JustCare

Tag: Amazon

  • Want your prescription drugs quickly? Get drone delivery

    Want your prescription drugs quickly? Get drone delivery

    Bruce Japsen writes for Forbes on drone delivery of prescription drugs. If you happen to live in certain cities, you can now have your prescriptions dropped  outside your door within an hour of your request to fill them, at no extra cost. Several companies are testing drone delivery service in various cities across the US.

    Amazon’s Prime Air drone will deliver the prescription drugs in College Station, Texas. Over time, residents of other cities will be able to receive fast drone deliveries of their prescriptions through Amazon. But, it could take a few years. Prime Air drones already operate in College Station and Lockeford, California.

    Amazon’s press release reports that “Eligible Amazon Pharmacy customers can select ‘free drone delivery in less than 60 minutes’ at checkout. A pharmacist will then ensure medications are loaded and transported to a customer’s home within the next hour. College Station residents selecting drone delivery will have access to more than 500 medications that treat common conditions, including flu, asthma, and pneumonia.”

    Walgreens, CVS Health and Walmart are already testing drone delivery of prescription drugs. Walgreen’s is using Wing’s drones to deliver prescription drugs as well as over-the-counter health and wellness products to tens of thousands of people in the City of Frisco and the Town of Little Elm.

    CVS Health was testing drone deliveries of prescription drugs as far back as April 202o in The Villages in Florida. It partnered with UPS to make these deliveries to about 130,000 people. But, since the initial launch, there is no information as to whether the drone delivery service is working or has been expanded.

    Walmart began working with DroneUp to deliver medicines and other products to about 4 million of its customers back in May 2022. For $3.99, it delivers up to 10 pounds of items in as little as 3o minutes in parts of Arizona, Arkansas, Florida, Texas, Utah and Virginia.

    The corporations say drone delivery of medicines is about helping people to adhere to their medication regimens. One in three people don’t fill their prescriptions. While some can’t get to the pharmacy, for which drone delivery should help, a lot of failure to adhere to drug regimens is about not being able to afford the prescription drug copays. Of course, when that’s the case, people will need more than drone delivery service to comply with their medication regimens.

  • Amazon Clinic now offers telehealth in all states but doesn’t take insurance

    Amazon Clinic now offers telehealth in all states but doesn’t take insurance

    Since the Covid-19 pandemic, Medicare has been covering a wide range of telehealth services, which have eased access to care for millions of older adults and people with disabilities. Telehealth services have been available through a wide range of providers. Now, Amazon is launching Amazon Clinic in all 50 states and the District of Columbia to treat basic medical needs through health messages and video visits 24 hours a day every day.

    It was nine months ago that Amazon came out with its virtual medical clinic. Back then, Amazon’s clinic addressed 35 common ailments, such as pink eye, acid reflux, birth control, hair loss, skin conditions and urinary tract infections. It now offers video consults and operates throughout the US.

    Wheel, which has a panel of board-certified physicians and nurse practitioners across the US, is partnering with Amazon to offer the video visits. Amazon Clinic will work with a host of telehealth companies to provide virtual consults. To help people choose among providers, Amazon will provide information on wait times and costs with different telehealth providers. Appointments are not needed.

    In February, Amazon bought One Medical, a company that delivers primary care and owns 188 medical clinics in 29 markets. One Medical has 815,000 members. Amazon also now owns PillPack a prescription drug pharmacy, providing drugs through mail order.

    It’s not yet clear whether Medicare will cover telehealth services through Amazon Clinic and, if so, whether Amazon Clinic will accept Medicare coverage for its Medicare patients.

    Right now, Amazon Clinic is not taking insurance. It is a cash pay business. But, unlike most medical visits, patients will know the cost in advance of their visit.

    Questions and concerns about Amazon Clinic remain, including patient health data privacy. Of course, if you have a primary care doctor and are able to schedule an appointment, it’s generally best to visit in person and have Medicare or other health insurance cover the visit.

    Here’s more from Just Care:

  • Amazon Care is shutting down

    Amazon Care is shutting down

    Surprise, surprise. HealthcareDive reports that Amazon is shutting down Amazon Care, its primary care business. By 2023, Amazon Care will be no more.

    Amazon Care started just three years ago. It began as a primary care service–both in person and virtual–for its workers in Seattle. In 2021, it expanded to meet the primary care needs of companies throughout the country.

    And, as recently as February of this year, Amazon announced that Whole Foods, Hilton and four other large companies were using Amazon Care for their workers.

    But, Amazon Care appears not to have offered Amazon’s enterprise customers enough. Amazon says that its corporate customers were not interested in Amazon Care. Perhaps they felt that the insurance coverage they provide did a good enough job of meeting the needs of their workers.

    The Washington Post reported that Amazon’s medical team was unhappy with Amazon Care’s inability to help people in crisis. The drive for Amazon Care to get bigger conflicted with struggles to meet patients’ needs. One telehealth nurse had nowhere to send a suicidal caller in crisis and had to hang up on the person.

    As I reported for Just Care last month, Amazon bought One Medical, a primary care company, for nearly $4 billion and planned to expand on its primary care business. But, it would have had to figure out how to make Amazon Care and One Medical work together, an apparently challenging feat.

    It’s not at all clear that the end of Amazon Care means the end of Amazon’s interest in offering health care services. It’s possible that Amazon decides it’s better off buying health care services than trying to build them.

    Here’s more from Just Care:

  • Amazon moves into primary care

    Amazon moves into primary care

    Amazon plans to buy One Medical, a large group of primary care doctors, for $3,9 billion. What does that mean for the future of health care in the US? Stat News reports.

    Amazon already owns a pharmacy business, health clinics and telehealth services. With the purchase of One Medical, it will own 180 medical facilities and business from a number of companies that use One Medical to care for their workers. One Medical says that it currently provides care to about 800,000 people.

    Once it acquires One Medical, Amazon will offer both in-person and virtual services through Amazon Care. It will offer primary care, lab services, vaccinations, preventive care, urgent care and an online pharmacy. Most likely, Whole Foods will offer some medical services on sit. Amazon Care also sends nurses to patient homes in some instances.

    Presumably, Amazon will generate revenues from big corporate health insurers and Medicare. One Medical has been contracting with Medicare on both the Medicare Advantage side as well as now in traditional Medicare as a direct contracting entity–an entity that is paid a flat rate by the government to “manage” care for people in traditional Medicare.

    Currently, employers and others pay One Medical an annual fee of $199 a person plus care costs to provide their workers and others primary care.

    Amazon intends to offer primary care services throughout the nation. The question remains as to whether Amazon will improve quality and lower costs. And, can it turn a profit? One Medical charges high costs for its primary care services.

    Primary care has never been a profitable business. Doing it well takes time. So, Amazon might be thinking it will use this primary care business as a tool to generate more revenue from its other businesses.

    And, how will Amazon address the care needs of people with costly and complex conditions? Older adults and people with disabilities who need a lot of care have always been a population corporate health plans have sought to avoid, for fear of losing money.

    I have always assumed that Amazon or Facebook or Google or Apple would take over our health care system. They continue to take over large tranches of the economy. It’s easy to imagine that these companies would not use their power to the good of patients. They need to generate profits. But, the current system is anti-competitive and completely broken. Could a world with Amazon Care be worse?

    What should you do? Choose your primary care doctor carefully. You need a good one for many reasons,, even if you’re healthy. You want one who puts your health care needs first and will direct you to the best specialists should you develop a complex condition. You want to avoid primary care doctors driven by financial incentives to delay or deny you care.

    Here’s more from Just Care:

  • Private sector can’t fix health care; we need government

    Private sector can’t fix health care; we need government

    This piece was originally published on the Health Justice Monitor.

    How Amazon, JPMorgan, and Berkshire Hathaway took on America’s health care system—and lost, FORTUNE, June 1, 2021, By Erika Fry

    Was it a press release, or a declaration of war?

    How else to explain the media and market frenzy that followed the announcement, issued on Jan. 30, 2018, that Amazon, Berkshire Hathaway, and JPMorgan Chase — three of the nation’s largest, most high-profile, and best-run companies, then with some $534 billion in revenues between them — were teaming up to take on the ever-more-expensive, ever-more-complex problem that is American health care.

    To those who had toiled in the world of employer-sponsored health care for decades, trying but never really succeeding to come up with new ways to control costs and improve outcomes … the statement, from three powerful CEOs, was cause for celebration.

    Five months in, the team announced another star would lead the venture: Atul Gawande, the surgeon and influential New Yorker writer whose clear-eyed analysis of America’s dysfunctional health care system had earned him the admiration of Barack Obama and Buffett. In March 2019, the venture finally got a name, Haven.

    The project officially sputtered to an end earlier this year. Even with its star power, Haven couldn’t break the black box that is U.S. health care.

    So, did Haven make a difference? Some argue the effort undermined progress by raising the obvious question: If they couldn’t do it, who can? In a recent Kaiser Family Foundation survey of very large employers, 85% of top executives think government support will be necessary to control costs and provide coverage.

    Gawande goes further and has recently argued that the employer-sponsored system can’t be fixed. Noting how many Americans lost their health insurance in a global pandemic, he said, “A job-based system is a broken system.”

    ***

    Comment by Don McCanne

    I contend that the Haven health reform effort of Warren Buffett, Jeff Bezos and Jamie Dimon, along with Atul Gawande, was a spectacular success, as an experiment in health policy. They proved beyond any reasonable doubt that the private sector is incapable of fixing our highly dysfunctional health care financing system. The only model that has shown promise is a single payer Medicare for All system. But you cannot set that up as an employer-sponsored system; it will have to be a public system for all the people.

  • Amazon dives deeper into health care

    Amazon dives deeper into health care

    Amazon’s venture into healthcare through Haven under Atul Gawande’s leadership did not succeed as planned, but Amazon is still diving deep into the health care space. This summer it is launching a new health care initiative for workers across the nation. Amazon Care offers on-demand healthcare services, both telehealth and in-person.

    Amazon Care has been around for Amazon employees since September 2019.  It allows Amazon workers to get telehealth services–both primary care and urgent care–via the internet. It also affords workers who need at-home care from a health care professional in-person services. For example, people who need their blood drawn or their lungs listened to can schedule an appointment for a health care provider to come to them; they do not need to leave their homes.

    Amazon Care also offers delivery of prescription drugs. Right now, Amazon Care is still only available to Amazon workers and their families in Washington state. But, this summer it is expanding its telehealth services to Amazon workers and workers at other companies throughout the US. And, it is also expanding its in-person at-home services to Washington DC and Baltimore, among other cities.

    Amazon Care provides almost instantaneous telehealth services. The goal is for its virtual care to be quick and efficient; if successful, it will stand apart from its competitors. Moreover, unlike many of its competitors, Amazon Care allows for continuity of care, so that people can stay with one medical team rather than having to switch teams each time they need care.

    To complement the telehealth and in-person services, there’s an Amazon Care app that can nudge people to refill prescriptions and to get follow-up care when needed. People can also schedule appointments through the app.

    There’s no information on what Amazon Care charges for its services. It appears that, at least for now, the cost is on top of insurance premiums for the workplace coverage employers offer. It’s easy to imagine that, over time, it will be integrated into that coverage.

    Amazon’s press release does not indicate whether it plans to coordinate with Medicare. Given the amount of money in Medicare, it’s hard to imagine it is not planning to do so. And, then, the question becomes, will Amazon Care drive down the cost of care and drive out its competitors?

    Here’s more from Just Care:
  • Why did Amazon’s health care venture fail?

    Why did Amazon’s health care venture fail?

    You likely recall that a few years ago, Amazon, Berkshire Hathaway and JP Morgan Chase decided that they would come together to address the health care needs of their employees collectively. They put Atul Gawande at the helm and paid him the big bucks to fail. Yes, Haven, the name of this health care venture, could not accomplish what it set out to do–take on the health insurers to lower costs and improve quality of care for 150,000 workers.

    Here’s a question for those people who believe that employers have the power to use their leverage to hold insurers accountable and deliver people the health care they need: Do you think Gawande/Amazon et al. messed up or have you come to recognize that the system must change in order to deliver better health outcomes at lower cost?

    Here are the biggest lessons learned, according to Gawande:

    • The Haven concept had a fatal flaw: Insurance tied to people’s work makes no sense. People are changing their work all the time, so employers have no interest in making long-term investments in their health. Employers want to limit their health care spending as much as possible to the short-term.
    • Government needs to step in and put an end to employer-provided healthcare if we want to ensure people’s long-term health.
    • People want insurance with low or no out-of-pocket costs. They want low-cost mental health care, primary care and prescription drugs. Gawande does not say this, but Haven designed its coverage without these costs, presumably in response to what employees were asking for.
    • Medicare for All, one public insurer investing in people’s care over the short and long-term, is the only cost-effective way to ensure critical investments in people’s long-term health. Gawande fails to say this. But, if he doesn’t believe it, how does he imagine getting insurers to meet people’s long-term health needs? How does Gawande imagine our health care system, as is, can protect rural hospitals, vulnerable communities, and other precious health-care resources when the marketplace cannot?

    Here’s more from Just Care:

  • Amazon will now sell prescription drugs

    Amazon will now sell prescription drugs

    It’s official. After months of talk about Amazon’s move into the pharmaceutical space, Amazon has announced that it will now be selling prescription drugs across the US through Amazon Pharmacy. And, big pharmacies, like CVS Health, are feeling the hit, with their stock prices falling. Time will tell whether Amazon will take over the prescription drug retail market.

    For the last several years, Amazon has been seeking licenses from states to be a wholesale distributor of prescription drugs. And a couple of years ago, Amazon bought PillPack, which delivers prescription drugs to people in packages that help them know when to take different drugs.

    Amazon now plans to sell prescription drugs directly to individuals online and in collaboration with pharmacies across the nation. Many local pharmacies as well as big chain pharmacies are likely to be hit hard. Without a doubt, Amazon will aim to price its prescription drugs below its competitors to squeeze them out of the market.

    Of course, if Amazon is successful and the competition withers on the vine, Amazon will be sitting pretty. It will have the market power to raise prescription drug prices and profit handsomely. Even if Congress does not step in to regulate drug prices, which is particularly unlikely with Mitch McConnell as Senate Majority Leader, the only possible downward pressure on prescription drug prices could come from the federal government lifting the ban on drug importation for personal use.

    Amazon Pharmacy starts off with a strong foundation of 100 million Prime customers to whom to market its prescription drugs. It will offer Prime customers a discount drug card program–as much as an 80 percent discount on generic drugs and as much as 40 percent off on brand-name prescriptions, for people who pay out of pocket and not through their health insurance.

    Amazon also will help people understand the difference between their out-0f-pocket costs with and without insurance. In some cases, copays are so high that it will be less expensive for people to buy their drugs without relying on insurance.

    If you use Amazon Pharmacy, you will be able to benefit from its drug prices at 50,000 retail locations around the country as well as online. It will be interesting to see how sizable Amazon Pharmacy discounts will be relative to drug copays for people with insurance. Even without Amazon in the market, sometimes the copays are higher than the full retail cost of the drug. Amazon plans to work with Evernorth, a Pharmacy Benefit Manager, to administer its prescription drug retail program.

    Here’s more from Just Care:

  • Amazon plans to sell and distribute prescription drugs

    Amazon plans to sell and distribute prescription drugs

    Amazon appears to be expanding into the retail market in health care with its plan to purchase PillPack, an online pharmacy that is growing quickly. Stat News reports that PillPack sells and distributes prescription drugs to chronically ill people needing multiple medications. It operates in all but one state.

    The question is whether Amazon can build on its enormous platform to take over a big share of the retail prescription drug business. PillPack still has only a small share of the business, with about 40,000 patients. And, some suggest that pharmacy benefit managers, who are gatekeepers of the drugs health insurers cover, may not be inclined to work with Amazon.

    Moreover, some question Amazon’s ability to translate its expertise and success in satisfying people’s on-demand purchasing desires to the sale of drugs to chronically ill patients. How much do these individuals value the “human touch,” which Amazon has never provided; and, how much do they value lower costs? Or, is Amazon prepared and able to deliver these patients a higher level of services than it currently delivers?

    It is still unclear how Amazon will insert itself into the health insurance industry. But, for sure, it can distribute drugs to the one million employees at Amazon, Berkshire Hathaway and JP Morgan.

    And, Amazon’s plan to expand into the sale of prescription drugs is disrupting the pharmacy distribution business and forcing the biggest players to rethink their business strategies. Mergers are in the making. It appears that Amazon is in some part responsible for CVS Health’s interest in buying Aetna. And, Cigna is partnering with Express Scripts, one of the largest Pharmacy Benefit Managers.

    Time will tell whether Amazon will succeed in the prescription drug space. It certainly has the resources to make a strong effort.

    Of course, in the best of all possible worlds, Congress will step in and negotiate prescription drug prices across the board through international reference pricing–setting prices at the average of what the Germans, the Japanese and other peer countries pay–the most practical and feasible way to cut drug prices in half and save more than $200 billion annually in prescription drug spending.

    If you believe Congress should step in to rein in drug prices, please sign this petition.

    Here’s more from Just Care:

  • Gawande to lead new Amazon health care company

    Gawande to lead new Amazon health care company

    Amazon’s Jeff Bezos is building a new health care company in partnership with Berkshire Hathaway and JP Morgan Chase. They have hired Dr. Atul Gawande to lead it.  Will he able to improve care for the companies’ one million employees and, better still, for our health care system?

    The new health care company, as yet to be named, is charged with finding smart ways to improve health care for company employees. There are so many smart things companies can do, if they want to, including eliminating copays and deductibles that keep people from getting needed care, applying evidence-based medical protocols and paying for best value drugs.  The issue is always how to drive these improvements.

    Without a federally administered plan to drive health system improvements, systemic improvements tend not to happen. For one, lots of learning is not shared publicly. And, even when it is, hospitals and doctors are often set in their ways. Peter Pronovost, MD, became famous for his protocols/checklist for reducing hospital infections. But many hospitals have resisted applying them.

    How much power will these three companies have to effect change? They are big. But insurers and hospitals are also powerful and have their own agenda. And, what changes will Gawande focus on? Leana Wen, Baltimore’s Commissioner of Health, makes an important point about the value of Gawande focusing on social determinants of health—good housing, nutrition, safety, transportation—if he wants to get to the root driver of health care use, But, it’s hard to believe he’ll focus on those issues given the demographics of the workers at Amazon, Berkshire Hathaway and JP Morgan Chase.

    Megan Ranney, an associate professor of emergency medicine at Brown University Medical School smartly suggests Gawande look at how emergency rooms can link patients to the array of services and resources they need. Right now, emergency rooms are huge cost centers. But, emergency rooms could do a lot more to keep patients out of hospital.

    Andy Slavitt suggests Gawande avoid the road traps created by commercial interests and stay focused on public health issues. Will he be able to do that given his employers?

    Here’s more from Just Care: