‘We Want to Support People Being in Their Home’: Walmart, Amazon Outline Health Care Strategies

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If home-based care is not a very real part of both Amazon (Nasdaq: AMZN) and Walmart’s (NYSE: WMT) future health care plans, each has done a bad job of hiding it lately.

During MATTER’s recent “Healthcare 2040: Changing Care Delivery Models” virtual event, each behemoth company had a representative touting home-based care and the outsized role it would play in the future of U.S. health care.

“We want to support people being in their home and aging in place,” Walmart Health Senior Vice President Marcus Osborne said during the event. “We also want to address social isolation and … how technology is playing a role there.”

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Walmart has been entering further into health care generally over the past few years through its Walmart Health arm. It came on the home-based care radar specifically, though, when it partnered with Amedisys Inc. (Nasdaq: AMED) in 2019 to put kiosks in its Walmart Health clinics that educated patients on home health services.

On its end, Amazon has been extremely busy with Amazon Care over the last two years.

In addition to being a founding organization for the “Moving Health Home” coalition, which vies for favorable home-based care legislation in Washington, D.C., it has also expanded its home-enabled Amazon Care coverage to a much larger population.

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Amazon Care is Amazon’s on-demand health service. It was piloted in Seattle — with its own employees as beneficiaries — and has since been expanded to its employees nationwide.

Its pursuit of customers outside of its own network was reflected by a recent report from Business Insider suggesting that Amazon had reached out to CVS Health’s (NYSE: CVS) Aetna and other health insurers to get them to pay for Amazon Care.

That opened home-based care insiders’ eyes to just how hard Amazon Care was trying to become a significant provider in its own right.

At the MATTER event, Amazon Business Development Lead Amanda Goltz discussed how else Amazon is currently working with home-based care players. Goltz also touched on how Amazon sees virtual assistant Alexa playing a part in the future of health care in the home.

Just as Alexa can relay information on the weather based on data from the Weather Channel, it can do so for health information, she said.

“This is exactly what we do when we build skills with hospitals and home health agencies to help patients with their care plan at home,” Goltz said. “We built a comprehensive skill on Alexa that helps each of those seniors access their care plan, simply by saying, ‘Alexa, ask Home Health Coach what I’m supposed to do today.’ Everyday this skill changes dynamically based on what the information in the EHR says about that patient’s instructions for their care plan.”

If a patient’s medications, dosing instructions or timing for those doses has changed, Alexa can let them know that. It can also let them know whether — or when — they have to do physical therapy or occupational therapy exercises based on their home health providers’ instructions.

This has been worked through thanks to Amazon’s partnership with ChristianaCare, which has a network of private, non-profit hospitals as well as a significant home health division.

Based in Wilmington, Delaware, ChristianaCare serves patients in four eastern states. It has collaborated with Amazon to build that “skill” for Alexa. The provider has about 250,000 seniors in its network living at home, many of whom did not want to enter brick-and-mortar hospitals during the pandemic.

“So they built a comprehensive skill on Alex that helps each of those individual seniors access their care plan from Alexa,” Goltz said. “Based on [the provider instructions], Alexa will light herself up at certain times today and say, for instance, ‘Now is time for your 10 a.m. medications.’”

Together, the patient and home health nurse can also program Alexa to offer up goals, incentives and encouragement when a patient is hesitant to comply with his or her care plan. An example of that may be reminding the patient of a goal to walk at a grandchild’s wedding in the coming winter after an instruction to do PT exercises.

Home care as a panacea

The list of forthcoming problems for the health care industry in the U.S. as the population ages is a long one. The home health and home care sectors are not removed from those problems, as staffing issues continue to be a major problem across the country.

But as the physician shortage in particular is exacerbated, Walmart sees a combination of technology and in-home care as a way to mitigate that issue.

In particular, Osborne brought up the concept of a PNP — or a “professional nice person” — being a larger part of care plans.

“There’s this rise of the role of the PNP, and we certainly are seeing it already today in health care,” he said. “You think about home care, the emergence of the personal care assistant model, and you think about health insurance and care management, the rise of community health workers.”

Those care workers, Osborne believes, will be vital to taking care to a sustainable place.

“What we know is that with physicians, there aren’t as many as we need. They’re expensive. They don’t scale. They often don’t have the time,” Osborne said. “But there’s this ability to take a reasonably trained person who is fully experienced in delivering great customer service and coupling them with a strong technology that is capable of guiding [patients] and directing them. If you think about that combination, you can deliver a very robust level of care that’s far more scalable.”

In a sense, that is already what many home-based care organizations are doing across the country, though with varying levels of technological capabilities.

What Walmart’s role is in the future of home-based care is still unclear. But it could be that it’s not a competitor at all — as Amazon may be — but instead solely a third-party player that can tie all of the care together and integrate it.

If that’s so, home-based care agencies could actually stand to benefit from Walmart’s influence, whereas Amazon may help on the legislative front and sometimes as a conduit, but in the end be a more direct competitor.

“You can think about sites of care, as well as telehealth, and actual, physical care in the home,” Osborne said. “It’s important to think about those not as independent, competing channels, but to think about a world that is increasingly based on an omni-channel. And an omni-channel is where all those channels start to actually integrate and you get an experience that no one channel by itself could produce.”

Walmart will obviously have the resources to produce a lot of the technology and resources that could help make that integrated channel a reality.

“I think this omni-channel environment is the one that actually defines the type of experience we’ll come to expect,” Osborne said. “And I think it’s the experience that we’re going to get.”

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