An announcement Tuesday by three of the nation’s corporate titans — Amazon, Berkshire Hathaway Inc. and JPMorgan Chase & Co. — that they are joining forces to address the high costs of employee healthcare has stirred the health policy pot. It immediately sent shock waves through the health sector of the stock market and reinvigorated talk about healthcare technology, value and quality.
Although details regarding the undertaking are thin, the companies said their partnership’s intent is to improve employee satisfaction and hold down costs by bringing “their scale and complementary expertise to this long-term effort.”
They plan to create an independent company, “free from profit-making incentives and constraints,” to focus on “technology solutions.”
Berkshire Hathaway Chief Executive Warren Buffett described healthcare costs as “a hungry tapeworm on the American economy.” Amazon founder and CEO Jeff Bezos said the partnership was “open-eyed about the degree of difficulty” ahead. Jamie Dimon, chairman and CEO of JPMorgan, said the results could benefit the employees of these companies and possibly all Americans.
But what does all this mean, and how can it be successful when so many other initiatives have fallen short? Kaiser Health News asked a variety of health policy experts their thoughts on this venture and what advice they would offer these CEOs. Some of the advice has been edited for clarity and length.
Tom Miller, resident fellow, American Enterprise Institute
“I welcome any new capital trying to disrupt healthcare.… The incumbents are comfortable and could use disruption. If Amazon has an idea, and is willing to put some money behind it, that’s wonderful. What they are willing to do other than fly low-cost providers for home visits in drones — I don’t know. They’d probably have to miniaturize them, wouldn’t they?”
Stan Dorn, senior fellow, Families USA
"No. 1, look at prices. America doesn’t use more healthcare than European countries, but we pay a lot more and that’s because of prices more than anything else. Look at hospital prices and prescription drug prices. I would also say, look to eliminate middlemen operating in darkness. I’m thinking in particular of pharmacy benefit managers. Often, the supply chain is hidden and complex and every step along the way the middlemen are taking their share, and it winds up costing a huge amount of money."
Bob Kocher, partner, Venrock
"It has been said that healthcare is complicated. One thing that is not complicated is that the way to save money is to focus on the sickest patients. And that’s the only thing that has proven to work in great primary care. I hope Amazon realizes this early and does not think that Alexa and apps are going to make us healthier and save any money.
Tracy Watts, senior partner, Mercer
“Everyone thinks millennials want to do everything on their phones. But that’s not necessarily the case.
“[There was a recent] survey about this — specifically, millennials are the most interested in new healthcare offerings, but it wasn’t as much high tech as it is convenience they are interested in — same-day appointments with a family doctor, guaranteed appointments with specialists, home visits, a wider array of services available at retail clinics. That was kind of an ‘aha’ — this kind of convenience and high-touch experience is what they’re looking for. And when you think of ‘healthcare of the future,’ that’s not what comes to mind.”
John Rother, president and CEO, National Coalition on Health Care
“Healthcare is complex and expensive, so the aim should always be simplicity and affordability. Three keys to success: manage chronic conditions recognizing the life context of the patient, emphasize primary care-based medical homes and aggressively negotiate prescription drug costs.”
Suzanne Delbanco, executive director, Catalyst For Payment Reform
“It sounds like they [the companies] are limiting the use of health plans, but if they’re going to get into that business, they’re going to come up with the same challenges health plans face. What would be really innovative would be to build some provider systems from the ground up where they can truly get a handle on the actual costs and eliminate the market power that drives the prices up, and they can have control over their prices.”
Brian Marcotte, president and CEO, National Business Group on Health
“They recognize this is long-term play to get involved in this. I’d have to say, this industry is ripe for disruption.
“I think we know technology will continue to play an increasing role in how consumers access and receive healthcare. We’ve also learned most consumers do not touch the healthcare delivery system with enough frequency to ever be a sophisticated consumer. What’s intriguing about this partnership is Amazon for many consumers has become part of their day-to-day world, part of their routine. It’s intriguing to consider the possibilities of integrating healthcare into consumer routine.
Joseph Antos, health economist, American Enterprise Institute
“My first suggestion is to look at what other employers have done [some unsuccessfully] and consider how to adapt those ideas for the three companies and more broadly. Change incentives for providers. Change incentives for consumers. Work on ways to reduce the effects of market consolidation. The bottom line: Don’t keep doing what we are doing now. I don’t see that these three companies have enough presence in health markets to pull this off any time soon, but perhaps this should be viewed as the private sector version of the Affordable Care Act’s Innovation Center — except this time, there may be some new ideas to test.”
Ceci Connolly, president and CEO, Alliance of Community Health Plans
"We know that 5% of any population consumes 50% of the healthcare dollar. I would encourage this group to focus on how to better serve those individuals who need help managing multiple chronic conditions.”
David Lansky, CEO, Pacific Business Group on Health
“We know well-intended efforts over the years haven’t added up to material impact on cost and quality. I would suspect they are looking at doing something broader, more disruptive than initiatives we have tried before.
“I think across the board they have the opportunity to set high standards for the health system in whatever platform they use. These companies have a history of raising the bar. Potentially, it could be a help to all of us.”