Three news items recently focused my attention on perhaps the biggest potential disruptor of senior living in the coming years: Amazon (Nasdaq: AMZN).
Here’s what the Seattle-based company has been up to lately:
— Amazon hired industry veteran Ginna Baik as senior business development manager for senior living
— Amazon Care is launching in all 50 states
— A consortium of companies including Amazon Care formed an alliance called Moving Health Home, with the goal of changing federal and state policies to expand at-home care
These are just some of the latest health care moves for Amazon, which for years has been positioning itself in the space. The company has also specifically focused on the older adult market — for instance, Amazon workers took a bus tour that involved Green House founder Dr. Bill Thomas, to get a crash-course in senior housing and aging services.
In hiring Baik, Amazon adds a leader with a deep understanding of the private-pay senior living industry. She had a leadership role at Emeritus and then joined CDW Healthcare. For 6.5 years at CDW, she interfaced with a wide variety of senior living providers and became a tech evangelist for the industry, with involvement in projects like the Thrive Center.
At Amazon, Baik will lead business development for Amazon Alexa Smart Properties for Senior Living. Alexa Smart Properties is driving the adoption of voice-technology at scale across real estate classes such as hotels and multifamily apartments, as well as senior living.
Already, senior living tech company K4Connect has been working with Amazon to create its Alexa for Hospitality offering, which streamlines enterprise management of Echo devices and enables features related to senior living services and amenities, K4 CEO Scott Moody told SHN in November 2020.
Alexa has become an increasingly familiar presence in senior living communities, especially during the pandemic. Amazon and K4 worked together to deliver 8,400 Echo Dots to senior living providers last year, and followed up with an initiative to distribute an Amazon Echo Show device to every assisted living community in North Carolina, at no cost to the providers.
With this as the backdrop, Baik’s hiring seems noteworthy for a few reasons.
Her knowledge of senior living and her relationships with providers could enable Amazon to refine its voice technology to meet the specific needs of operators, perhaps making Echo the product of choice for the sector as Amazon competes with the likes of Google.
But also consider that Amazon has identified senior living as a special focus for Alexa Smart Properties. The webpage for Alexa Smart Properties singles out just four property types by name: hotels, vacation rentals, apartments and senior living.
It seems clear that Amazon views senior living as an important node in its grander ambitions related to health care, and outfitting communities with Echo devices is only one step in a much larger strategy that could affect providers in a variety of ways.
Amazon Care and the future of senior living
There’s no simple way to analyze all the moves that Amazon has made into health care and how they could combine into a grand strategy. But, one common thread is that the company is focused on increasing the amount of care that can be delivered in people’s homes — which stands to reason, considering that the core of Amazon’s business is delivering goods to consumers’ doorsteps.
Amazon almost surely appreciates that senior living communities are residential settings, and units in these buildings are in fact people’s homes. The senior living industry likely is an incredibly attractive space for Amazon to target because these communities offer the best of both worlds: the benefits of at-home care with the efficiencies of institutional care, as ATI Advisory CEO Anne Tumlinson recently pointed out to me.
In other words, insofar as Amazon is setting out to transform at-home care, the company is setting out to transform senior living.
Amazon Care’s involvement in the new Bringing Health Home coalition is one clear indication of how important home health services are to the company.
The new group’s mission is to convince lawmakers and policymakers to create payment streams for more at-home care, ranging from primary care to behavioral health and chronic disease management, and even hospital-level care.
Such changes would support the Amazon Care model, which enables Amazon employees to connect virtually with doctors and clinicians working for Care Medical, an independent practice. Amazon Care patients can also receive medication delivery and in-person follow-up care — which can be delivered in the home by mobile nurses dispatched by Care Medical.
So far, Amazon Care has only been available to workers on Amazon-sponsored health plans, who live in the Puget Sound area. But news broke today that Amazon Care is going national, and will contract with third-party employers.
Imagine a future senior living community that is “powered by Amazon” and operates this way, on a model similar to Amazon Care:
— Resident units are equipped with Echo devices that are custom-made for the sector, providing passive health monitoring, environmental control, entertainment, and replace old-fashioned nurse call systems
— The Echo devices offer a way for residents and staff members to manage medications and get refills (delivered via drone!) from Amazon-owned PillPack, and to communicate with Care Medical or a similar organization, which provides telehealth and dispatches clinicians for in-unit visits
— Staff use Amazon Business to order equipment and supplies
— On the backend, Amazon handles the massive amount of data being collected and integrates with medical records and other tech platforms
And, let’s say this senior living provider is partnered with Medicare Advantage plans that cover the services that residents are tapping into via Echo devices, and those MA plans are owned by Amazon.
If it seems outlandish to think of Amazon becoming an insurer, consider rumors that circulated in 2018 that Walmart might acquire Humana — in large part, as a defensive play against Amazon’s incursions into health care.
Next steps for senior living
Some senior living providers might want to work with Amazon to drive innovations and improve the aging experience. Health care system Ascension, which operates one of the largest nonprofit senior living portfolios in the United States, joined with Amazon Care in the Bringing Health Home coalition.
But given Amazon’s incredible scale and almost unimaginably deep pockets, there does seem to be a real threat that the company becomes an unstoppable force, and providers will have little choice but to play on terms set by executives in Seattle.
To prevent that, there need to be alternatives to Amazon in the market — other ways of enhancing the resident experience and bringing comparable efficiencies to operations.
With that in mind, I think of how Brookdale has just cozied up to hospital giant HCA through a home health JV. The two companies have the scale and resources to create the kind of telehealth/mobile nurse offering that Amazon Care is pioneering, which could bring services into senior living communities as well as patients’ single-family homes. And, as a few readers pointed out to me after my recent column about the two companies, Brookdale and HCA logically should be thinking about launching a health plan to cover such services.
Smaller providers, meanwhile, need to think even harder about how to gain scale and sophistication. Juniper Communities, for instance, operates 25 communities, but has built out a tech-enabled health care platform that is the basis of a Medicare Advantage model being rolled out in partnership with other providers across the country.
Juniper CEO Lynne Katzmann is now thinking hard about home care and how to replace traditional “activities” with a more meaningful, integrated and intergenerational lifestyle model. Industries are particularly vulnerable to Amazon disruption if “customer experience has been an afterthought,” CB Insights noted in a report on Amazon’s health care strategy. Putting the resident experience first, and making necessary investments to improve it, therefore is crucial for providers if they want to deal with Amazon-ification on their own terms going forward.
“We need to talk about ecosystems, because that is what Amazon is putting together. We need to think ahead and, if not do an end-run, think about how we can fit in,” Katzmann told me. “We have to be daring and step out. That’s hard for us.”
Being daring might be hard, but with the Amazon effect growing with each passing week, it is also necessary.