Haven: From Manhattan Project to Side Project

What to make of Haven’s demise?

The partnership of Amazon, JPMorgan Chase and Berkshire Hathaway was launched in 2018 to credulous fawning, despite the announcement being utterly devoid of anything.

Turns out, all the money in the world can’t buy a clear vision for success in healthcare. The industry is immune to half-hearted, drive-by attempts at big change, no matter your brand. It’s all or nothing, and without total buy-in from leadership (and deep pocketed backers), you end up where Haven did: What could have been a Manhattan Project turning out to be a side project.

It’s as easy today to mock Haven’s failure as it was to be skeptical at its creation – so we won’t judge if you do some mocking, because it’s fun. And fun can be hard to come by these days.

But once we’re done laughing and enjoying some self-righteous “told-you-so’s”, we face the same reality this industry has faced for decades: Who’s going to get healthcare costs under control?

We’re 11 years out from the passage of the ACA, which was successful in expanding coverage and unsuccessful in reining in costs. The cool kid “disruptors” have been narrowly focused on disrupting the wheelbarrows of healthcare money long enough to scoop some up for themselves, not on changing the market dynamics in a way that pays off for patients.

Big employers may yet unlock the vault with instructions for bending the cost curve, and it would still be dumb to bet against the world’s richest person and Amazon Care. But as costs continue to rise and many patients are forced to rely on having the best GoFundMe story in order to pay for their medical expenses, demands for substantive change will only increase.

This line, from one of the many Haven postmortems, stands out: “Healthcare providers and insurers have significant market leverage, and that’s difficult to overcome in trying to control costs,” said Kaiser Family Foundation’s Larry Levitt. To put another way: Providers and insurers are the reason healthcare costs are high.

For the moment, and as we have detailed throughout the last year, healthcare providers enjoy a considerable amount of trust, along with favorability ratings that we haven’t seen this century. Hospitals and health systems should view that positivity as ephemeral, a byproduct of the heroism displayed by frontline clinicians throughout the pandemic. As insurers continue, uh, let’s call it throwing their weight around, providers can leverage the current landscape to draw sharp contrasts with them – keeping in mind that the public goodwill might not extend indefinitely.

As we move through 2021 and the pandemic begins to recede, other elements are likely to come into sharper focus and scrutiny, including issues like price transparency and hospital consolidation. Now is the time to lead on these issues. You may not like the price transparency rule (ok, I know you don’t), because of the context it lacks. If that’s the case, then get to work providing that context. Get out ahead of the regulators and your consumers. Maybe you have a great partnership opportunity on the horizon – now is the time to start building a comprehensive story beyond “uh, scale?” for why it is great for the people you serve.

If the “incumbents” in healthcare aren’t going to change, and even the biggest disruptors can’t shake up care delivery in a meaningful (read: cheaper) way, then it is only a matter of time (and polling trends) before a broad coalition across this country views greater federal involvement in the delivery of healthcare as their only hope. If that bothers you, you’ve got time to change course. But not much.

Tim Stewart
tstewart@jarrardinc.com