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Amazon treads carefully with M&A strategy amid growth, regulatory pressures

Amazon.com Inc.'s recent acquisitive streak aims to close big deals by targeting new sectors as executives look for future growth, analysts said.

The company's M&A strategy appears tailored to withstand the scrutiny faced by Amazon's Big Tech peers, some of which are pulling back on dealmaking amid heightened regulatory headwinds. A key question is whether concerns about how Amazon will handle sensitive data like medical records could lead to roadblocks for the company's recently announced acquisitions.

In the past month, Amazon announced two big deals that, if approved, would account for the company's third- and fourth-largest acquisitions ever. The targets are 1Life Healthcare Inc., which oversees a health provider network known as One Medical, and iRobot Corp., a company best known for its autonomous vacuum, Roomba.

"They're able to do acquisitions in areas where they can claim small market share," said Loup Ventures managing partner Gene Munster.

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The One Medical deal, a cash transaction valued at about $4.3 billion including the target's net debt, would be Amazon's fourth in healthcare or related services. The company first entered the healthcare sector with its purchase of online pharmacy PillPack Inc. for $753 million in 2018.

Amazon has completed two smaller healthcare-related deals since then, acquiring healthcare technology company Health Navigators LLC in 2019 and buying a minority stake in pharmaceuticals company Optimus Drugs Pvt. Ltd. earlier this year.

In 2021, Amazon expanded its homegrown medical provider service Amazon Care, allowing nonemployees to access its telehealth and in-person services. The One Medical deal is expected to expand the reach of Amazon Care.

"Members of Amazon Care will now have access to both virtual and in-person primary physician care, as well as prescription delivery, all under one umbrella," wrote Third Bridge analyst George Congdon in a research note following the One Medical deal announcement.

Meanwhile, the $1.58 billion iRobot deal would add to Amazon's smart home portfolio, which includes Alexa-powered speakers and other devices.

Historically, Amazon has excelled at pushing into new markets, but its moving further into healthcare has elicited concern from some investors who question the timing, given Amazon's two consecutive quarterly losses this year.

"A lot of investors right now are scratching their head saying, 'well, hold on a second, you've made some mistakes in your core, like overhiring and overbuilding,'" said AB Bernstein managing director Mark Shmulik. "'Maybe we refocus attention there, and revisit some of these more far-reaching initiatives at a later date.'"

Amazon shares had fallen 13.9% for the year-to-date through Aug. 12, compared to a decline of 16.6% for the tech-heavy Nasdaq stock exchange.

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Political concerns raised following the deal announcements focus on data handling and consumer privacy.

Sen. Josh Hawley, R-Mo., on July 28 sent a letter to the Federal Trade Commission asking for a review of the One Medical transaction to evaluate the potential for mishandling or misuse of patient data. An FTC spokesperson confirmed receipt of Hawley's letter but declined to comment further.

Amazon declined to comment on the concerns voiced in Hawley's letter. In an emailed statement to S&P Global Market Intelligence, a spokesperson said the company plans to comply with all applicable privacy laws and Health Insurance Portability and Accountability Act regulations. Amazon would not share the personal health information of One Medical customers "without clear permission from the customer," the spokesperson said.

Any acquisition involving large tranches of data is risky because the companies that accumulate that information often are not able to clearly distinguish where it is supposed to go, said Jesse Lehrich, co-founder of advocacy group Accountable Tech.

"It's just really hard to have any confidence that they wouldn't be able to get away with using those data points, intentionally or accidentally," Lehrich said. "A lot of these companies have made clear they don't really know how to disambiguate specific data points to ensure that they're not being used for certain functions."

Concerns surrounding the unauthorized disclosure of medical information have mounted as more medical records are digitized. But properly aggregated and anonymized data can be useful to practitioners for improving healthcare if it is collected by a company like Amazon with sophisticated tools at its disposal, said James Capretta, senior fellow and Milton Friedman chair at the American Enterprise Institute.

"I think most people are not against trying to make sure that there's good insight gleaned from better use of collected data," Capretta said. "But it has to be made so that it's anonymous at the patient level."