• No major health M&A spree, and none of the named targets were acquired. Amazon did complete its previously announced $3.9B acquisition of primary‑care provider One Medical in February 2023, strengthening its primary‑care and virtual‑care footprint. (health.economictimes.indiatimes.com) But from 2023 through late 2025 there is no record of Amazon acquiring Ro, Hims & Hers, Peloton, or Whoop; all continue to operate as independent companies (Hims doing its own acquisitions such as ZAVA, Ro partnering with Lilly, Peloton remaining a standalone public company, and Whoop launching new devices and policies under its own brand). (investors.hims.com) Coverage of healthcare M&A in 2025 also notes that big buyers like Amazon have become cautious and are not doing large new health deals, further contradicting the prediction of an aggressive acquisition push. (businessinsider.com)

• Healthcare is still treated as an experimental or “potential” pillar, not an actual fourth pillar on par with Marketplace, Prime, and AWS. Internal figures reported by The Information (via Business Insider) suggest Amazon’s healthcare unit generated about $2.5B in revenue but lost roughly $1.3B in 2023, and explicitly describe healthcare as a potential fourth pillar, not one that has already reached that status. (theinformation.com) Other analyses say Amazon is still searching for its next big pillar business, with initiatives like Project Kuiper (satellite internet) and Zoox (autonomous vehicles) also framed as candidates, and note that bets such as healthcare have so far struggled to become large, profitable franchises. (livemint.com) Even optimistic coverage only describes healthcare as an area where Amazon could eventually find a fourth pillar, underscoring that this has not yet happened in practice. (geekwire.com)

• Operational reality looks like ongoing experimentation and restructuring, not a mature fourth pillar. Amazon has continued to invest in and reorganize its health efforts (PillPack/Amazon Pharmacy, One Medical, Amazon Clinic integration, new telehealth offerings, and partnerships like Eli Lilly’s LillyDirect and nutrition startup Fay), but these are being refined and restructured—its healthcare business was split into six units and has seen executive turnover and job cuts—rather than celebrated as a core, proven business on the scale of AWS or Prime. (reuters.com) Nearly three years after the January 2023 prediction, health remains a strategic bet with mixed financial performance and no broad consensus that it has become Amazon’s definitive “fourth pillar.”

Given that: (a) Amazon did not buy Ro, Hims, Peloton, Whoop, or similar marquee wellness companies; (b) there was no broad health‑M&A push starting in 2023; and (c) healthcare has not clearly achieved pillar status alongside Marketplace, Prime, and AWS, the prediction that Amazon would quickly make health its fourth pillar via a wave of such acquisitions has not come true.