July 12, 2021

Amazon is in talks with insurers to cover Amazon Care

Daily Briefing

    Amazon CareAmazon's medical care service—has approached Aetna and other health insurers to discuss including Amazon Care in their networks as a covered benefit. Conversations on what the payment structure would look like are ongoing, according to three sources close to the matter, Blake Dodge and Shelby Livingston report for Insider.

    From Radio Advisory: When disruptors fail to disrupt: Lessons from Amazon's venture with Haven Healthcare

    Background

    Currently, Amazon Care contracts directly with large companies to provide employees access to its services, which users can access via a mobile app. People using the service can access a medical care team via text message, video chat, or—in certain U.S. locations—in person, Dodge and Livingston report. Those medical teams can give patients vaccines, do lab tests, write prescriptions, and more.

    Initially, Amazon Care began as a pilot for Amazon employees in Washington. This summer, however, Amazon Care aims to expand its telemedicine services to Amazon's entire U.S. workforce, which consists of around 950,000 people, Dodge and Livingston report. In-person care will still be limited select cities.

    Amazon approaches insurers to cover Amazon Care

    Three sources familiar with the matter—who were not authorized to go on record—told Insider that Amazon has approached large health insurers, including Aetna and Premera Blue Cross, as well as regional health plans like Blue Cross Blue Shield of Massachusetts, to join the insurers' health networks as a covered benefit.

    According to the sources, Amazon Care is now looking to become a covered benefit on these plans in part because the companies it currently contracts with individually—including Amazon—have asked it to do so.

    Currently, companies that have contracted with Amazon Care typically pay a monthly fee for their employees to have access to the service, in addition to fees when workers use the service, Dodge and Livingston report. Patients, meanwhile, are charged a copay, and pharmacies and labs working with Amazon Care bill insurance separately.

    However, if Amazon can reach an agreement with an insurer and become a covered benefit, people insured under that health plan would be able to use Amazon Care as they would any other in-network health care provider, Dodge and Livingston report. This would make Amazon Care available to millions of people. In addition, as a covered benefit, the cost of using the service could be applied to patients' deductibles and their out-of-pocket maximums.

    Further, under such an arrangement, large companies could more easily work with Amazon Care. They would likely have to pay only for visits, Dodge and Livingston report, rather than paying for visits on top of a monthly fee.

    An ongoing negotiation

    However, according to the three sources, Amazon Care and the insurers it has reached out to are struggling to align on a payment structure.

    The sources said that Amazon Care wants to set up a value-based payment structure. However, some of the health insurers have instead requested a fee-for-service payment structure, in part because they want to see if Amazon Care is able to lower health care costs, Dodge and Livingston report.

    But Amazon Care does not currently have the infrastructure necessary for a fee-for-service payment structure within its app, which could delay agreements with some health insurers, the sources told Insider.

    A spokesperson for Amazon Care said they couldn't comment on rumors or speculation, while both Aetna and Premera declined to comment. (Dodge/Livingston, Insider, 7/7)

    When disruptors fail to disrupt: Lessons from Amazon's venture with Haven Healthcare

    Radio Advisory, a podcast for busy health care leaders.

    When Amazon, JPMorgan Chase, and Berkshire Hathaway in 2018 announced they would form a joint venture called Haven, it sent ripples throughout the health care industry at the thought of how those three companies could disrupt the health care space.

    Now, three years later, the venture has shut down, but what can health care leaders learn from the rise and fall of Haven? In this episode, Rae sits down with Advisory Board's Andrew Rebhan to discuss exactly that, among other topics like why big tech is even trying to get into the health care space in the first place.

    Listen now

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