What’s going on with Amazon-Berkshire-JPMorgan?

Cam asked a good question yesterday in comments:

I wonder if you have any thoughts on this press release from Amazon/JPMChase/Berkshire Hathaway?

Right now it is mostly a press release. I don’t have enough information to really have a strong opinion. My first professional thoughts though are the following:

  1. Healthcare is hard
  2. Big data is already being run hard in healthcare by incumbents (Optum), start-ups (Oscar, Clover) and tech companies (Google/Verily)
  3. What are they planning to do differently than previous private sector consortiums?
  4. What are they planning to do differently than CalPers and other large pension pools?
  5. What are they planning to do differently than large insurers with significant fully insured pools?
  6. What are the planning to do differently than large integrated delivery networks that also self-insure?
  7. 1+ million covered lives is a good pool for experimentation and beta testing but not a representative sample for the nation
  8. Healthcare is hard

We have good ideas on how to reduce costs.  They mainly involve a variety of ways of saying “No” or at least saying “No, not at this price” as well as care design.  I could see a strong play for reference pricing, centers of excellence and value based insurance design.  Bringing that all in-house could make some sense on some level.  But I am really scratching my head on the so-what unless they really think that they have a special sauce that can accurately and effectively intervene so far upstream of preventable costs at pennies on the dollars.  If that is the case, great but so far no one has found that special sauce.

My unprofessional thoughts:


Have fun storming the castle!

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