Amazon’s New Prime Offer: Delivering Six Health Clinics For 20,000 Workers In Dallas-Fort Worth

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Amazon is getting into the health care delivery business, at least for its employees.

Last month, the e-commerce giant opened a primary care clinic in Irving and soon plans to open similar health centers in Coppell, Garland, Duncanville, North Fort Worth and near Haslet. The local launch is the first stage of a pilot project that will include four other U.S. metros by early next year, Amazon said.

Registered nurse Jodyne Schlachter explains the technology in one of the clinical rooms at the new Amazon health center in Irving. Amazon plans to open five additional clinics in North Texas this year.(PHOTO CREDIT: Ben Torres / Special Contributor)

Depending on results in Dallas-Fort Worth, Phoenix, Louisville, Detroit and San Bernardino, Calif., Amazon could eventually expand the clinics to additional employee hubs.

The project was conceived over a year ago, before COVID-19 emerged. Officials said the coronavirus has had little effect on their plans, except to put even more emphasis on virtual health visits.

Amazon’s centers will be staffed by Crossover Health, a California company that operates onsite and near-site facilities for some large self-insured employers, including Microsoft, Facebook and LinkedIn. The clinics will include doctors, nurses, chiropractors, physical therapists and behavioral health experts.

Amazon has about 20,000 employees in North Texas and has been growing rapidly here. About 11,000 work in operations and fulfillment centers, and the rest are corporate staff, management and tech workers.

Amazon is hardly a pioneer in this space. Walmart unveiled its own health clinics in 2014, charging $4 for a doctor’s visit for employees and $40 for store customers.

Amazon clinics will be limited to employees and their dependents. To accommodate so-called Amazonians on late shifts, the centers will have extended hours, including weekends.

“Hopefully, we’re within 10 miles of almost everybody who works for Amazon in the D-FW area,” said Derek Rubino, senior program manager for workplace health and safety. “Amazon was proud to offer health insurance to all full-time employees on their first day, including hourly workers. But many in D-FW don’t use the benefit. A lot of it really comes down to convenience. Having benefits only gets you part-way there.”

Amazon wants to remove barriers that keep workers away and persuade them to embrace primary care. That includes a range of services, from check-ups and immunizations to managing chronic conditions. Studies show primary care helps avoid more complicated, costly problems later.

“I honestly believe this is going to be life-changing for some folks,” Rubino said.

Onsite clinics are usually embraced by large employers and often were started to address workplace injuries. More recently, companies have adopted them for general medical care, putting clinics near the workplace, not inside it.

In 2017, one-third of companies with at least 5,000 employees had a general medical clinic at or near their worksite, according to a survey by Mercer, a human resources consultant. That share was twice as high as a decade earlier.

“The vast majority of these clinics have done very well, both in meeting their financial objectives as well as improving health and wellness,” said Larry Boress, executive director of the National Association of Worksite Health Centers.

Companies cite many reasons for investing in clinics, from lowering health spending to boosting worker productivity.

“Over 40% of employees who use the clinics don’t have a personal doctor,” Boress said, “and in the Mercer survey, more than 1 in 3 said the clinics served as their medical home. These clinics often become their only source of medical care.”

Health advocates, employers and insurers are emphasizing primary care as a way to bend the curve in health spending. In Plano, to encourage city employees to go to certain doctors, the health plan charges a copay of just $5 for a visit. In Fort Worth, it’s free for city employees to use certain clinics or virtual health providers — but there’s a stiff penalty for going to the ER if it’s not an emergency.

The Amazon health centers are in-network providers so employees will pay the standard rate, which depends on the health plan they’ve chosen. Amazon officials would not provide a number or range. On Amazon’s benefits website, the price of an in-network office visit is $30.

“We wouldn’t drive anyone away because of price,” Rubino said.

Crossover Health, which started in 2010, said employers save 30% on health spending through its program. One reason is that it claims to cut urgent care visits and imaging services by half.

During the pandemic, Crossover said it has shifted 90% of interactions to virtual care, and secure messaging — emails and texts between patients and providers — is up 40%.

“We can identify things that may be important to a specific population and really tailor the program,” said Dr. Stephen Ezeji-Okoye, Crossover’s chief medical officer. “The extended hours, the range of services, the coverage of young dependents — all that was designed for Amazon employees.”

Crossover also emphasizes short waits, usually fewer than five minutes, to see a doctor. Visits last 30 minutes or more, in part because doctors aren’t reimbursed on a fee-for-service basis.

“Crossover gets a monthly payment, based on a per-member fee or a cost-plus arrangement,” Ezeji-Okoye said, “and that keeps the focus on keeping patients healthy. The long encounters lead to fewer tests and imaging and fewer referrals because we have the time to establish a relationship.”

“While many companies and providers are rethinking their approaches to health care, Amazon’s move could have an outsize influence,” said Boress of the worksite trade group. “Employers like to benchmark themselves against the leading edge companies. They look to the leaders, and in many cases, they follow ’em.”

 

Source: The Dallas Morning News

New Report Signals Growth In Behavioral Health Sector

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A new report from Colliers International signals there is a rising demand for behavioral health services in the US.

Construction for behavioral health hospitals has increased dramatically since 2017, according to the report. In 2018, the supply level was 3.8 million square feet. By 2019, that figure more than doubled to 8.1 million square feet. In 2020, in light of the COVID-19 pandemic, the sector is still growing with 6.4 million square feet set to deliver this year.

While construction costs are declining due to the pandemic, the costs for behavioral health hospitals are expected to hold steady in 2020 at $403.60 per square foot, which is up from $346.80 per square foot just in 2018.

The report states that while in any given year one in four Americans is impacted by behavioral health conditions there is a shortage of behavioral health physicians. Kaiser Foundation research found the US was only fulfilling around 44% of its need for mental healthcare professionals. One of the biggest factors affecting the shortage is the cost of care.

Colliers found the average cost per bed in a behavioral health asset averages $330,000. The Advisory Board said that treating patients with behavioral health diagnoses costs $900 more per month than for patients with no behavioral health diagnosis. As a result, less than half of patients receive treatment, according to Colliers.

And now, COVID-19 is placing an unprecedented impact on behavioral health services. In late March, a McKinsey survey found 63% of respondents were feeling anxious, depressed or both.

“The anxiety, stress, financial strife, grief, and general uncertainty of this time will undoubtedly lead to behavioral health crises,” McKinsey said in their survey.

The pandemic has signaled the greater need to integrate both physical and behavioral health. The company stated that integration between the two services could help lessen the shortage of people getting help.

Colliers echoed that sentiment by stating “the majority of patients with a behavioral health diagnosis also have a medical comorbidity.”

One of the suggestions from Colliers is screening in both physical and behavioral health settings. Moving forward, Colliers said the success of behavioral health services is dependent on a system where physical and behavioral conditions are treated together and where private/public partnerships occur more often. The 10 largest behavioral health hospitals in the U.S. are all either government-run or owned by nonprofits.

They note that the success of Orange County, CA initiative BeWell OC is just one example of what the healthcare system could look like in the future. The “wellness hub” was a public/private development.

 

Source: GlobeSt.

The CARES Act Is Positioning Healthcare Real Estate For A Bright Future

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The Coronavirus Aid, Relief, and Economic Security Act, known as The CARES Act, was passed with great fanfare and a lot of promise.

In a lot of ways, it hasn’t lived up to that hype as small businesses struggled to get the help that they needed. But Kyle O’Connor, President and Founder of MLL Capital, which owns medical and life sciences facilities, thinks one sector was well-positioned to benefit from The CARES Act.

“One of the things that has been a big help for the medical industry has been The CARES Act, whether it be the payroll protection program [PPP] or the other funding that went to the health systems,” O’Connor says. “That has, I believe, helped quite a bit.”

O’Connor thinks the medical sector has received many benefits from the act that haven’t been there for other sectors.

“If you look throughout the economy, not every type of business was as well suited as the health care industry was to take advantage of the payroll protection program,” O’Connor says.

The employee size limitation for PPP grants is 500 employees. Since most medical offices won’t clear that threshold, they are great candidates for that funding.

“Most medical practices plan to rehire all of their laid off or furloughed employees given they expect demand to resume,” O’Connor says. “It’s also important to note that the health systems received/will receive funding from other elements of The CARES Act. In the medical field, The CARES Act has allowed doctor’s offices to keep critical medical workers employed. The doctors can only see so many people. So the nurse practitioners, the administrative staff, all the nurses that support each individual practice are a pretty important part of the system.”

Doctors are also adopting things like telehealth to offset a decline in office visits.

“The occupiers in our buildings were organizing themselves for dealing with the issues that have been caused by the stay-at-home orders,” O’Connor says.

Once the COVID crisis eases up or clears, O’Connor does not doubt that patients will return to medical offices. And demand could be even more significant as there is pent-up demand for medical services.

“They’re going to be much more comfortable going back to the doctor, and there will be a flood of requests for appointments,” O’Connor says. “There will likely be greater levels of health care that is being provided as the impact of the stay-at-home orders dissipates.”

The support from The CARES Act, in addition to the resilience of the sector, has made O’Connor optimistic about its future.

“Medical offices and life science property types have a defensive element to them,” O’Connor says. “We are going to hold their value better than some of the other property types.”

 

Source: GlobeSt.