When Haven was founded in January 2018, the whole American medical and health industry felt shivering.
The news of Haven's establishment was announced in a cryptic press release. At that time, the sponsor of the joint venture company Amazon 、 JPMorgan Chase and Berkshire Hathaway He said that he would set up an independent company, free from profit pressure, to focus on improving medical and health services for employees and reducing costs.
A person familiar with the situation said in 2018 that the idea of establishing Haven came from the personal dissatisfaction of CEOs of these companies, including Jeff Bezos, Jamie Dimon and Warren Buffett, with the rising medical costs of enterprise employees.
Buffett said in the statement at the time: "We have no answer to this question, but we do not think it is inevitable. On the contrary, we all believe that by putting our common resources into the hands of the best talents in this country, we can timely curb the rise of medical costs, while improving patient satisfaction and medical outcomes."
Similarly, Bezos said in a statement that when the joint venture was established, it was clear that it would be difficult to achieve the desired goals, but the efforts were worthwhile. Dimon added that the achievements of this company may eventually benefit all Americans, not just the employees of these sponsor companies.
Haven was not allowed to disclose specific information for a long time.
Every year, American employers provide insurance for about half of Americans, and the total annual expenditure on health care can reach 880 billion dollars. The three companies that are the sponsors of Haven are facing a particularly severe situation. In 2019, they covered the annual medical expenses of more than 1.2 million employees, with a total expenditure of more than $4 billion.
On the day Haven announced its establishment, the market value of medical and health companies in the United States lost billions of dollars. It is generally believed that the CEOs of the three largest and strongest companies hope to grab jobs from these industry companies, including medical insurance companies, pharmaceutical companies and pharmaceutical agencies.
However, looking back, Haven had fundamental defects from the beginning.
According to the press release, the new company is in the "initial planning stage" and has not determined its name, headquarters, CEO, long-term management team and mission. Except that the purpose of reducing the cost of medical and health services is clear, Haven has not set a specific area.
In short, the details of the new company are very sketchy. In the next three years, the mission of the company never really realized.
As Nikhil Krishnan, a former analyst and writer of CB Insights, showed in the data news "Technology companies enter the medical industry", employer funded medical health services are well-known organizational problems.
Krishnan believed that although "everyone should applaud for the reform attempt in the medical and health field", putting three large companies with different employee groups in the United States together would make the situation of the joint venture more difficult. In fact, Amazon's internal work on employee medical care is also full of problems.
"It will be complicated from the beginning," he said
Lack of clear focus
In June 2018, Haven found his leader, Dr. Atul Gawande. This certified surgeon, an adviser to former U.S. President Bill Clinton, a professor and writer of Harvard University, and a contributing writer of The New Yorker are considered to be visionary and capable of solving difficult industrial problems.
At that time, Gawande had a preliminary idea. He had always advocated the introduction of a simple "checklist" in the pharmaceutical industry, so as to reduce surgical errors by 50%. However, it is reported that Gawande has no previous experience in enterprise management, nor has he left other roles, and he has devoted himself to Haven's work.
Kimberly MacPherson, head of health management at the Haas School of Business at the University of California, Berkeley, said: "Artur has a vision, but he is not suitable to be the CEO of a business company. He has no way to do something different in the medical and health field."
For a period of time after taking this position, like Bezos, Buffett and Dimon, Gawande did not know what kind of company Haven should be. Five months after joining, he said to the audience at a public event that he estimated that Haven might focus on those middle and lower class people who cannot afford commercial insurance but are not eligible to receive federal aid.
The company didn't have an official name until March 2019, nine months after Gavant joined the company.
According to media reports, because of his enthusiasm for primary medical services, Gawande led Haven to carry out the first pilot, code named "Starfield", hoping to connect enterprise employees with a dedicated primary medical service team.
The pilot project was launched in November 2019, but failed in only five months.
The only big project failed
Starfield focuses on JPMorgan Chase's employees in Ohio and relies on the local supplier Central Ohio Primary Care. This project encountered unfavorable factors in many aspects. First of all, Haven's confidentiality culture makes it impossible for qualified employees to know that the new application has been launched in Columbus, Ohio. In addition, the project is not supported by Amazon, because Amazon is building a similar project internally.
What makes the problem more complicated is that the business and employees of the sponsor company are scattered all over the United States.
Brian Marcotte, president and CEO of American Health Business Group, believes that it is difficult for such localized pilot projects to leave specific markets and promote to the United States. "I think that the reform of medical and health services needs to start with a virtual and scalable solution. Such a solution can be combined with localized services, but will not be limited by the latter."
In April this year, Gawande told employees that Haven is stopping Starfield project, which is due to the commercial pressure brought by the COVID-19 epidemic. The company subsequently laid off about 20 per cent of its staff. A few weeks later, Jia Vande resigned as CEO of the company and became chairman.
However, at this time, Haven has already faced great pressure. LinkedIn data shows that Haven lost 21 employees from May to December this year, leaving only 59 employees in the company. According to media reports, the heads of product management, recruitment, supplier analysis and product design have all left their jobs, and others who left include Serkan Kutan, chief technology officer, and Yvette Pasqua, vice president of engineering development.
By December, Haven confirmed that he no longer paid attention to primary medical services. Although various pilots and at least one data project are still in operation, the company has never found another guiding strategy that satisfies all sponsors.
Tension with the sponsor
A source close to Haven said that although Gavande is the right leader for Haven, he lacks the necessary support from the sponsor's human resources department.
Haven was founded because the CEOs of the three sponsor companies were dissatisfied with the status quo, but the CEOs of the companies were dissatisfied and the operation managers responsible for daily decision-making of these companies paid attention to this problem and really wanted to promote this project. For example, Amazon did not cooperate in recruiting employees to participate in Haven's primary medical service pilot.
The source said: "Once the organization and budget are put together, you'd better ensure that all parties reach an agreement and know how to achieve their own success as partners. However, such an agreement has not been reached, nor has it been reached until now."
Haven spokesman said in a statement that the three companies will continue to carry out loose cooperation and pursue their own ideas in the future, depending on what they think is the most reasonable approach for their respective employee groups.
Amazon Care has launched its own project to try to control medical expenses inside and outside the company. This service is similar to Haven's pilot program, providing employees with services such as doctor home visits, telemedicine and prescription drug delivery. Amazon plans to promote the service nationwide in the United States and hopes to push it to more other companies.
Beth Galetti, Amazon's senior vice president of human resources, is also a member of Haven's board of directors. A source close to Amazon said that she participated in the incubation of Amazon Care, which was merged by the project of Amazon Human Resources Department and Grand Challenge, a confidential laboratory.
A person familiar with the matter said: "Nobody at Amazon is satisfied with Haven, because Bezos is actually beating up the internal team, believing that the internal team has not done a good job in cost control. Therefore, all the ideas put forward by Haven have no voice at the beginning."
It is said that JPMorgan Chase will also continue to promote the pilot of its own projects Aetna and Cigna. The company began promoting Haven's programs to employees in Ohio and Arizona in 2019. These programs eliminate deductibles, and employees can get additional subsidies if they reach certain health goals.
The third company, Berkshire Hathaway, is also not good at implementing a unified welfare plan. As a group, Berkshire Hathaway has about 60 companies and more than 360000 employees worldwide. A source close to Haven said: "In Buffett's investment, the management maintains the decision-making power. This is also the key to the success of Buffett's operating holding company. Buffett's acquisition of a company is not to completely change them, so he will not do more than provide some options."
Potential: still exists
At present, Haven's concept is still optimistic. Elizabeth Mitchell, CEO of Pacific Health Business Group, said that achieving the goals behind Haven is more meaningful now than it was three years ago. The medical system in the United States is constantly integrating, leading to price increases, while the COVID-19 epidemic has brought more pressure on enterprises on how to cut costs.
She said, "We are very encouraged by Haven's senior management." At present, Pacific Health Business Group is incubating a confidential enterprise based on member companies Wal-Mart 、 Maxon And Lloyd's eight years ago.
Mitchell said that the company will find the best doctors for employers, focusing on specialized and primary medical services. The employer will participate at the most appropriate time, and the Pacific Health Business Group will do a good job in basic work, looking for the best service and ensuring the scalability of the service. (Viking)
