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INDUSTRY WATCH Healthcare Policy


Haven Healthcare Joint Venture Disbanded by Amazon, Berkshire Hathaway, JPMorgan Chase


On Jan. 4, a much-vaunted collabora- tion among three major U.S. corpora- tions that had initially been touted as a potentially revolutionary new approach to help push the U.S. healthcare deliv- ery system into value was declared dis- banded, just under three years after it had been created.


Haven Healthcare had been inaugu- rated on Jan. 30, 2018, as a not-for-profit joint venture by Amazon, Berkshire Ha- thaway, and JPMorgan Chase. Though it was not named for more than a year, the joint venture was hailed as a break- through at the time. The initial focus of the new company was stated to be on “technology solutions that will provide U.S. employees and their families with simplified, high-quality and transpar- ent healthcare at a reasonable cost,” according to the Haven announcement three years ago.


At the time, Berkshire Hathaway


chairman and CEO Warren Buffett stated in the press release that “The ballooning costs of healthcare act as a hungry tapeworm on the American economy. Our group does not come to this problem with answers. But we also do not accept it as inevitable. Rather, we share the belief that putting our col- lective resources behind the country’s best talent can, in time, check the rise in health costs while concurrently en- hancing patient satisfaction and out- comes.”


The following is an accompanying analysis from Editor-in-Chief Mark Hagland, who further opined on this development: Inevitably, as Business Insider re-


ported, the leaders of the Haven joint venture got tangled up in the com- plexity of the healthcare delivery sys- tem. What might have seemed rather self-evident to the CEOs of three of the most powerful and influential corpo- rations in America actually turned out to be endlessly complicated in real- ity, when approached on the ground level. As that report noted, the theory was that the combined strength of the three corporations as healthcare pur- chasers should have worked to the venture’s advantage, but in the end, Haven turned out to produce only small-ball pilot projects, and began


But on Jan. 4, the leaders of the three corporations essentially threw in the towel and conceded that the experi- ment had not worked out. A very brief statement on Haven’s website read: “In the past three years, Haven explored a wide range of healthcare solutions, as well as piloted new ways to make pri- mary care easier to access, insurance benefits simpler to understand and easier to use, and prescription drugs more affordable. Moving forward, Am- azon, Berkshire Hathaway, and JPM- organ Chase & Co. will leverage these insights and continue to collaborate in- formally to design programs tailored to address the specific needs of their own employee populations. Haven will end its independent operations at the end of February 2021.” As the Associated Press’s Tom Murphy wrote in a report covering the development, a company spokeswoman gave no reason for the dissolution of the venture. As Murphy noted in his report, “The independent company was created to focus on improving the care deliv- ered to employees of those businesses while doing a better job of managing the expense. But benefits experts ex- pected any plans developed by Haven to become widely adopted by other companies if they proved effective in controlling costs. News of the ven- ture’s creation nearly three years ago sent a brief shudder through the stocks


by “tackling primary care pilots that it couldn’t market widely to employees in an effort to maintain secrecy.” And then, in retrospect, one can see that bringing in a superstar like Atul Ga- wande, M.D., likely only added to the challenges, as, one surmises, clashes of egos began to infiltrate the initia- tive. So what the Haven people discov-


ered was the problem that so many other internal system reformers have discovered: the “Goldilocks problem” of internal health system reform. Ei- ther one tries to boil the ocean, or one ends up creating teensy pilots that don’t really move the needle at all. It is in that vast conceptual space between teensy-pilot-launching and ocean-boiling that genuine internal health system reform is happening,


of health insurers that manage em- ployer-sponsored coverage,” Murphy added. “But the Boson-based venture has been largely silent since naming a high-profile CEO — Harvard professor, author and surgeon Dr. Atul Gawande — and then announcing its name in 2019. Gawande departed last May.” In another story, Business Insider


noted, “Haven was supposed to use the combined companies’ resources to get costs under control and improve care for the member companies’ em- ployee populations, but it struggled to find an identity. It began by tackling primary care pilots that it couldn’t mar- ket widely to employees in an effort to maintain secrecy,” the story stated, ref- erencing The Information’s Paris Mar- tineau’s July piece on the venture. The BI report continued, “The pilot connected employees to primary care teams, similar to Amazon’s app and service Amazon Care.” Amazon Care, as Business Insider reported, was under- way at the tech giant before Haven got started.


“Haven lost financial backing,


The Information reported, as well as key leaders. Tensions escalated between Ha- ven and the founding companies as the upstart struggled to come up with ideas quickly, and Amazon in particular has been the most reluctant to make com- mitments to Haven, according to The Information and a person close to Ama- zon,” as reported by Business Insider.


and happening now, most clearly among the pioneers of value-based and risk-based contracting, including among the leaders of ACOs (account- able care organizations). But it’s really hard work, and takes years. One gets the very strong sense here that these titans of industry—golden wizards of big business Jeff Bezos, Warren Buffett, and Jamie Dimon— simply lacked the patience to actually plunge headlong into the unending complexity that is healthcare delivery. The simple truth turns out to be one around complexity: there is no quick, easy way to reform and reengineer the U.S. healthcare delivery system, cer- tainly not from the outside. It involves hard work, tremendously complex work, and an acceptance of health- care’s endless complexity.


JANUARY/FEBRUARY 2021 | hcinnovationgroup.com 5


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