

In 2019, just a year after acquiring online pharmacy PillPack Inc, Amazon launches Amazon Pharmacy with prime delivery and pharmacists available 24/7. With a $753 million bid, Amazon beat out Walmart which was also eyeing the rapid growth startup.

In 2019, Amazon Care was created which is a telehealth primary care clinic with at home follow up care for labs, tests, and treatment visits. This bundle also includes prescription delivery. Initial rollout was to Amazon employees in Washington State who were enrolled in an Amazon-sponsored Aetna or Premera health plan. Just last month, this same service of 24/7 primary and urgent care was offered as an employee benefit to large employers in what some call a national rollout.

A look at their job postings shows hiring in Georgia, Virginia, Texas, Maryland, Massachusetts, New York, North Carolina, Illinois, Colorado, Michigan, Indianapolis, Pennsylvania, Florida, Tennessee, California, Arizona, Missouri, and Minnesota! Did we miss any? Combining Telehealth visits with at home visits and simplifying prescription drug costs and delivery is a tremendous achievement. Could there be more to offer? In the same job postings we see calls for analysts and data scientists which might mean Amazon is potentially gearing up to offer disease management services for chronic diseases like diabetes and chronic kidney disease or it might just be expanding its integration team following its recent acquisition of a analytics startup.

Also in 2019, Amazon acquired Health Navigator which offers an analytics platform that is an add-on to existing telemedicine platforms. The platform has a number of tools including:

  • Symptom checker & consumer engagement bots that act as clinical documentation support and an automated triage by asking patients the appropriate sequence of questions.
  • After care instructions for better customer service and improved treatment adherence.
  • Automated coding of clinical notes for insurance billing, and
  • Diagnosis engine that generates a differential diagnosis based on symptoms as shown in the image above.
  • Future outlook: What some might not realize is how well resourced Amazon is and how well it has executed its strategy in just a few years. It has one of the strongest data science engines (Amazon HealthLake) sitting on top of its own cloud services to scale its solutions at lower cost to competitors as well as a nationwide supply chain capable of delivery pretty much any product a patient needs.

    So where do we go from here?

    They can continue to expand their digital services as there are multiple telehealth and analytics products that can be built to improve health and lower costs. Teladoc a Telehealth company recently merged with Livongo, a diabetes care company. Cigna spun out a similar platform play called Evernorth. Both Teladoc and Evernorth are building platform plays with multiple services which Amazon could look at as the beginning of what could be a very interesting care model.

    They could also expand prescription products from drugs to durable medical equipment (think oxygen tanks or blood sugar meters).

    They could expand to additional at-home services. This is especially important for the Medicare population. This is where Amazon Alexa could be integrated into a disease monitoring service especially since Amazon has been working hard to secure conversations so that it is HIPAA compliant. Recently in fact, Amazon introduced a new service called Care Hub that offers caregivers a log of their family member's activity with alerts if no activity is detected over a period of time.

    Lastly, Amazon could build a new insurance product wrapped around Amazon Care which in of itself would be a much needed upgrade to the customer experience compared the status quo. The only hiccup is that securing the appropriate licenses and approvals takes time which leaves Amazon with only one move if it wants to enter this space quickly--acquisition. The good news is that there are more than 950 different health insurance companies spread out across the country.