Haven has been quiet for the past 2 years — what does that mean for healthcare?

On Jan. 30, 2018, three dynamic companies partnered with the goal of revolutionizing healthcare delivery and lowering costs. Since then, we haven't heard much from them about the venture.

Amazon, Berkshire Hathaway and JPMorgan Chase & Co., set out to improve employee satisfaction while decreasing the cost of care through a new venture, dubbed Haven. The three partners aimed to bring scale and expertise to their new venture, with a focus on technology solutions that would provide transparent healthcare at a "reasonable cost."

"The ballooning costs of healthcare act as a hungry tapeworm on the American economy," Berkshire Hathaway Chairman and CEO Warren Buffett said when the venture was launched. "Our group does not come to this problem with answers. But we also do not accept it as inevitable. Rather, we share the believe that putting our collective resources behind the country's best talent can, in time, check the rise in health costs while currently enhancing patient satisfaction and outcomes."

The announcement was made with much bravado but few details, which ignited speculation about how the three would work together. The emphasis on technology and transparency is intriguing, and given the 1.2 million lives covered by the companies, some speculated they would negotiate directly with healthcare providers to lower costs. Others wondered whether they would test new distribution models for prescription drugs through Amazon.

Amazon acquired PillPack shortly after the announcement, and last year also launched a telehealth service for employees. The company also continues to support data storage efforts through Amazon Web Services for hospitals and health systems, but during their most recent earnings call addressing revenue growth in 2019, CEO Jeff Bezos was silent about the company's involvement in Haven.

In June 2018, Atul Gawande, MD, became the CEO of Haven and its headquarters officially followed Dr. Gawande to Boston. The partners also announced then that Haven would operate independently from the others as an entity "free from profit-making incentives and constraints."

The last time Haven publicly issued a statement was last March, when its name was revealed, and website launched. At the time, the company said Dr. Gawande was meeting with employees across all three founding organizations to understand their healthcare experiences, and he was hiring experts from a variety of backgrounds. Since then, the company has seemed dormant to the public eye. What does that mean?

"Even such incredible minds and visionaries have been surprised at the true complexity and difficulties in bringing about change in healthcare," said Randy Davis, CIO of CGH Medical Center in Sterling, Ill. "It's 3-dimensional chess, and surprise, surprise, those in healthcare like it that way. They'll nibble at their easy wins, but it won't amount to huge dollars. CVS/Aetna is better positioned to really run at it than these folks. They have location going for them. The Panama Canal wasn't a canal project; it was a railroad project to move dirt. When these 'players' figure out what the real project is, look out. I expect a major reference lab to be on their purchase list in the near future."

It also takes time to really get a new venture off the ground, and mindfully execute change. Their silence could be a good sign, said Lee David Milligan, MD, senior vice president and CIO of Asante Health System, based in Medford, Ore.

"In this case, their silence has earned my respect because it demonstrates that they are willing to accomplish the necessary due diligence before framing up their plan and executing. If they focus on their own employees and families, leverage technology only where it makes sense, eliminate the mind-boggling bureaucracy for patients and providers, and emphasize clinically proven health maintenance programs, they have a real shot at creating something special and sustainable."

Theresa Hush, CEO of Roji Health Intelligence, isn't surprised by the slow start either. However, she is intrigued by the venture's focus on first dollar coverage and primary care access with an incentive for wellness and health maintenance.

"That is the opposite direction that market coverage and employers have been going," she said. "It would not surprise me for Haven to begin partnerships with providers, or even to create its own health system as a logical next step. What that approach so far says is that they believe that healthcare has to go back to the basics before sophisticated disruptive tools to control costs and reform healthcare can be considered, and targeting their own large employee population creates the perfect experimentation platform for the venture."

Haven's 2018 debut also sparked a flurry of partnerships, acquisitions and acceleration of non-traditional entrants into the healthcare market. CIO of Memorial Healthcare System Jeffery Sturman expects more new entrants in the future, including retail companies, as healthcare remains ripe for disruption.

"Although Haven may be quiet for now, I wouldn't underestimate the capabilities they and others can impart upon our healthcare industry," he said. "I think this can create opportunities for us as we look to new forms of partnership and delivering care in different and more productive ways."

Bruce Metz, PhD, executive vice president and CIO of the Accreditation Council for Graduate Medical Education, agrees. As industry giants in technology, retail, insurance and pharmacy see opportunity to make healthcare more efficient and less costly through consumer-driven technology, he sees more disruption with artificial intelligence, virtual care, big data, advanced analytics, robotics, automation, genomics and precision medicine.

"Progress in the democratization of healthcare information fueled by heightened consumer expectations is another significant sign that disruption is underway," said Dr. Metz. "The power of the resulting new digital business models rests in the disintermediation or removal of traditional players from the process, altering once reliable revenue streams. Disintermediation also eliminates a high bar to healthcare marketplace entry. As a result, established healthcare organizations, particularly those in the healthcare delivery space, can no longer afford to change at their historically slow pace. Rather, the need for these organizations to adopt a forward-looking, flexible and adaptive approach to conducting business has never been greater. Organizations that do so in ways that find the right balance between patients, providers and technology should persist and may well thrive once Haven's quiet period ends."


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