A Safe Haven:

The Future of Employer Contracted Health Coverage

With the wide array of territories the tech and corporate industries seem to span over, healthcare appears to be their latest frontier of interest. This year, annual family premiums for employer health coverage have risen by over 5%, sitting at a whopping average of $20,576. Workers have collectively averaged $6,015 towards their premium costs—with the remainder at the hands of employers, according to a survey done earlier this year [1]. In the summer of last year, a joint venture startup was created in hopes of addressing rising costs. The venture itself, Haven Healthcare, was formed as a conglomeration between a few unexpected, new players in the field of healthcare—Amazon, Berkshire Hathaway, and JPMorgan Chase [2]. At the head of the initiative, as appointed CEO, is a name that might ring familiar to those already in the field: Atul Gawande, a world-renowned surgeon at Brigham and Women’s Hospital, author, and public health leader and professor at Harvard Medical School.

The Boston-based joint entity was designed as a non-profit, healthcare model with a vision of improving overall healthcare services. Based on the company’s description, it aims to do so through reducing annual coverage costs for employees, granting easier access to primary care, making insurance plans more transparent and easier to navigate, and cutting costs of prescription medications [3]. If this plan sounds a little idealistic and vague, that’s because the company has primarily worked in secrecy since its formation, with released details being few and far between.

In July 2018, JPMorgan CEO, Jamie Dimon, reported that Haven would begin with small steps, focusing on reducing costs of medical services at the employee level before advancing towards bigger solutions and approaches on the healthcare system as a whole. Some of Haven’s first steps and pilot stages have begun to unravel this year. Under the program, JPMorgan has offered 30,000 employees in Ohio and Arizona two different plans for the upcoming 2020 year run by existing insurance firms—Cigna Corp. and Aetna Inc. This plan reportedly covers approximately 20% of the bank’s overall U.S. workforce [4]. One unique component of the new plan being offered by Haven, unlike the existing coverage for JPMorgan’s U.S. employees, is that it does not require workers to pay deductibles. They additionally offer various incentives including monthly earned money through wellness activities, such as keeping blood pressure under a certain individualized target value. This earned money can then be used to offset costs of regular doctor visits or prescription medications [3]. Dimon has emphasized the importance of designing plans that incentivize and empower employees stating, “Our people want transparency, knowledge, and control when it comes to managing their healthcare”. Personalized coverage with reduced costs has been the vision in mind for JPMorgan since partnering with Haven.

Joe Evangelisti, spokesperson for JPMorgan has stated that the bank’s offered plan is much more cost transparent and simplified. He reports that employees should, and will, know exactly what the costs for their medical services are—no closed doors. He additionally made mentions that “new plans will include free preventative care, no coinsurance or deductible, $15 copays for in-network visits, flat fee for medical services, procedures, and prescription drugs, and annual out-of-pocket maximums” [2].

Amazon has initiated its role with Haven by offering coverage to its employees in Connecticut, North Carolina, Utah, and Wisconsin. Amazon’s plans are structurally similar to those being offered with Haven at JPMorgan. Together, Amazon and Haven have been working closely with clinicians and insurance providers to address all the moving parts necessary to create a reduced cost comprehensive plan. Specifically, a large focus has been on how to use data and technology to make overall healthcare better [5]. These implemented plans will be combined in supplement with Amazon’s very own corporate-based virtual care program, Amazon Care. Amazon Care utilizes a full telemedicine service to provide employee patients with a more convenient experience. The program provides a mobile application that encourages employees to access virtual and in-person services. Amazon has contracted with Oasis Medical in their Seattle location, a private practice that provides in-home care for Amazon employees [5]. The idea here is that by offering a variety of avenues to personal healthcare coverage, people will become more focused on preventive care and personal health management in the long run, according to a spokesperson at Amazon. The telemedicine-based program isn’t new or revolutionary but appears to be drawing higher satisfaction on both ends according to various surveys—from both patient and provider standpoint [3]. Other tech moguls including Apple and Google are beginning to follow this trend and are developing their own versions of healthcare ecosystems for their employees.

The question then remains, what does this mean moving forward? Is the health insurance system going to experience an undertow from private industries? For now, we can only watch and wait to find out. Atul Gawande, CEO of Haven, has made it clear that substantial changes to the current system will take years to come. But he insists on “relentlessly striving to deliver simplified, high-quality, and transparent healthcare at a reasonable cost,” a goal and vision that, if executed, can hopefully turn transform healthcare plans for employees and families around the United States [3].

Aaron Tran

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Aaron Tran is a member of The University of Arizona College of Medicine – Phoenix Class of 2023. He graduated from Arizona State University in 2018 with a degree in Kinesiology. In his spare time, he enjoys training Brazilian Jiu-jitsu, bodybuilding, playing guitar and piano, and hanging out with his labrador retriever, Rex, outdoors.

For questions, concerns, or discussion: atran13@email.arizona.edu

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