Amazon recently launched Amazon Care, a new service to help Seattle-area employees get more convenient and affordable health care. The program offers virtual consultations with in-home follow-ups. While home visits might sound like a luxury, Amazon hopes they will help catch health problems earlier and cut down on costly emergency department (ED) visits. This development caught our attention because we believe that advanced primary care should be a cornerstone of any strategy to manage cost by improving healthcare quality.
This recent CNBC article walks through what it’s like to use Amazon Care. Of particular interest is the front-end, app-based triage to help guide the member to the ideal site of care. We have seen other efforts of this type recently. For instance, Crossover Health now offers an expanded primary care network that includes a “virtual first” entry point directing the member to either a health center or telemedicine option.
Home visits are not part of the Crossover Health offering, but they are being deployed as a separate intervention by other risk-bearing entities like health plans and provider groups. While home visits have been shown to prevent ED visits and hospital admissions in a more elderly, Medicare population, for employer populations they may be more of a convenience than a big cost-saver. Home health visits for minor issues would likely cost more than telemedicine or retail clinics, and possibly even more than urgent care services. However, for the subset of home visits that replace an ED visit, dollars will certainly be saved. Thus, it is important for a plan sponsor to establish expectations and goals up front. If the initiative is meant to maximize member experience rather than save money, tracking metrics should be established accordingly.
The new Amazon offering does challenge employers to consider whether their current programs are optimally organized through a central point of access. For example, telemedicine services will be more effective if integrated with onsite or nearsite health clinics; employers offering both should pursue the maximum possible integration. In short, an engaging digital triage function that links service offerings like telehealth, onsite care and even home visits should be on your radar as you consider strategies to bring convenient, cost-effective care to your employees.
-Written by Andrew Halpert, MD