On July 21, 2022, Amazon announced plans to acquire One Medical — a primary care practice with nearly 200 locations serving more than 700,000 patients — for $3.9 billion. The deal, if approved, would represent Amazon’s largest payment for a healthcare company to date. On September 5, 2022, CVS Health confirmed its acquisition of Signify Health, which offers in-home and traditional primary care, for around $8 billion.
These deals reflect a broader trend in the United States toward corporate investment in primary care, driven by an increasing focus on “total-cost value-based care” — a model in which healthcare providers are paid to manage the total cost of care for their patients and the size of each patient’s capitated budget may be increased on the basis of the patient’s health risks and the provider’s performance on quality metrics. Though potentially beneficial for certain well-insured patients, the trend of corporate investment in primary care could threaten equitable access to care, raise healthcare costs, and reduce physicians’ clinical autonomy. Physicians, patients, and policymakers should understand what’s driving these investments, their potential benefits and risks, and possible policy levers for mitigating those risks.
“Primary care has evolved from family doctors visiting patients by horse and buggy, to professional physician groups, to integration into larger health systems. Now, corporate investors are moving aggressively into this field, drawn by financial opportunities created by the shift to value-based care, with major ramifications for the decades ahead. It is critical that neither the historical creed of medicine nor patients’ trust in primary care physicians be sacrificed along the way.”1
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References
- Shah, S., Rooke-Ley, H., & Brown, E. C. F. (2023). Corporate Investors in Primary Care — Profits, Progress, and Pitfalls. The New England Journal of Medicine. https://doi.org/10.1056/nejmp2212841
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