Amazon is increasingly hard to escape: It's your grocer via Whole Foods, your convenience store via Prime, your home assistant via Alexa. And soon, it could be your primary care provider.
"I am less than pleased to learn that Amazon is acquiring my doctor," tweeted cloud consultant Corey Quinn after catching wind of Amazon's plan to acquire One Medical for roughly $3.9 billion. It was a common reaction among some One Medical patients, of which there were 736,000 as of December 2021.
The deal will not only shake up direct-to-consumer care; it could transform employer-based health care as well. One Medical works with more than 8,500 enterprises that offer employees access to the provider’s in-person and telehealth services. Some employers even house One Medical clinics on-site.
The acquisition may ring antitrust alarm bells, but it will be difficult for regulators to target, as primary care is a new space for Amazon. This means consumers and human resource managers will likely have to decide themselves whether to embrace an Amazonified One Medical, weighing data concerns against convenience. Many may be inclined to choose the latter, considering the mess that is the American health care system.
“For so many people, convenience trumps anything else,” said Christina Farr, a health tech investor with OMERS Ventures. “If they're going to offer a convenient, affordable experience for people, then that might be the thing that causes them to join a service like this versus cancel their membership.”
Is your medical data vulnerable to Amazon’s whims?
Your medical information should be safe. Compromising individual One Medical records would be devastating for Amazon. It is illegal, folks! An Amazon spokesperson told Protocol that One Medical customers’ HIPAA-protected information will be “handled separately from all other Amazon businesses” should the deal close.
“As required by law, Amazon will never share One Medical customers’ personal health information outside of One Medical for advertising or marketing purposes of other Amazon products and services without clear permission from the customer,” the spokesperson wrote.
For Quinn, the concern lies in Amazon simply having access to this data. In his view, Amazon is too large a company with too many opportunities for internal data misuse. Amazon’s track record of data protection on Prime is by no means perfect. A 2020 Wall Street Journal investigation found that Amazon employees used data about independent sellers to develop competing products, which then-CEO Jeff Bezos couldn’t deny to Congress. In late 2021, Wired revealed carelessness by employees in handling Amazon’s retail customer data.
“When you have 1.4 million employees, you can’t guarantee that anything has never happened,” Quinn said. “I don't particularly want the notes from my therapy appointments being something that anyone at Amazon has access to.”
Not all health information is protected by HIPAA, which focuses on privacy in a patient-provider relationship. Amazon can already access a lot of this kind of data. A simple Prime purchase can provide valuable insight into our health — a fact that has especially crystallized for Americans in a post-Roe world. Data privacy expert Debbie Reynolds said Amazon’s direct access to much of this secondary health information, coupled with ownership of the portals holding more sensitive health data, is where people’s concern lies.
I don't particularly want the notes from my therapy appointments being something that anyone at Amazon has access to.
“The concern is having such a big, powerful company that has [its] hands in so many different areas of people’s lives being able to also gather data about people, even tangentially, around their health,” Reynolds said.
When it comes to digital data security, the consequences for individuals are hypothetical and murky. But the end result for Amazon is clear: It’s a win. One Medical’s data might help inform future Amazon AI-based health products. “When you’re a first-party data holder, which Amazon will be, there’s more that you can do with data,” Reynolds said.
Quinn canceled his One Medical membership and exported his medical records, but he isn’t sure whether the company will accommodate his request to delete all of his medical data. One Medical did not respond to Protocol’s request for comment on the company’s data deletion policies.
Could this make consumer and employee health care more convenient?
Yes, it could. Farr said the deal may represent Amazon’s ambitions to build a “digital front door” to health care. Primary care is increasingly elusive for most Americans. One Medical, which some describe as “concierge medicine,” isn’t exactly the picture of accessibility just yet. It has a $199 annual membership fee and is primarily urban. Still, a Prime-like digital interface for health care could be transformative.
“There’s no real shopping experience for health care,” Farr said. “Nobody’s done that.”
Josh Bersin, an HR industry analyst, is in favor of bringing retail and health care closer together. He described a scenario that, depending on your data and surveillance inclinations, might strike you as either useful or dystopian.
“Imagine you're clicking through the Amazon web page, you click on a bottle of aspirin, and the website says, ‘Are you having problems with headaches?’” Bersin said. “‘Would you like to visit a clinic? Click here to make an appointment.’ I mean, that's not a bad idea.”
Michael Yang, health tech and workplace tech investor at OMERS Ventures, said the deal likely doesn’t change One Medical’s appeal to enterprises, even if employees have concerns about health data. He thinks the One Medical purchase will go better for Amazon than its previous attempt to disrupt employee health care, Haven.
“You’re able to take a job and be matched with a primary care physician through a clinic type of model,” Yang said. “And then you have different modalities. It could be in person, it could be virtual. It could be at a pop-up.”
What about competitors, like Google, that provide One Medical memberships for employees and host clinics on-site? Yang doesn’t see the deal deterring Google or other companies’ adoption of One Medical. One Medical’s primary care model may bring self-insured employers’ health care expenses down, and the telehealth, near-site and on-site offerings are too convenient, he said.
“It would be penny-wise, pound-foolish to take a stand against a quote-unquote competitor when your employees need it and you as an employer want them to have it,” Yang said.
But One Medical isn’t the only boutique primary care outfit out there, competing against direct health care companies like Premise Health and Crossover Health (which Amazon previously partnered with to launch employee health centers). If nervous employees lobby against an Amazon-backed One Medical or employers become spooked, they have other options.
“We’ll see how it goes with Amazon being part of that bidding process,” Farr said. “They’re certainly not the only ones.”