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What shutting down Amazon's national care delivery service means about its health care ambition

By John LeagueTy Aderhold

September 20, 2022

    Amazon announced it will shut down Amazon Care—its primary care service sold to employer health plans—by the end of the year. There's one thing that Amazon's decision will surely mean: It will continue to be fashionable to mock Amazon.

    People may look at this, compare it to Amazon's Haven misadventure, and say that everyone (including Advisory Board) who speculated that Amazon could succeed in health care is either naïve or delusional.

    But there's more to it.

    In looking at what Amazon reportedly said about the challenges facing Amazon Care, we believe that the acquisition of One Medical is the clearest signal yet that Amazon intends to succeed at health care.

    The problems with Amazon Care

    Amazon Care appears to have struggled to understand the nuances and demands of care delivery, as detailed recently in the Washington Post. Clearly, the tension between expectations for growth and quality were real. This raised questions for us: Was Amazon going to truly "iterate" on its health care capabilities? When it came to care delivery, would Amazon get better, or would it do enough to get by?

    Amazon concedes that its product was not comprehensive enough for its employer partners. It's unclear whether that means it simply wasn't saving them money, even if employees were using it. At the same time, we wonder how hard it was to persuade employees to embrace Amazon-branded health care or to attract employees to a product centered on virtual and home-based care—or some combination of the two.

    Remember: Everyone had to try out telehealth in 2020 because, in many cases, they had no choice. There isn't any similarly powerful and pervasive force pushing anyone to virtual-first care today. People tend to like virtual visits, but that doesn't mean that they want to receive all adequately satisfy users or keep care from fragmenting with its mosaic of services, channels, and providers.

    What shutting down Amazon Care suggests about Amazon's health care ambition

    Amazon's willingness to jettison its homegrown but underperforming health care business suggests three things.

    1. One Medical is the centerpiece of Amazon's health care strategy, not simply one component among many. When viewed this way, the details of the acquisition make more sense than they did four weeks ago. Knowing that a virtual and home-based model wasn't attractive for employers, we can understand more clearly why Amazon wanted a partner with both in-person and digital health capabilities. Knowing that its own product was struggling, we can see why it was willing to pay a huge premium for One Medical.
    2. Amazon is iterating on its health care capabilities, but it is iterating at an enormous scale. "Fail fast" is axiomatic in technology. It's usually applied to minimum viable products—applications and services that are quickly built, delivered, and assessed for their ability to meet customer demands and gain traction in the market. Products that don't meet those demands are replaced as quickly as possible. Obviously, Amazon Care was not a minimum viable product. It was rolled out three years ago, and it offered telehealth services in all 50 states and in-home services in seven markets. But when you look at the pivot Amazon seems to be making from virtual and home-based care with Amazon Care to in-person and virtual with One Medical, it's hard not to reach for the "fail fast" comparison.
    3. Amazon is a different kind of competitor in health care. We can't think of another organization that would spend years building out a care delivery enterprise, roll it out in 50 states, and then simply shut it down. We also can't think of another organization whose alternative care delivery plan is to spend nearly $4 billion on another company. It's not just the scale and the money—it's the willingness to throw around those assets that makes Amazon a potentially potent competitor.

    There are still enormous execution challenges for Amazon and One Medical. Massive disruption of the industry is not a given, no matter how much money is spent or how many companies are bought and/or fail.

    It seems likely that the impact of Amazon on the market will be centered, at least for the immediate future, on the same direct-to-consumer approach that One Medical has taken and at which Amazon is expert in its other lines of business.

    That does not mean Amazon can be dismissed as a dilettante or a dabbler in health care. Its mere presence in the market already seems to have sparked a bidding war for Signify Health. Amazon's continued iteration of its approach to health care demands ongoing attention.

    Retail and tech giants: Disruptors or collaborators?

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