Amazon gets all tangled up on their $3.9B One Medical buy as FTC widens antitrust scrutiny

Amazon’s ride towards being the #1 threat to healthcare hits an oncoming train. A report in stock analysis newsletter Seeking Alpha, picked up from other sources (the subscription Dealreporter), states that the Federal Trade Commission (FTC) hired outside economists to scrutinize Amazon’s $3.9 billion purchase of provider network One Medical (1 Life Healthcare). In a little-noticed action in early December, FTC also sent out subpoenas to current and former One Medical current and former customers as part of its investigation.

Both the Wall Street Journal and Bloomberg (paywalled) are reporting that this appears to be part of a larger FTC action in developing a wide-ranging antitrust lawsuit against Amazon on multiple anticompetitive business practices. In a recent example, FTC held up Amazon’s acquisition of iRobot (Roomba) during the summer, and in September, requested information from 1 Life and Amazon above and beyond the usual required Hart-Scott-Rodino Act (HSR) reports reviewed by the FTC and DOJ [TTA 15 Sept 2022]. This examination has been going on for some years, across two administrations, but may come to fruition as early as this spring. The main investigation is around Amazon favoring its own products, how it treats outside sellers on its platform, and copycatting the products of outside sellers. It may also cover Amazon Prime bundling practices. Prime also plays into its healthcare strategy. FierceHealthcare

Another factor: the highly profitable growth of Amazon Web Services (AWS) has taken a nosedive along with the cloud market, killing Amazon’s growth and value, according to Seeking Alpha’s analysis (may be paywalled). Amazon is also closing or pausing already built-out food stores–Fresh supermarkets and Go convenience shops–ending a long-term commitment to developing them.

When all of these factors are combined with Amazon’s 18,000 layoffs and huge 2022 net loss of $2.7 billion, it’s hard to believe that Amazon now has enough blue sky fisc to make the huge investment and long-term commitment that a largely new and cash-intensive business, delivering healthcare through real live providers in offices, will require. Amazon’s current health business is either transactional virtual retail (Pharmacy and the new non-face-to-face Amazon Clinic for virtual medical referrals) or hardware+subscription (Halo)–areas that Amazon knows well. But managing an entirely new and complex area that provides expensive and regulated provider services?

This Editor will go out on a wintry limb and predict that Amazon, facing FTC and state anticompetitive actions plus plenty of shareholder profit pressure , will cancel the deal with One Medical–leaving One Medical on another limb.

News/deals roundup: Amazon’s health accelerator, digital health library opens, Ziegler’s ‘Hospital at Home’ paper, SEHTA announces MedTech event; $670M in funding for Talkspace, Pear, DrChrono, NuvoAir

First, the news….

Another Amazon angle on healthcare. This time, it’s the Amazon Web Services (AWS) Accelerator for healthcare startups. It’s designed as a virtual four-week technical, business, and mentorship for 10 select companies. Naturally, it’s targeted to cloud-based operations for companies with ‘demonstrated commercial traction’ in remote patient monitoring, voice technology, analytics, patient engagement, and virtual care technologies and systems. Applications opened on 21 June and proposals are due 23 July. It’s limited to US-based healthcare startups or international startups with existing US operations. This round is in collaboration with KidsX, the world’s largest pediatrics digital health accelerator formed by a consortium of over 50 children’s hospitals from North America, Europe, and Australia. AWS blog announcement, FierceHealthcare

A crowdsourced library exclusively for digital health resources and research now open. The Clinical and Translational Science Institute (CTSI) and Center for Health + Technology (CHeT) at the University of Rochester have created a crowdsourced library for the digital health community. It’s hosted by the Digital Medicine Society (DiMe); the link to the library is here. “Resources” are defined as specific pieces of specific regulations, guidances, policy, or literature that are relevant and useful “as-is”. 

Another free resource is investment bank Ziegler’s white paper on ‘Hospital at Home’. The paper addresses the leading Hospital at Home models, providers, and the reimbursement dynamics for this growing tech-enabled option serving acute patients requiring higher medical care. A worthwhile read (24 pages)-see if your tech can fit into these models.

In the UK, SEHTA (South East Health Technology Alliance) announced their 2021 International MedTech conference on 8 October in a hybrid live and virtual event format. The live portion will be at the Hilton London Tower Bridge Hotel. They’ve also added a new director, Sven Bunn, Life Sciences Programme Director at Barts NHS Health Trust & Queen Mary University of London. SEHTA news page

A lightning roundup of $670 million in deals that aren’t taking the summer off….

Talkspace finally executing its SPAC with Hudson Executive Investment Corp., with a deal expected to give the company $250 million in capital. It was originally announced in mid-January [TTA 14 Jan]. Talkspace is a consumer mental health app that helps a user assess their concerns, then matches them with a therapist. Shares are listed at $8.90 on Nasdaq with approximately 152 million shares outstanding for a valuation of $1.4 billion. Mobihealthnews

Pear Therapeutics is planning a hefty SPAC towards the end of this year with Thimble Point Acquisition Corp., backed by Pritzker family interests. It’s estimated that it will round up about $400 million giving it a valuation of $1.6 billion. The new Pear Holdings will trade on Nasdaq as “PEAR”. Pear develops end-to-end platforms for prescription digital therapeutics (PDTs) for serious diseases as stand-alone software treatments or jointly with pharmaceuticals. Pear releaseFierceBiotech

Mobile-friendly EHR DrChrono now has a friendly $12 million in growth funding from ORIX Growth Capital. DrChrono also handles practice billing and management. This is on top of their January funding of $20 million, also by ORIX. Mobihealthnews (exclusive)

Stockholm-based digital respiratory care management system NuvoAir also raised $12 million (€10 million) to expand its chronic disease management and clinical trial platforms. It combines an app with data from a spirometer and sensors that attaches to asthma and COPD inhalers plus NuvoAir Cough, which assesses changes in nighttime coughing. The Series A was led by AlbionVC. Mobihealthnews, TechCrunch

What’s up with Amazon in healthcare? Follow the money. (updated)

Updated–click to see full page. Amazon is the Scary Monster of the healthcare space, a veritable Godzilla unleashed in Tokyo, if one listens to the many rumors, placed and otherwise, picked up in mainstream media which then are seized on by our healthcare compatriots.

According to CNBC’s breathless reporting, they have set up a skunk works HQ’d in Seattle. When they posted job listings, they were under keyword “a1.492” or as “The Amazon Grand Challenge a.k.a. ‘Special Projects’ team.” In late July, these ads for people like a UX Design Manager and a machine learning director with experience in healthcare IT and analytics plus a knowledge of electronic medical records were deleted. Amazon has separate initiatives on selling pharmaceuticals and building health applications to be compatible with Echo/Alexa and other smart home tech. Both have come up in the context of the CVS-Aetna merger, where buying up state pharmacy licenses cannot be kept secret (see end of our 8 Dec article) and that efforts to extend Alexa and Echo’s capabilities aren’t particularly secret.

A quick look at Bezos Expeditions, Amazon supremo’s Jeff Bezos’ personal fund, on Crunchbase reveals several healthcare investments, such as GRAIL (cancer), Unity Biotechnology (aging), Rethink Robotics, and Juno Therapeutics (cancer). Not really things easy to sell on Amazon.

Last week, Amazon reportedly hired Dr. Martin Levine, who ran integrated primary health Iora Health’s Seattle-based clinics, according to CNBC and Becker’s. They met with Iora, Kaiser, and the now-defunct Qliance about a year ago on innovative healthcare models. More breathless reporting: they are hiring a “HIPAA compliance lead.” 

What does this all mean? It may be more–or less–than what the speculation is. Here’s what this Editor believes as some options:

  • Alexa and Echo are data collectors as well as assistants–information that has monetary value to healthcare providers and pharma. To this Editor, this is the most likely and soonest option–the monetization of this data and the delivery of third-party services as well as monitoring.
  • Amazon now employs a lot of people. It is large enough to create its own self-funded health system. It’s already had major problems in the UK, Italy, and even in the US with healthcare and working conditions in its warehouses. Whole Foods’ non-union workers are prime for unionization since the acquisition (and also if, as rumored, robots and automation start replacing people).
  • A self-funded health system may also be plausible to sell  (more…)

Philips dives into global consumer health tech with new wearables ‘ecosystem’

Philips has made another substantial, if traditionally risky, move into the direct to consumer (DTC) health monitoring segment with a limited wearables ‘ecosystem’ under a new Personal Health Solutions division. It contains five FDA-cleared products for monitoring vital signs. Four peripherals download via a watch to iPhone/Android phone apps which run on version 2.0 of the Philips HealthSuite (with Salesforce1) mobile app. Earlier the apps were marketed in NL and BE.

While the release states they are globally available, initially it appears they are being marketed direct to consumer for the US only. Purchase is direct on the site. All devices are Bluetooth LE and sync with the watch and smartphone app/dashboard (available on Google Play and the Apple Store). The watch/app also tracks exercise with activity recognition, calorie tracking and sleep patterning, with the app providing some education content.

  • Watch $249
  • Body Analysis Scale (weight, body fat, BMI) $100
  • BP/pulse (upper arm) $100, (wrist) $90
  • Ear Thermometer $60

Interestingly, their existing DTC PERS enterprise, Lifeline, is not linked to or mentioned.

Prices are mid-range to high, making this a prima facie tough sell. (more…)

Philips Healthcare partners with Amazon Web Services, adds more IoT

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/Philips_AWS-IoT-infographic.jpg” thumb_width=”200″ /]The once-quiet Philips is expanding its connectivity for HealthSuite through a partnership with Amazon‘s recently announced collaboration with Amazon Web Services (AWS). The objective in connecting through AWS is to expand to hundreds of million devices through a secure, stable IoT ‘device cloud’ that securely collects and analyzes data from apps (like the diabetes app in test with Radboud University, TTA 18 Sept), medical devices and EMRs/PHRs. The Philips HealthSuite Digital Platform is a product of Philips’ collaboration with Salesforce, and is also (for now) targeted to senior care for adults. Philips’ release and case studies are, unfortunately, buried in this very busy page. It’s another move for Philips that confirms their ‘Hospital to Home’ repositioning.