An Tuesday by three of the nation鈥檚 corporate titans 鈥� Amazon, Berkshire Hathaway and JPMorgan Chase & Co. 鈥� that they are joining forces to address the high costs of employee health care has stirred the health policy pot. It immediately sent shock waves through the and reinvigorated talk about health care technology, value and quality.
Though details regarding the undertaking are thin, the companies said in a release that their partnership鈥檚 intent is to improve employee satisfaction and hold down costs by bringing 鈥渢heir scale and complementary expertise to this long-term effort.鈥�
They plan to create an independent company, 鈥渇ree from profit-making incentives and constraints,鈥� to focus on 鈥渢echnology solutions.鈥�
Berkshire Hathaway CEO Warren Buffett described health care costs as 鈥渁 hungry tapeworm on the American economy,鈥� and Amazon founder and CEO Jeff Bezos said the partnership was 鈥渙pen-eyed about the degree of difficulty鈥� 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 of this mean and how can it be successful when so many other initiatives have fallen short? KHN asked a variety of health policy experts their thoughts on this venture, and what advice they would offer these CEOs as they go forward. Some of the advice has been edited for clarity and length.
Tom Miller, resident fellow, American Enterprise Institute (Courtesy of Tom Miller)
Tom Miller, resident fellow, American Enterprise Institute:
鈥淚t鈥檚 great that someone theoretically with resources would try to build a better mousetrap. But it鈥檚 been difficult to do, and part of it is regulatory and competitive barriers are well-constructed in the health care sphere, which tend to make it less receptive or subject to competitive pressures.
鈥淚 welcome any new capital trying to disrupt health care. 鈥� The incumbents are comfortable and could use disruption. If Amazon has an idea, and is willing to put some money behind it, that鈥檚 wonderful. What they are willing to do other than fly low-cost providers for home visits in drones 鈥� I don鈥檛 know. They鈥檇 probably have to miniaturize them, wouldn鈥檛 they?鈥�
Stan Dorn, senior fellow, Families USA (Courtesy of Stan Dorn)
Stan Dorn, senior fellow, Families USA:
鈥淣umber one, look at prices. America doesn鈥檛 use more health care than European countries, but we pay a lot more and that鈥檚 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鈥檓 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.鈥�
Bob Kocher, partner, Venrock (Courtesy of Bob Kocher)
Bob Kocher, partner, Venrock:
鈥淚t has been said that health care is complicated.聽One thing that is not complicated is that the way to save money is to focus on the sickest patients.聽And that鈥檚 the only thing that has proven to work in great primary care.聽I hope Amazon realizes this early and does not think that [its smart digital assistant] Alexa and apps are going to make us healthier and save any money.
鈥淚t would sure be nice if they invest in a 鈥榩ost-CPT-ICD-10-and-many-bills-per-visit鈥� world where we know prices, can easily know what is known about quality and experience, and have same-day service.鈥�
Tracy Watts, senior partner, Mercer (Courtesy of Tracy Watts)
Tracy Watts, senior partner, Mercer:
鈥淓veryone thinks millennials want to do everything on their phones. But that鈥檚 not necessarily the case.
鈥淸There was a recent] about this 鈥� specifically, millennials are the most interested in new health care offerings, but it wasn鈥檛 as much high-tech as it is convenience they are interested in 鈥� 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 鈥榓ha鈥� 鈥� this kind of convenience and high-touch experience is what they鈥檙e looking for. And when you think of 鈥榟ealth care of the future,鈥� that鈥檚 not what comes to mind.鈥�
John Rother, president and CEO, National Coalition on Health Care (Courtesy of John Rother)
John Rother, president and CEO, National Coalition on Health Care:
鈥淗ealth care 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.鈥�
Suzanne Delbanco, executive director, Catalyst for Payment Reform (Courtesy of Suzanne Delbanco)
Suzanne Delbanco, executive director, Catalyst for Payment Reform:
鈥淭he biggest driver of health care costs is prices. Those are being driven up by health care providers who have consolidated and will continue to consolidate and amass more market power.
鈥淚t sounds like they [the companies] are limiting the use of health plans, but if they鈥檙e going to get into that business, they鈥檙e 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.鈥�
Brian Marcotte, president and CEO, National Business Group on Health (Courtesy of Brian Marcotte)
Brian Marcotte, president and CEO, National Business Group on Health:
鈥淭hey recognize this is [a] long-term play to get involved in this. I鈥檇 have to say, this industry is ripe for disruption.
鈥淚 think we know technology will continue to play an increasing role in how consumers access and receive health care. We鈥檝e also learned most consumers do not touch the health care delivery system with enough frequency to ever be a sophisticated consumer. What鈥檚 intriguing about this partnership is Amazon for many consumers has become part of their day-to-day world, part of their routine. It鈥檚 intriguing to consider the possibilities of integrating health care into consumer routine.
鈥淎nd I think that therein lies the opportunity. Employers offer a lot of resources to their employees to help them maximize their experience, and their No. 1 challenge is engagement.鈥�
Joseph Antos, health economist, American Enterprise Institute (Courtesy of Joseph Antos)
Joseph Antos, health economist, American Enterprise Institute:
鈥淢y 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.聽Change incentives for consumers. Work on ways to reduce the effects of market consolidation.聽The bottom line:聽Don鈥檛 keep doing what we are doing now.聽I don鈥檛 see that these three companies have enough presence in health markets to pull this off anytime soon, but perhaps this should be viewed as the private-sector version of the Affordable Care Act鈥檚 Innovation Center 鈥� except, this time, there may be some new ideas to test.鈥�
Ceci Connolly, president and CEO, Alliance of Community Health Plans (Courtesy of Ceci Connolly)
Ceci Connolly, president and CEO, Alliance of Community Health Plans:
鈥淲e know that 5 percent of any population consumes 50 percent of the health care dollar. I would encourage this group to focus on how to better serve those individuals who need help managing multiple chronic conditions.鈥�
David Lansky, CEO, Pacific Business Group on Health (Courtesy of David Lansky)
David Lansky, CEO, Pacific Business Group on Health:
鈥淭he incumbent providers of services to our members are not doing as much as we need done for affordability and quality. So, we are pleased to see them go down this path. We don鈥檛 know what piece of the puzzle they will tackle.
鈥淲e know well-intended efforts over the years haven鈥檛 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.
鈥淚 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.鈥�
Staff writers Julie Appleby, Rachel Bluth, Jenny Gold, Jay Hancock, Shefali Luthra, Jordan Rau, Julie Rovner and Chad Terhune contributed to this report.