New health care initiative by Amazon, Berkshire and JPM-C

[GTFan]

I'm still trying to figure out how they get to the 'transparent' part. Within a limited network with agreed-upon pricing accessible to consumers, maybe.

Lack of transparency remains one of the big obstacles to cost reform, but I applaud any effort from big players like these to shake up the market. It is indeed a huge drag on business especially when compared to other countries.

 

[Gotadimple]

Part of the announcement highlighted technology.
This is interesting, and possibly one source of disruption. That is, the ability to deliver high quality health care at a much lower price.

Technology in health care has been applied much differently than other industries. It is much more proprietary and directed toward generating revenue for the patent-holder, rather than focused on efficiency and business growth, as seen in other industries. In other words, over a long period it does not enable the provider to provide more service at the same (or lower) cost, but it does enable the provider to generate more revenue, even when there is no compelling evidence of better health outcomes.

The use of knowledge based systems in medicine has great potential, but is critically limited by state regulatory systems designed to preserve and reinforce the traditional role of physician and pharmacist. If this venture can find a way to get around that, the potential is compelling.

You know several large insurance carriers already do this. People insured with them have access to databases of hospital listings that include quality of care measurements, relative cost pricing for procedures among local providers, and indicators regarding which providers (hospital, labs, physicians) are pricier based on the plan that has been purchased (meaning higher out of pocket to use the provider). So lack of transparency is already there for those who want to take advantage of it.

There are startup technology companies that do this as their role: they take the data and provide an analysis on cost and quality and put it in terms that an insurance carrier can post on their members' website.

So, from the perspective of what this group announces they will be doing: it is a repeat of what is already available. I suspect there is some other nuance in their planning that hasn't been demonstrated yet - and that is where they are heading.

I encourage you to log in to your own health insurance carriers web site and see what info and transparency they offer you.

- Rita

 

[flintnational]

I'm still trying to figure out how they get to the 'transparent' part. Within a limited network with agreed-upon pricing accessible to consumers, maybe.

Lack of transparency remains one of the big obstacles to cost reform, but I applaud any effort from big players like these to shake up the market. It is indeed a huge drag on business especially when compared to other countries.

+1
I read a proposal, not sure where, that included requiring all health care providers to publish their charges. It also included a requirement that the cash price had to equal the lowest negotiated insurance rate. I have always thought you could tell we are making progress when doctors and hospitals advertise prices in the newspaper, similar to dentists and eye doctors.

 

[Huston55]

Just published Economist article refers to the A/B/J effort, and says that “data” and our personal access to our own, is the key.

https://www.economist.com/news/lead.../n/bl/n/2018021n/owned/n/n/nwl/n/n/NA/96088/n

Hopefully, you can access this link. I have a subscription but, not sure that’s required.

 

[unclemick]

Like many of the shipyard workers in CA and OR were African Americans from the south and local physicians & health care facilities shunned them.

Or refugees from 'NEW YORK CITY!!'.

Guess who's hospital outside the shipyard I was born 1943.

heh heh heh - 'Coming in on a wing and a prayer' was on the radio that month.

 

[GTFan]

You know several large insurance carriers already do this. People insured with them have access to databases of hospital listings that include quality of care measurements, relative cost pricing for procedures among local providers, and indicators regarding which providers (hospital, labs, physicians) are pricier based on the plan that has been purchased (meaning higher out of pocket to use the provider). So lack of transparency is already there for those who want to take advantage of it.

I think you meant transparency and not the lack of it but no matter what they say, for any given hospital visit you're likely going to get a laundry-list bill that bears no relevance to any procedure cost data you can see on any website. Followed by the insurer paid portion that once again bears no relevance to what the hospital asked for. This is what frustrates comsuners the most.

Doctors are relatively straightforward compared to hospital bills, so transparency for them should be an easy fix IMO. Notwithstanding the usual drive-by doc bill (i.e. the doctor you never see that bills you) while you're laid up in the hospital of course.

 

[JoeWras]

I'm late to this recent discussion, but find the talk about "non-profit" hospital buildings interesting. My recent visit was at a for-profit hospital, and it was just comfortable, but not crazy nice. Meanwhile, some of the local non-profits seem to be in some sort of design war, complete with carpet bombing advertising on TV, which can't be cheap.

Another example I'd give of being "comfortable", but not crazy is one of the newer VA hospitals (Lovell, N. Chicago). I thought it reached the right balance of comfort and cost control, at least in the design.

 

[Gotadimple]

I think you meant transparency and not the lack of it but no matter what they say, for any given hospital visit you're likely going to get a laundry-list bill that bears no relevance to any procedure cost data you can see on any website. Followed by the insurer paid portion that once again bears no relevance to what the hospital asked for. This is what frustrates comsuners the most.

Doctors are relatively straightforward compared to hospital bills, so transparency for them should be an easy fix IMO. Notwithstanding the usual drive-by doc bill (i.e. the doctor you never see that bills you) while you're laid up in the hospital of course.

My lack of transparency statement was in response to an earlier post where the writer said there was no transparency. I was just trying to show that some insurers do make info available.

Will they share what they pay a provider? Absolutely not. Why not? Because they negotiate a reimbursement rate with each provider separately and they don't want to share that they agreed to pay Hospital A $150, and Hospital B $125 (or you can substitute Provider A and Provider B in this sentence). They consider what they pay a provide as proprietary because they are in competition with other carriers to contract with the same provider.

Healthcare apparently is not a commodity, but is a custom service tailored to the needs of a client and funded by negotiation with an insurance payor.

Regarding your comment on hospital bills. The bill is all for show. What you see is what they would charge someone without insurance (called usual and customary rate). What you see on the insurance EOB is what has been negotiated.

 

[Mr._Graybeard]

Doctors are relatively straightforward compared to hospital bills, so transparency for them should be an easy fix IMO. Notwithstanding the usual drive-by doc bill (i.e. the doctor you never see that bills you) while you're laid up in the hospital of course.

In my area, an independent physician is a thing of the past. Nearly all doctors are affiliated with multi-hospital medical groups, and all billing goes through the groups. IME, doctors have at best only a vague idea what a patient will be charged.

 

[ncbill]

True nationwide in-network coverage would be nice.

We will be paying for health insurance 2x for our youngest who plans to attend an out-of-state school starting this fall - here under our family plan and through their school so they are covered in-network there.

 

[eytonxav]

I suspect they will find lots of opportunity to do, and only wonder if what they find or achieve is scalable or transferable.

I suspect you are right and imagine it will be scalable. At least I hope that is the case.

 

[Huston55]

Regarding your comment on hospital bills. The bill is all for show. What you see is what they would charge someone without insurance (called usual and customary rate). What you see on the insurance EOB is what has been negotiated.

Dimple-

I’ve always wondered if there is a tax benefit for the hospitals to show the high ‘ususal & customary’ rates on the bill, perhaps to justify losses? Can you comment on this?

 

[Gotadimple]

Dimple-

I’ve always wondered if there is a tax benefit for the hospitals to show the high ‘usual & customary’ rates on the bill, perhaps to justify losses? Can you comment on this?

Nope no tax benefit, no losses to take, as most are non-profits.

UCR (usual and customary rate) is a holdover from the 1930's when most did not have health insurance. The local county medical societies set an agreed upon range of rates that physicians could use when providing services, so the community could afford to get health care services. So UCR is the standard against which insurers and clinics/hospitals negotiate with each other. If you have no insurance, a doctor or hospital will want to charge the UCR, but the rate is negotiable.

 

[landover]

I guess that this has more to do with Machine Learning and AI. They will get more data with this and they have a population to test the machines. It seems in some cases machines are already better than Radiologist in diagnosis. It looks that doctors just follow a flow chart.

 

[MichaelB]

It seems this may have spurred others to react. The WSJ reports WalMart is considering acquiring Humana, a major national health insurance company. CNBC report here https://www.cnbc.com/2018/03/29/wal...lks-with-humana-dow-jones-citing-sources.html

Walmart has begun discussing a possible acquisition of health insurer Humana, The Wall Street Journal first reported Thursday citing people familiar with the matter. Reuters also reported the companies are discussing a partnership, but that a full acquisition is also possible.

 

[Chuckanut]

This could get interesting and it might be what we need.

I doubt if the current Old Line institutions will reform medicine in the USA very much. There is to much money to make in the current system's inefficiency.

 

[MichaelB]

All good things must come to an end, and that has now been announced for this initiative. From the website https://havenhealthcare.com/

In the past three years, Haven explored a wide range of healthcare solutions, as well as piloted new ways to make primary care easier to access, insurance benefits simpler to understand and easier to use, and prescription drugs more affordable.
Moving forward, Amazon, Berkshire Hathaway, and JPMorgan Chase & Co. will leverage these insights and continue to collaborate informally to design programs tailored to address the specific needs of their own employee populations.
Haven will end its independent operations at the end of February 2021.

 

[PaunchyPirate]

All good things must come to an end, and that has now been announced for this initiative. From the website https://havenhealthcare.com/

Unfortunately, healthcare in the USA is not a simple fix.

 

[Bamaman]

I'm afraid of anything more to do with Amazon. Instead of getting phone calls from India, we'll be getting phone calls from China.

 

[Markola]

I’m sad to read this, because if those wealthy behemoths failed to create a more sensible system-within-a-system, it does not bode well for the rest of us Americans.

 

[grayv]

would like to know what they accomplished or learned.

not a lot on https://en.wikipedia.org/wiki/Haven_Healthcare

 

[bobandsherry]

I’m sad to read this, because if those wealthy behemoths failed to create a more sensible system-within-a-system, it does not bode well for the rest of us Americans.

It seems they just didn't play nice with each other. Each company executed their own projects separately, at least according to this article. Someone I know working at JPM said Dimon's letter to the employees was much the same as what's in the article. So is it a case of one size doesn't fit all and that's why it doesn't work? When the Dr who was leading stepped down and Buffett sold off his JPM interest, I knew the writing was already on the wall.

https://www.cnbc.com/2021/01/04/hav...t-healthcare-is-disbanding-after-3-years.html