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Our Take: Haven pilots insurance plans for employees in six states

Nov 11, 2019
Haven, the joint venture between Amazon, JPMorgan Chase, and Berkshire Hathaway, is making its first move as a disrupter in the health care space by offering two health plans to 30,000 JPMorgan employees in Ohio and Arizona — almost 20% of JPMorgan’s U.S. workforce. Reported first by Bloomberg, the plans will be run by CVS Health’s Aetna unit and Cigna under a program called Haven Healthcare.

Bloomberg also noted that Amazon will offer health plans for workers in Connecticut, North Carolina, Utah, and Wisconsin with undisclosed payer partners.

The plans reportedly will be zero-deductible and will offer financial incentives to employees who achieve certain wellness targets, such as meeting blood pressure and cholesterol targets. The money can be used to offset other health care expenses.

Our Take:
Baby steps. The latest news from Haven is hardly disruptive, but we suppose you have to start somewhere.

Let’s take stock of where we are with two potential game changers in health care today.

First, there’s Google and its parent company, Alphabet. So much is going on there that we would far exceed our self-imposed 1,200-word limit for Our Take if we covered it all. GV, Alphabet’s venture capital arm, has invested in more than 60 health-related companies, including Oscar Health, Doctor on Demand, and 23andMe. The Advisory Board reports that Google has hundreds of health care-related patents, including 186 obtained between 2013 and 2017.

Google has partnerships with powerhouse IDNs like Cleveland Clinic, Mayo Clinic, and Stanford Medicine. More than a few heads turned when Google snapped up former Geisinger CEO Dr. David Feinberg to lead Google Health, which, according to the tech giant, “brings together groups from across Google and Alphabet that are using AI, product expertise, and hardware to take on big health care challenges.”

Then, there was last week’s announcement that Alphabet was acquiring Fitbit in a deal valued at $2.1 billion.

Haven’s mission, according to the company’s website, is to improve access to primary care, simplify insurance, and make prescription drugs more affordable for its collective 1.2 million employees. Haven says it later intends “to share our innovations and solutions to help others.”

Since Haven was founded in January 2018, its most notable achievement is the appointment of writer and Harvard professor Dr. Atul Gawande as CEO. “We will be an advocate for the patient and an ally to anyone — clinicians, industry leaders, innovators, policymakers, and others — who makes patient care and costs better,” Gawande wrote in a letter appearing on Haven’s website. “We will create new solutions and work to change systems, technologies, contracts, policy, and whatever else is in the way of better health care.”

Within Haven, Amazon’s PillPack has CVS and Walgreens shaking; within the last year, both major pharmacy retailers have announced same- or next-day delivery for prescriptions. Amazon’s formidable brand presence and estimable focus on the shopping experience make Haven a threat to nearly every health care channel conceivable.

If you doubt this, watch for Amazon (or Haven) clinics to start appearing by 2021. That’s their next bold move.
What else you need to know
Amgen will pay $2.7 billion for a 20.5% ownership stake in BeiGene, a research-based, oncology-focused biotech company headquartered in Beijing. That sum is based on a purchase price of $174.85 per ADS, a 36% premium to BeiGene’s 30-day average share price as of Oct. 30, according to an Amgen press release. The transaction is expected to close in early 2020, subject to BeiGene shareholder approval and customary closing conditions. BeiGene will commercialize three of Amgen’s oncologic drugs in China. Initially, Amgen and BeiGene will share profits and losses on the products equally, but eventually two of the products will revert to Amgen and BeiGene will have the right to retain one. The companies will also collaborate to advance 20 drugs from Amgen’s oncology pipeline, in China and globally.

Stryker signed a definitive agreement to acquire Wright Medical Group, a global medical device company focused on extremities and biologics. Wright Medical was founded in 1950 in Memphis, Tenn. The total equity value of the transaction, based on a share price of $30.75, would be approximately $4.0 billion; the total enterprise value, including convertible notes, would be about $5.4 billion. The boards of both companies have approved the acquisition, which is expected to be completed in the second half of next year, pending regulatory approvals and other closing conditions.

KentuckyOne Health is now UofL Health. The University of Louisville announced that it has completed the acquisition of KentuckyOne Health’s Louisville-area assets from CommonSpirit Health, a health system formed in February with the merger between Catholic Health Initiatives and Dignity Health. To facilitate the acquisition, the state of Kentucky has promised a 20-year, $50 million loan, half of which is to be forgiven if the university “meets certain criteria in terms of employment or service to underserved areas.” Additionally, the Jewish Heritage Fund for Excellence and the Jewish Hospital and St. Mary’s Foundation are investing a total of $50 million in the deal.

Bloomington, Minn.-based HealthPartners is closing its mail order and all 30 retail pharmacy locations, and will lay off 300 workers, including about 100 pharmacists. Scott Schnuckle, senior vice president for pharmacy business at HealthPartners, told the Pioneer Press that it was struggling to complete with larger chain pharmacies that are “able to support extended hours, drive-thru pickup and other conveniences that we’re not able to offer.” HealthPartners will continue to offer specialty, infusion, and hospital pharmacy services.

Dr. Philip Ozuah will become Montefiore Medicine’s new CEO on Nov. 15. Montefiore Medicine is the umbrella organization for Montefiore Health System, where Dr. Ozuah, a pediatrician, currently serves as president, and the Albert Einstein College of Medicine. Dr. Steven Safyer, who announced his retirement in July, has been president and CEO of Montefiore Medicine since 2008.

Dr. Stephen Hahn has been nominated as the FDA’s new commissioner. An oncologist, Dr. Hahn currently is the chief medical executive at The University of Texas’ MD Anderson Cancer Center. Until the Senate confirms Dr. Hahn, Dr. Brett Giroir, an assistant secretary of health, will lead the FDA. Dr. Ned Sharpless became the agency’s acting commissioner after Dr. Scott Gottlieb stepped down earlier this year, but Dr. Sharpless’ term expired on Nov. 1.

CMS updates
CMS is proceeding with site-neutral payments and cuts to the 340B drug discount program, according to a finalized rule for the Medicare Outpatient Prospective Payment System — despite court rulings against both policy changes. Consequently, after a two-year phase-in period, physicians will receive the same amount for basic visits whether the visits are conducted at an off-campus hospital outpatient clinic or in the physician’s office, and payments under the 340B program will be reduced by 22.5% in 2020 — unless ongoing litigation prevents the agency from following through with its intentions.

CMS also issued a final home payment rule that increases payments for home health agencies by 1.3% in calendar year 2020 and adds a home infusion therapy benefit, to be implemented in 2021. The new benefit will cover in-home administration of certain drugs with the use of a durable medical equipment pump, as well as nursing and other home-based care. That final rule will also phase out prepayments for home health services, eliminating them entirely by 2021

In addition, CMS finalized policies for its end-stage renal disease prospective payment system, including an increase of 1.7% in provider payments in 2020 and incentives for facilities to provide innovative dialysis treatments.

Finally, CMS approved a first-of-its-kind Medicaid waiver request from the District of Columbia that will increase mental health services and substance use disorder treatment for beneficiaries who live in D.C.

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