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  While these providers may have better digitally enabled providers and platforms, they lack the longer-term relationships of [https://www.merritthawkins.com/news-and-insights/media-room/press/ Physician Practice Patterns Changing as a Result of COVID-19] half of physicians</a>&nbsp;now treating patients through telemedicine platforms,[https://www.fiercehealthcare.com/tech/ industry voices virtually or person automation improves healthcare experience"] up from just 18% in 2018</a>.</li><li><strong>Digital First Providers</strong> - <a href="https://www.beckershospitalreview.com/finance/5-startups-changing-the-way-physicians-get-paid.html">these are startup physician groups</a> that partner with Medicare Advantage health plans and employers to manage the overall health and cost of members and employees. These organizations developed effective digital platforms to engage their patients, manage health and value-based care contracts. They include <a href="https://www.onemedical.com/">One Medical</a>, <a href="https://www.oakstreethealth.com/">Oak Street Health</a>, <a href="https://www.iorahealth.com/">Iora Health</a>, <a href="https://www.chenmed.com/">ChenMed</a> and <a href="https://www.villagemd.com/">VillageMD</a>. While they represent a tiny fraction of physician services, so did Amazon when it started selling books. </li><li><strong>Hybrid Providers</strong> – The hybrid providers are health insurance companies that are buying physician practices that include Optum Care (United Healthcare), CVS/Aetna, <a href="https://www.modernhealthcare.com/article/20180602/NEWS/180609985/reigniting-the-physicians-arms-race-insurers-are-buying-practices#:~:text=Humana%20is%20moving%20its%20health,200%20doctors%20serving%2070%2C000%20patients.">Conviva</a> (Humana) and a digital first hybrid <a href="https://www.hioscar.com/">Oscar</a>. <a href="https://www.beckersasc.com/asc-transactions-and-valuation-issues/optum-has-50-000-employed-affiliated-physicians-and-a-vision-for-the-future.html">Optum Care now has 50,000 employed or affiliated physicians</a>, <a href="https://www.forbes.com/sites/brucejapsen/2019/12/12/urgent-care-centers-eclipse-9200-thanks-to-optum-and-hospitals/#6f17066d84c1">250 urgent care centers</a> and <a href="https://www.bizjournals.com/twincities/news/2020/01/10/allina-looks-to-optum-to-run-its-surgery-centers.html#:~:text=Optum%2C%20which%20includes%20most%20of,centers%2C%20with%20over%207%2C500%20physicians.">210 surgery centers</a>. These hybrid providers continue to grow and begin to alter certain markets. </li><li><strong>Retail Health</strong> – There has been significant growth in retail health that can be delivered virtually and at local retail stores. <a href="https://www.forbes.com/sites/gregpetro/2020/06/25/walmart-and-amazon-lead-the-retail-pack-by-leveraging-healthcare/#2c2b17613d76">This is being led by massive investments by Walmart, CVS, Best Buy, Walgreens and Amazon</a>. They are trying to make the physician visits easy and convenient. </li><li><strong>Digital Therapeutics</strong> - These are new services that provide patients alternatives to traditional patient office visit models. They combine digital health (mobile app, devices, monitoring, symptom and coaching 'bots) with people through virtual coaching and even physician consults. They often focus on specific chronic conditions (<a href="https://www.lark.com/">Lark Health</a>, <a href="https://www2.livongo.com/">Livongo Health</a>, <a href="https://www.vida.com/">Vida Health</a>, <a href="https://www.virtahealth.com/">Virta Health</a>), lifestyle changes (Noom, <a href="https://www.omadahealth.com/">Omada</a>) and behavioral health (<a href="https://www.talkspace.com/">TalkSpace</a>). While Digital therapeutics do not provide comprehensive physician practice services, this could change in the future. If they establish long-term relationships with their patients, they can become formidable competitors to existing physician practices.  </li><li><strong>Other</strong> - There are many more potential competitors that could play a role in the traditional patient-physician relationship. The companies stepping include pharmacy discount card company <a href="https://www.goodrx.com/">GoodRx</a> offering physician visits. There are many innovative new models such as <a href="https://heal.com/about/">Heal</a> which provides home visits with physician and nurse practitioners.</li></ul>