The entire healthcare sector is about to be rocked and reshaped. But the forces driving change aren’t coming from health insurers, managed care plans, Big Pharma, or hospital conglomerates. They certainly are not arising from within conventional medicine. Nor will they come from a federal government or the states.

To be clear, all these legacy players will play a role. But the transformative heat and pressure are coming from outside existing systems—from the world’s biggest technology and finance companies on one side, and from good old-fashioned grassroots consumerism on the other.

Across the corporate world, and at family dinner tables all over the country, frustration with healthcare is at an all-time high, and it seems to track closely with rising costs.

In IT circles, there are many people who believe the legacy systems—major insurers, managed care plans, big hospital systems—have had their day. Hell, they’ve had their decades. They’ve proven themselves incapable of reducing costs and improving care.

For years now, Silicon Valley folks have been gleefully talking about “Uber-izing” healthcare. That means optimizing operations, maximizing efficiency, increasing accessibility, driving down prices, and improving convenience.

Those visions will start to become reality in the coming years. As the change occurs, it will send ripples—no, make that shockwaves—through any business sector involved in healthcare. That certainly includes the dietary supplement and nutrition industry.

Consider the emergence of a joint venture between Amazon, Berkshire Hathaway, and JPMorgan Chase. Late in 2017, the companies announced they were going to do “something” in healthcare.

More than a year later, that “something” is still a huge question mark. All we really know is that the “triumvirate” is committing serious resources toward improving healthcare for their 1 million-plus employees, they’re hiring heavy-hitting talent to run whatever it is, and the model will not be profit-driven.

A Triad of Giants
Last spring, Berkshire Hathaway Chairman Warren Buffett stressed that the trio is not building its own insurance company, and has no immediate plan to compete with existing insurance players. “The motivations are not primarily profit-making. We want our employees to get better medical service at a lower cost .... We do think that there may be ways to make real significant changes that could have an effect.”

At a meeting of the Economic Club of New York in January, JPMorgan CEO Jamie Dimon echoed Buffett’s statement. “Ours is a not-for-profit thing. We want better outcomes for our people. We think we can save a lot of lives at our own company.” Though he withheld details, he stressed that the new system is all about “data and analytics.”

Dimon said he fundamentally supports the notion of universal insurance for all Americans, and considers it a travesty that there are 40 million uninsured people in this country. But he’s no fan of the Obama administration’s healthcare reform, or anything else proposed in Washington.

“The thing about ObamaCare is it didn’t fix the fundamental problems. It just added more people to them. So, we just gotta kind of go back and say, ‘How can we do a great job for the American citizen, fixing the problems?’ And it’s not against anybody.”

Given the size of Amazon, Berkshire, and JPMorgan, the technological and financial resources at their disposal, and the talent they can draw, such benign statements are kind of like the Jolly Green Giant promising he won’t crush any daisies as he traipses through the valley.

Let’s face it, Amazon has profoundly disrupted every business sector it has touched, for good and for ill. (If your company’s not feeling it, then ask a friend who works in retail). There’s every reason to believe its impact on healthcare will be just as thunderous.

Amazon’s core strengths are a precise inversion of mainstream healthcare’s biggest weaknesses. The company is very good at giving people what they want—where and when they want it—as quickly as possible, and for the lowest prices (which are disclosed at point of purchase). It is user-friendly and driven by a highly-integrated IT system. Mainstream healthcare systems fall far short on all of these counts.

There are signs to suggest this joint venture will be highly impactful:

1) It is marshalling very high-level healthcare talent. Atul Gawande, MD, is the CEO. An endocrinology surgeon at Brigham & Women’s Hospital, Gawande was an advisor to the Clinton administration during its attempt at reform. His public health work was also a major influence on the ObamaCare plan.

He’s known for his popular book, Being Mortal: Medicine and What Matters in the End, a thoughtful treatise on life and death in an era of high-tech “solutions.” But Gawande was also one of the first physicians to call out the vast regional variations in the cost of care, and the hard fact that there’s little correlation between dollars spent and health outcomes obtained.

In February, the joint venture hired Serkan Kutan as its chief technology officer. Kutan was the IT chief at Zocdoc, and played a key role in its ascent as a leading online physician appointment platform.
The triad also pulled David Smith, a former executive at UnitedHealth Group’s Optum division, which handles data analytics, pharmacy benefits management, and a host of IT-driven services. The move irked UnitedHealth, which retaliated with a lawsuit against Smith, claiming he violated a non-compete agreement and knowingly transferred sensitive information from Optum to the new entity.
Industry-watchers say UnitedHealth’s reaction indicates the degree to which established insurance conglomerates feel threatened by the Amazon-Berkshire-Morgan alliance.

2) It will affect a lot of people. Between them, Amazon, JPMorgan, and Berkshire Hathaway employ over 1 million people. That’s bigger than a lot of regional insurance pools. Even if the triad does keep it “in house” for years to come, whatever emerges will likely have big ripple effects.

3) It will be comprehensive. Last summer, Amazon acquired PillPack, an online prescription fulfillment service for roughly $1 billion. PillPack is licensed to ship prescription medicine in 49 states. Prior to the deal, Rx drugs were one of the only product categories not available on Amazon.

The PillPack acquisition changes that, and enables Amazon to compete with major drug store chains like CVS Health, Rite Aid, and Walgreens on the prescription front. These retailers have already lost significant sales of household staples to Amazon.

In short, the triumvirate has all the elements to create an entirely new healthcare ecosystem. It remains to be seen whether Amazon-Berkshire-Morgan will be able to improve health and lower costs where others have failed.

The Scent of Change
Last year, the founding executives of doTERRA, one of the world’s largest marketers of botanical essential oils, announced a plan to launch a network of brick-and-mortar clinics that would operationalize integrative medicine and make it accessible to more people. This year, that bold vision started to become a reality as Prime Meridian Health Clinics.

Prime Meridian’s goal is to establish insurance-free, integrative primary care centers all over the country. They’ll be headed by holistic MDs, DOs, and nurse practitioners who will oversee a wide spectrum of other natural healthcare practitioners.

Patients pay a monthly fee, roughly equivalent to their cellphone bills, for unlimited comprehensive primary care, including 24/7 access to practitioners via telemedicine, urgent care, wellness coaching, nutrition counseling, genome testing, and a host of functional medicine services.

More than 40,000 people have already joined the network, according to Brannick Riggs, MD, Prime Meridian’s medical director. “Our goal is to deliver life-changing healthcare. That’s what we’re about. We try to remain true to our vision, and consistent across everything we do,” said Riggs, a conventionally-trained primary care physician who practiced in mainstream settings for many years before becoming personally interested in essential oils. That led him to doTERRA.

“I was using the oils at home, and got to know the doTERRA executive team. They’d always wanted to partner with traditional western medicine practitioners, and they asked me to sit on their board.” He worked closely with David Hill, DC, a founder of doTERRA, to develop the vision, the practice model, and the aesthetic of Prime Meridian.

Of the company’s decision to go entirely insurance-free, Riggs said, “We can’t bring in stuff from the old conventional system. It will poison the well. We don’t have to worry about coding and documenting for insurance plans, Medicare, or Medicaid. The only people making the healthcare decisions are the patients and the doctors. You’ll no longer have a third-party administrator in the picture.”

After piloting the model for doTERRA employees at the company’s headquarters in Pleasant Grove, UT, they opened the first independent clinic in St. George, deep in the heart of Red Rock country, and a second one in Nashville. A third, in Phoenix, is slated to open later this spring. Prime Meridian plans to have 50 to 100 centers across the country over the next few years.

The potential client base is huge. doTERRA’s multilevel marketing network includes well over 1 million distributors and 5 million regular customers. The vast majority are women who are signaling some degree of dissatisfaction with mainstream medicine, and a willingness to explore other alternatives, considering their deep engagement with essential oils.

On top of that, the company has 16 corporate offices worldwide, and directly employs 2,600 people. In short, Prime Meridian has its own ready-made market.

doTERRA now accounts for 23% of the global aromatherapy and essential oils industry. But Riggs stressed that the Prime Meridian clinics will not be selling essential oils—or any other healthcare products. They will certainly be aromatherapy-friendly. But the company wants to send a clear message that these centers are true primary care facilities, not points of sale for doTERRA or any other product line. 

CrossFit Puts Healthcare in the Box
doTERRA’s not the only consumer-facing company that wants to whip healthcare into shape. Over the last 6 years, CrossFit—the wildly popular branded fitness franchise—has been quietly training up an army of ripped and ready physicians. Last year, CEO Greg Glassman announced the launch of CrossFit Health—a network of fitness-savvy physicians versed in CrossFit principles and practices, and able to interface easily with the company’s 15,000-plus affiliated gyms and its trainers (or “boxes” as they’re known to CrossFit enthusiasts).

To that end, the company has developed a special training program called MDL1—a medicalized version of its free, two-day, level-one training course. Since January 2018, CrossFit has hosted more than 340 doctors at its California headquarters. The program is also going global, with training in France and Brazil.

Like doTERRA’s Prime Meridian clinics, the CrossFit Health program taps into a large and active network of people who want something different from what mainstream medicine offers. CrossFitters want physically-fit doctors who understand things like high-intensity interval training, Paleo diets, and fast-mimicking regimens.

CrossFit health also plays to frustrated physicians tired of working within systems where people often don’t get better and corporate overseers questioning their every decision.

Though the specialty of sports medicine has existed within conventional healthcare for decades, the CrossFit ethos, its entrepreneurial spirit, and its customer centricity bring something new and different to the equation. 

Glassman hopes that CrossFit-savvy doctors will incorporate the program’s principles into their practices, giving patients new and meaningful tools for improving their health while serving as conduits for patients to become paying CrossFit members. He’d also like to see more physicians open up CrossFit boxes of their own.

CrossFit Health is very deliberately blurring the line between fitness coaching and medical practice. It is one more example of the ways in which creative thinkers are attempting to remake 17% of the U.S.’s GDP from far outside the healthcare mainstream—Glassman is a college dropout whose business generates roughly $100 million per year.

Be sure to join us for The Practitioner Channel Forum 2019 in San Diego at the Marriott Coronado Island Resort, May 8-9. We’ll be exploring the impending healthcare shake-ups from multiple angles and perspectives.

See you there ...

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Erik Goldman
Holistic Primary Care

Erik Goldman is co-founder and editor of Holistic Primary Care: News for Health & Healing, a quarterly medical publication reaching about 60,000 physicians and other healthcare professionals nationwide. He is also co-producer of the Practitioner Channel Forum, the nation’s leading conference focused on opportunities and challenges in the practitioner segment of the dietary supplement industry.