A hot startup could be the perfect model for the JPMorgan-Amazon-Berkshire Hathaway healthcare initiative
- The news that JPMorgan, Amazon and Berkshire Hathaway are forming a new independent nonprofit venture aimed at lowering healthcare costs for their employees has people looking at employer-sponsored health plans in a new light.
- The details of the new venture have been limited, which has left a lot of room for speculation about how it could play out.
- One way would be for the companies, which already act as their own insurance companies, to form their own sorts of plans that fit their employees — from warehouse workers to Wall Street bankers.
- An example of a new technology platform company working with employers in this way is called Collective Health.
A new nonprofit healthcare venture from business giants Amazon, JPMorgan, and Berkshire Hathaway has generated a lot of interest in a certain type of health plan: the self-insured employer health plan.
If you're an employee with a self-insured employer, it means that when you're an employee going to a doctor's appointment, your employer is ultimately footing the bill for the MRI you receive, rather than a health insurer.
The insurance companies are there in the middle to handle the logistics of getting the claim from one place to another, which means you might not realize your employer's footing the entire bill on the other end. Employers pay insurance companies for their services on a per member, per month basis. More than half of the non-elderly population is covered by an employer-sponsored plan, and almost 80% of large companies are self-insured.
"I tell people, JPMorgan Chase already buys a $1.5 billion of medical, and we self-insure," JPMorgan CEO Jamie Dimon told Business Insider. It's why his company, along with Amazon and Berkshire Hathaway, two other massive self-insured employers, are looking for new options. "Think of this, we're already the insurance company, we're already making these decisions, and we simply want do a better job," Dimon said.
There are a few ways that could play out.
The three companies could simply use the lives they cover to negotiate for better prices. Or, they could go in and create their own alternative health plan built around their priorities, like giving them more information via their phones or introducing more integrated wellness programs.
The wheels on this are already turning. For example, Collective Health, a startup that's raised $119 million from investors including Peter Thiel's Founders Fund and GV since getting its start in 2013, works with employers to build out plans that fit their needs, adding technology with the hope of making things like submitting claims and reading bills easier than it tends to be.
A case study: Collective Health
Chief Health Officer Dr. Rajaie Batniji cofounded Collective Health with CEO Ali Diab, who was working in technology, including working on the search team at Yahoo. At the same time, Batniji was going the academic route, getting a PhD in healthcare financing.
"I was taking the academic route thinking I'd make the system better by writing papers about it," Batniji said.
Like many startups with tech founders, the idea started out with a bad experience with the existing healthcare system. Diab was hospitalized in 2013 with an intestinal condition. While recovering, he kept getting bills that weren't exactly bills, and confusing statements about what was covered and wasn't.
They wanted to answer the question: "Can we provide a better user experience layer?" As they started to look into it, they realized they couldn't just add something on top: They'd have to go in and act as the plan. "You have to recreate the whole stack," Batniji said.
To start, they decided to tackle the employer-sponsored health plans. The employers already act like "mini health insurance companies," which means they can often move faster to adopt new technology than other plans can, Batniji said.
Collective Health's clients include tech companies Zendesk, Palantir, eBay, and Pinterest. In total, it covers about 125,000 members, consisting of employees and their dependents.
Batniji said there'd be some worries that because employees would regularly be able to access their health information, they might start to over-use it. So far, that hasn't been the case. Batniji said Collective Health has seen fewer ER visits, unnecessary imaging has gone done, and there's been an increase in behavioral health visits.
Collective Health also helps connect services companies might want to provide for their employees, integrating them into the plan. For example, an employer would like to cover therapy appointments for all employees, even if the therapist is out of network. If one company handles fertility benefits really well, that can be plugged in as well. Collective Health acts like a landing page, so that you have everything in one place from being able to search for doctors and facilities that are in network to what kind of breast pump is covered by your plan.
Batniji has one piece of advice to share with the teams at Amazon, Berkshire Hathaway, and JPMorgan as they try to lower costs and improve healthcare for their employees: "I think it's important for them to prioritize just like we did where you build and where you partner," he said.
For Collective Health, that meant building out a system that lets them to connect to any medical network,and partnering with other technology companies for things like telemedicine or behavioral health services.
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Contributer : Tech Insider http://ift.tt/2C87CvZ
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Tuesday, February 20, 2018
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