Amazon One Medical Primary Care Concierge Service is Now Available

In a previous post, I recounted how Amazon ended its primary care service called Amazon Care, which was initially offered to its own employees, and instead purchased the company One Medical. In simplest terms, One Medical can be described as a concierge primary care service with an emphasis on health technology.

According to ChatGPT, concierge primary care, also known as concierge medicine, boutique medicine, or retainer-based medicine, is a model of primary care in which patients pay an out-of-pocket fee (often an annual or monthly retainer) directly to the physician or medical practice. This fee typically covers a variety of services, ensures greater accessibility to the physician, and often allows for more personalized and attentive care. Here are some features and benefits often associated with concierge primary care:

• Enhanced Access: Patients typically have easier access to their healthcare provider. This might include the ability to reach out to them via phone or email directly, shorter wait times for appointments, and longer, more in-depth appointments when necessary.
• Personalized Care: With a smaller patient load, concierge physicians can spend more time with each individual, allowing them to understand the nuances of their health and wellness needs in greater depth.
• Comprehensive Annual Physicals: Many concierge practices offer thorough annual exams that go beyond typical physicals, covering more extensive screenings and evaluations.
• Preventative Care: Emphasis on proactive health measures and wellness can be more pronounced in a concierge model, given the time available for education and counseling.
• Fewer Patients: Concierge doctors often have fewer patients than physicians in traditional primary care settings, which means they can spend more time with each patient.
• Coordination of Care: Concierge physicians often act as a patient's healthcare advocate, helping coordinate care with specialists, navigating hospital stays, and ensuring the overall continuity of care.
• Fee Structure: Patients typically pay an annual or monthly fee, in addition to or instead of traditional billing methods. Some concierge practices don't accept health insurance for the retainer fee but may bill insurance for specific medical services.
• Enhanced Services: Some concierge practices might offer services that aren't traditionally covered by insurance, like nutritional counseling, genetic testing, or travel medicine consultations.

In sum, you are paying an additional fee for convenience, a more personalized doctor-patient relationship and perhaps improved overall medical care although the latter has not been demonstrated in a rigorous fashion.

How much is the fee?

Last month I received an email from Amazon (presumably sent to all Amazon Prime members) with the following offer: Amazon said it would "discount One Medical memberships for U.S. users to $144 from $199 for the first year. A membership gives you access to the One Medical app, where you can get 24/7 on-demand virtual care nationwide."

The announcement prominently mentions the One Medical app which facilitates the following services:

• Get 24/7 on-demand virtual care nationwide, at no extra cost
• Send and receive secure messages with a provider
• Access your health records and care plan
• Request prescription refills and renewals
• Easily book an in-person or remote visit in a state where we have offices

However when I visited the Android Play Store (I have an Android smartphone), the One Medical app is rated with 3.9 stars (out of 5), and the first three reviews are not very complimentary (Figure 1):

1. “For starters the Care Plan tab just flat-out doesn’t work.”
2. “The app is pretty much trash on Android/”
3. “Another update: Support contacted immediately and helped me resolve the issue.”

By comparison the app from the telehealth company Teladoc received 4.1 stars.

Amazon One Medical is not available everywhere for everyone. In particular, only certain health plans are accepted. The service is replacing your PCP and just like your PCP must be approved of by your health insurance plan, so too must Amazon One Medical. Beyond the offered primary care services, the rest of your healthcare remains the same as dictated by your health insurance policy.

In terms of in-person visits, there are geographic restrictions. It seems to be available in only certain major cities presumably where One Medical has physical clinics. The company has more than 200 physicians' offices and 125 clinics in the U.S.

At this stage, the prudent approach may be to watch and see how Amazon One Medical builds out the service. For those willing to pay extra, the convenience and faster access may be worth it. Indeed, one of the criticisms of concierge medicine is that it will lead to a two-tier medical system.

Figure 1. First three reviews of the One Medical app in the Android Play Store (8/27/23).