Haven, the recently named joint venture of Amazon, Berkshire Hathaway, and JPMorgan Chase, has officially emerged from the shadows with a public persona, giving industry pundits new details about the company’s ambitions and intended trajectory within healthcare. Haven has struck fear in the hearts of many healthcare organizations (HCOs), in part because of Amazon’s reputation for disruption but more so because the healthcare industry in the United States is particularly vulnerable. It is unnecessarily expensive, grossly overcomplicated, and seems incapable of self-correction.
Haven’s Short- And Long-Term Ambitions
Haven’s early focus will be on improving care for employees and families of its founding companies: Amazon, Berkshire Hathaway, and JPMorgan Chase. Optimizing care delivery for these million covered lives is a short-term threat to no one. Haven will not have a beachhead in healthcare by morning; as CEO Atul Gawande notes, “We know that this work will take time.” This will be a revolution measured in modest increments. But as we have been saying since Day 1, this team is too talented and too ambitious to find contentment in managing care for one million covered lives. In recent days, Gawande has not shied away from the fact that success realized within Haven will be made generally available in time.
One method of forecasting what Haven is building long term is to look at who is part of Haven. Atul Gawande is a surgeon and a firm believer in perpetual process improvement. In his work The Checklist Manifesto, he describes our healthcare challenges succinctly: “The volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably.” He outlines how relatively simple changes can drive harmful variance out of complex systems.
Expect Gawande to take the same approach at Haven. He will want to measure and manage the efficiency of the system and the health of the population, incubating ideas that can drive meaningful improvement to one or both. He has built a leadership team that brings expertise in population health analytics, chronic disease management, care coordination, and patient engagement.
What It Means
Haven is not the first, nor will it be the last, big business to come to healthcare with grand plans. While it iterates toward a better healthcare experience for its employees, healthcare organizations should do two things:
- Watch and wait. Haven’s success is far from guaranteed, and what success it does derive will take time to materialize. Watch, note its successes, replicate if it makes sense for your own organization, and learn from its failures. Gawande is a thought leader and a prolific author. The opportunity to follow the Haven story from afar will be made available to us all.
- Be wary of misaligned revenue streams. Haven is representative of a broader cultural shift in the US. HCOs should expect increasing alienation of organizations that resist outcomes-based reimbursement agreements. Employers are evaluating all options to control costs for themselves and their staff. Payers are pushing hard to drive downside risk into contracts. In turn, providers and life sciences companies will face increased pressure to deliver measurable clinical outcome improvements.