In a new report, the American Hospital Association (AHA) outlines the seven biggest potential disruptors in the healthcare industry and explains what traditional providers can do as the market becomes increasingly crowded with competitors.

The healthcare disruptors to watch out for

"The nation's largest retail, payer and tech disruptors once again invested billions of dollars in healthcare in 2022, continuing to build out their visions to transform the field" by grabbing market shares in primary care, virtual care, concierge medicine, in-home medical services, and more, AHA writes.

In its report, AHA outlines seven of the biggest disruptors in the healthcare industry right now, including:

Amazon

"With major moves in 2022 to transform its pharmacy operations, the medical supply chain and care delivery, Amazon is poised for another year of health care growth," AHA writes.

One of the biggest moves made by Amazon last year was its proposed plan to buy primary care provider One Medical for roughly $3.9 billion. One Medical has 188 offices in 28 markets, as well as 767,000 members.

Currently, the proposed acquisition is under review by the Federal Trade Commission, but if it goes through, it could "dramatically shake up the primary care field," HealthLeaders writes.

Aside from its foray into primary care, Amazon has also expanded its pharmacy services with RxPass, which allows subscribers the ability to fill as many prescriptions as they need for a flat monthly fee. The company has also expanded access to diagnostics and therapeutics through its Amazon Dx program.

CVS Health

Currently, CVS has more than 10,000 retail pharmacies in the United States and Puerto Rico, as well as 1,000 Minute Clinics. Through its ownership of health insurer Aetna, which serves around 34 million Americans, CVS is working to incentivize its health plan clients to use the company's health services.

CVS is also working on several acquisitions. Last summer, the company announced a plan to purchase home health services provider Signify Health for $8 billion. In addition, CVS this month announced a $10.6 billion acquisition of primary care provider of Oak Street Health.

The company is also investing heavily in both virtual care and digital health through its HealthHUB locations as well as early-stage and start-up tech companies.

UnitedHealth Group*

UnitedHealth Group (UHG), which includes Optum, has made a significant effort to diversify its offerings, including investments in digital health, care coordination, and remote patient monitoring. Last year, Optum announced a $7.8 billion merger with data and analytics company Change Healthcare, which handles client records for more than 85 million patients.

Optum has also invested heavily in virtual behavioral healthcare through Brightline, which addresses depression and anxiety among adolescents, as well as Alma and Talkspace. The company also acquired Refresh Mental Health, which includes 200 outpatient mental health facilities, in 2022.

In addition, UHG is working on expanding its use of value-based care through an ACO partnership with Walmart, a partnership with HealthEdge, and its acquisition of Imperium Health.

Walgreens Boots Alliance

One of Walgreens' largest investments has been in primary care provider VillageMD. Currently, Walgreens has a roughly two-thirds controlling interest in VillageMD and plans to expand its locations significantly over the next few years.

According to AHA, Walgreens plans to open at-least 600 co-operated VillageMD practices in 25 markets by 2025 and 1,000 practices by 2027. VillageMD has also recently expanded by acquiring Summit Health, which also includes the urgent care clinic chain CityMD, for $8.9 billion.

Aside from expanding into primary care, Walgreens has also invested in home healthcare through CareCentrix. Currently, CareCentrix has 7,400 provider locations and serves 19 million patients.

Walmart

Walmart is the largest retailer in the country, which brings significant traffic for both its pharmacies and walk-in retail health clinics. The company has also added virtual care, a discount drug platform, and an EHR for its clinic patients.

Going forward, Walmart plans to add more free-standing health centers around the country, starting with 16 new centers in Florida this year. The company is also working to increase community access to healthcare research through its Walmart Healthcare Research Institute.

Apple

Instead of venturing into primary care, Apple is leveraging its devices, such as the Apple Watch and iPhone, to expand its healthcare platform and allow providers, payers, and researchers new ways to connect with patients.

Through its devices' health-related features, Apple is planning to focus on four specific areas:

1. Providing a secure, centralized location to store and view health data in the Health app
2. Offering features that allow the Apple Watch to effectively monitor users' health
3. Offering features that help users improve health outcomes
4. Supporting third-party health and fitness apps with developer tools

Google/Alphabet

Much like Apple, Google is using its data platform and devices to develop personalized healthcare data. In particular, it is investing in artificial intelligence (AI) technology and hardware to make healthcare data more accessible and to enhance research and development projects.

In 2022, Google invested in several AI drug discovery startups, including BenchSci, Seismic Therapeutic, and InstaDeep. The company has also partnered with several health systems on EHRs and healthcare data engine accelerators, which will help "improve health equity, patient flow, and VBC," AHA writes.

What can traditional providers do in an increasingly competitive market?

As retail disruption continues in the healthcare industry, AHA encourages healthcare organizations to ask four questions:

1. Do we have an omnichannel presence that provides the convenience, access, transparency, pricing and other information and services that patients want?
2. Are there partnership opportunities with any of the Big 5 companies transforming primary care?
3. How can we leverage our strength in established trust and rapport with existing patients to use our outpatient, clinic and virtual services for routine and nonemergent care?
4. How can we partner with big tech firms around research, data sharing, etc., to improve care?

Overall, "[h]ealthcare organizations can't continue with a business-as-usual approach," HealthLeaders writes. "Consumers are more in control of their healthcare expenses and decisions, and they have the ability to shop around. Likewise, payers and self-insured businesses are looking for better ways to deliver and track healthcare, with the goal of cutting out the tremendous amount of waste that the industry has been supporting for years."

"In order to keep up with the disruptors, they may have to be the disruptors," HealthLeaders adds. (Wicklund, HealthLeaders, 2/20; AHA "Health Care Disruption: 2023 Outlook" report, accessed 2/20)

*Advisory Board is a subsidiary of Optum, a division of UnitedHealth Group. All Advisory Board research, expert perspectives, and recommendations remain independent.