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Does the battle for primary care have any technology implications?


 Today in health it the battle for primary care.

 my name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week Health Set of Channels dedicated to keeping Health IT staff current and engaged. We wanna thank our show sponsors who are investing in developing the next generation of health leaders.

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All right. I think we will use the modern healthcare story for the Amazon one medical, , acquisition only because it, , accentuates another challenge for this, but I really do want to focus in. On the battle for primary care that's currently going on, , modern Healthcare. Yesterday, FTC says, Amazon one medical investigation isn't over, and here's the story on it.

Amazon has closed the 3.9 billion acquisition of primary care company One Medical. The Tech Giant said Wednesday. The announcement comes after multiple news outlets report late Tuesday, that the Federal Trade Commission declined to block the deal between the two companies after a five month review.

that began in September. The deal was announced in July. However, the FTC said Wednesday. We'll continue to look at the combination. The Ft C'S investigation of Amazon's acquisition of One Medical continues said spokesperson, Douglas Farar, F A R R A R. The commission will continue to look at possible harms to competition created by this merger as well as possible harms to consumers that may result from Amazon's.

And use of sensitive consumer health information held by one Medical, an FTC source with knowledge of the investigation said the agency would take interest in how Amazon handles the medical records it purchased as part of the deal. The source said Amazon has received a pro consummation warning letter, which alerts parties the transaction remains under investigation.

Now, before you get too, , excited about this, let's see. Experts. said the letter has no legal significance. Dale Collins, an adjunct professor at Georgetown University, said the agency didn't have a case against Amazon for the one medical edition because it's ancillary business. Similar to the tech firm's acquisition of gross Whole Foods.

The conventional wisdom is a fair number of companies have received these letter letters, but as far as I'm aware, there has been no further legal actions brought against any of these companies. . Okay, so one medical offers virtual brick and mortar primary care services to commercially insured patients.

Amazon is offering memberships to one medical $444 per year, so forth and so on. , this, , let, let's stop there for a second and then I want to get into what I want to really focus in on, talk about, , first of all, the, the deal went through Amazon is one of the few tech companies that is. , positioning themselves as a healthcare provider.

They are going to provide healthcare services, and this won't be the last in a series of acquisitions, is my guess. Those acquisitions will be focused in on the, , again, we talked about this yesterday, the acquisition of primary care services and getting in between the consumer and the acute care systems in their community.

And so there's a lot of benefits for them in doing. And those are, , essentially establishing themselves in a 4 trillion market. Second, they have a lot of ancillary services and products that they sell, , such as pharmacy services and durable goods and whatnot, that they benefit from establishing that relationship.

In order to expand that business, they have to continue. To add the number of patients and the number of providers. , but they have clearly established themselves as a, , co-opetition to the local acute care health system. So that's, , that's Amazon's play. And by the way, one of the things I didn't mention yesterday, and I believe.

Is still true and I predicted, mm, I don't know, five years ago, is I think at some point you're gonna see Amazon get into the insurance business, , because their competitors are and they get that first dollar and that first dollar is what they want. It's arr as it's known in the industry, it's angel recurring revenue, and that is key for shareholder growth, which is what they are after as a publicly traded company.

Okay. So this article goes on. Primary care has been a hot area for merger and acquisition activity. On February 8th, CVS Health announced a deal to acquire primary care provider Oak Street Health for 10.6 billion. Village md, a unit of Walgreens, boots Alliance acquired primary care providers, summit Health City, MD for 8.9 billion in November, bringing on one medical and it goes on to talk.

, some of the other things with this, , I wanted to touch on those two acquisitions plus, , if, if you blink, Optum has acquired a new primary care practice. , and so the, the big five players in this Walmart, Walgreens, cvs, Amazon, and Optum, , division of, , obviously UnitedHealthcare, , and, and they continue to grow out the primary care practice.

The question becomes, you know, what does a health system do? Against that strategy. And this gets back to the how much of healthcare is local, , question, right? So these are gonna be national players. They're gonna have a series of national services. That, , that are gonna be really compelling to the consumer.

Quite frankly, it'll have a combination of technology and, , telehealth and access, and that's gonna be really hard to compete against. If I were competing against that. The health systems have to look at their local geographies and know their local geographies really well and deliver services to those local geographies that these national players cannot.

Right? And so, you know, think about this. CVS has great parking. They have these little stores sprinkled around the community. What could a, a health system with a proven brand for healthcare in the community offer that a CVS can't? Well, they could do partnerships locally. with a lot of different organizations.

They could do it with hotel, , with hotels. They could do it with apartment complexes. They could do it with, , with, , retail outlets. Other retail outlets. They could, they could partner with. , the, but again, this is a battle for primary care. Primary care doesn't necessarily, in and of itself make that much money, but it is a feeder for the rest of the health system.

I think the start of this has to be rethinking how you go to market. You are not an acute care facility, you are a health facility. You are about partnering with people on their health, and so we talk a lot about the consumer mindset. How do you, how do you start treating every one of your patients as if they were a.

the experience matters. Access matters. Convenience matters, right? Transparency matters, choice matters. So all those things matter. And if you know all those things matter you, you have to make the investments to, , to accentuate all of those things. There has to be a technology component to that. There has to be, Realization that the campus, the big old campus in town, I mean, needs to be welcoming and all those things, but you need to rationalize the buildings that you have today.

It was based on an old model, and that model is slowly being attacked and may not be the best model. All you have to do is travel through Europe and you can see monuments to old models. and you know, a lot of it is real estate based. A lot of it is building based. And if your buildings are not adjusting to this, then you are going to be left out in the cold healthcare and how healthcare is being provided.

I, I recorded a show yesterday for News News Day. How healthcare is being provided will change dramatically over the next 10 years. It will move to the home, it will move to smaller facilities, it will move to, , outpatient. We know all these things are gonna. , but we have a history of knowing things are gonna happen and then watching them happen and then complaining that they happened instead of, and looking for somebody to bail us out instead of saying, look, in the next 10 years, healthcare is moving to the home.

We know it's moving to the home. We know that it's gonna be more sensor based. We know that, , that the. Patients are looking for health, not just healthcare or sick care. They are looking for the, the full range of services. We have an opportunity to step into these things. How is this at the intersection of technology and healthcare?

, and I'll close on this. This is at the intersection of technology and healthcare because everything that the health system does today is technology related. , everything that is done today in the healthcare system is digital related. I've, I'm on record as saying the leader of digital in your health system is the ceo, and they have to be digitally focused and, and have a digital mindset to the business because the business is changing.

Digital is changing that. and you can just see it in the players and the investments that they're making and where they're going. And you cannot serve the consumer in today's day and age without a great digital platform, without good technology investments that are centered on creating experiences. And you know, we talk enough about the clinician experience and we'll come back to that, but this is about the consumer experience.

What consumer experience are you? and that is gonna be important as we make this transition over the next 10 years.

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