Haven Healthcare

Haven Healthcare was a healthcare-focused, not-for-profit entity created in 2018 by Amazon, Berkshire Hathaway, and JPMorgan Chase. The three companies announced the venture as an attempt to address the high cost and complexity of healthcare for their combined U.S. employee populations and their families. The initiative attracted substantial public attention because its founders controlled major businesses in technology, finance, insurance-related services, and employer benefits, and because senior executives described the venture as an effort to develop practical solutions that could eventually benefit people beyond the founding companies. The organization was conceived around several broad objectives rather than a single conventional healthcare product. These objectives included making primary care easier to obtain, lowering the price of prescription medicines, improving the clarity of insurance benefits, and using data, technology, and purchasing influence to improve the quality and efficiency of care. The founding companies did not present Haven primarily as a hospital operator or a traditional insurer. Instead, it was intended to function as an employer-healthcare innovation platform that could test new approaches for the companies' workforces and potentially influence the wider American healthcare market. Haven was headquartered in Boston and later established a second office in Manhattan's Union Square area focused on technology and engineering. Atul Gawande, a physician, author, and public-health figure, became chief executive in June 2018. The organization also recruited leaders from established healthcare and technology companies, including Dana Gelb Safran, who joined as head of measurement, David Smith from UnitedHealth Group's Optum subsidiary, and Serkan Kutan, formerly chief technology officer of Zocdoc. Its leadership structure changed repeatedly during its short existence. Chief operating officer Jack Stoddard departed in 2019, and Gawande left as chief executive in May 2020. Mitch Betses assumed day-to-day operational responsibility while the organization searched for a successor. Haven eventually announced a limited health-plan initiative involving Cigna and CVS Health's Aetna for approximately 30,000 JPMorgan Chase employees in Arizona and Ohio. Amazon also explored employee healthcare coverage in several states with an outside payer. The wellness offering associated with these plans included monthly financial incentives tied to health and fitness goals. These activities demonstrated a shift from broad system-reform ambitions toward employer benefits, plan design, and workforce wellness, but they did not produce a large independent healthcare platform. The venture announced in January 2021 that it would end its independent operations at the end of February. At the time of its closure, it reportedly had 57 employees at its Boston headquarters. Analysts and commentators attributed the outcome to several overlapping factors: an expansive and difficult mission, unclear positioning, leadership turnover, limited market leverage, the challenge of persuading profitable providers and insurers to change their economics, and the fact that each founding company continued pursuing healthcare initiatives independently. Amazon's own healthcare activities also created potential strategic tension with an entity that was supposed to coordinate the founders' interests. Haven therefore remains best understood as a short-lived corporate healthcare experiment rather than a continuing hospital system, insurer, or consumer healthcare brand.

Haven Healthcare originated in January 2018, when Amazon, Berkshire Hathaway, and JPMorgan Chase announced that they were forming a joint healthcare venture. The announcement responded to the growing cost of healthcare for American employers and their workers. The founders said they wanted to pursue better-quality care at lower cost, with particular attention to primary-care access, prescription-drug affordability, and making insurance benefits easier for employees to understand. The initiative was notable because it brought together companies with very different capabilities: Amazon's technology and logistics expertise, Berkshire Hathaway's investment and employer perspective, and JPMorgan Chase's large workforce and benefits infrastructure. The entity was organized as a not-for-profit and headquartered in Boston, with additional offices in New York City. Atul Gawande became chief executive in June 2018. During its first year, Haven assembled a management and measurement team that included Dana Gelb Safran, formerly associated with Blue Cross Blue Shield of Massachusetts, and David Smith, formerly of UnitedHealth Group's Optum business. Optum sued Smith over an alleged breach of a non-compete obligation after his appointment. In February 2019, a federal district judge denied Optum's request to prevent Smith from working for Haven. Haven added Serkan Kutan, previously chief technology officer of Zocdoc, as chief technology officer in February 2019. In April, it announced a second office in Manhattan's Union Square neighborhood, intended to concentrate on technology and engineering. The organization experienced leadership turnover soon afterward. Chief operating officer Jack Stoddard left in May 2019, explaining that frequent travel between Philadelphia and Boston was interfering with family life. By late 2019, Haven had moved toward concrete employer-benefit experiments. It announced an arrangement involving Cigna and CVS Health's Aetna to provide health plans to approximately 30,000 JPMorgan Chase employees in Arizona and Ohio. Amazon separately planned to offer healthcare coverage to employees in Wisconsin, North Carolina, Utah, and Connecticut in cooperation with an outside payer. The related wellness design offered monthly financial rewards for employees who met specified health and fitness objectives. These initiatives were more limited than the original rhetoric surrounding a wholesale transformation of the U.S. healthcare system, but they reflected Haven's focus on testing benefit models among the founders' employees. Gawande announced his departure in May 2020. Mitch Betses handled daily operations while Haven searched for another chief executive. The organization subsequently failed to develop the scale or market influence necessary to reshape provider and insurer economics. Observers pointed to the breadth of its mission, an unclear operating model, executive and consultant departures, and the continuing healthcare initiatives of Amazon, Berkshire Hathaway, and JPMorgan Chase themselves. The COVID-19 pandemic also made it more difficult for a small organization without substantial market presence to establish a new model. On January 4, 2021, Haven's website was reduced to a notice stating that the company would end its independent operations at the end of February. It reportedly had 57 employees at its Boston headquarters when it disbanded. The venture's closure ended one of the most highly publicized employer-healthcare experiments of the late 2010s, although its founders continued to pursue healthcare-related activities separately.

1. 2021Independent operations end

   Haven announces that it will cease independent operations at the end of February.

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2. 2020Chief executive departs

   Atul Gawande leaves the chief executive role, with Mitch Betses overseeing daily operations during the search for a replacement.

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3. 2019Technology leadership and New York expansion

   Serkan Kutan becomes chief technology officer, and Haven announces a technology and engineering office in Manhattan.

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4. 2019Employer health-plan initiatives announced

   Haven announces health-plan and wellness initiatives involving Cigna, Aetna, and an outside payer for employees of the founding companies.

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5. 2018Founding announced

   Amazon, Berkshire Hathaway, and JPMorgan Chase announce a joint not-for-profit healthcare venture aimed at improving care and reducing costs for their employees and families.

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6. 2018Atul Gawande becomes chief executive

   Atul Gawande is appointed to lead the new organization.

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7. 2018Healthcare measurement leadership added

   Dana Gelb Safran joins as head of measurement, supporting evaluation of healthcare outcomes and performance.

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8. 2018Optum litigation involving David Smith

   After David Smith joined Haven from Optum, Optum brought a claim concerning an alleged non-compete violation; a court later denied an effort to restrict his work at Haven.

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A not-for-profit employer-healthcare innovation venture seeking to make American healthcare more accessible, understandable, and affordable through benefit redesign, primary-care access, prescription-drug savings, wellness programs, and technology.

• Employer health-plan arrangementsEmployer healthcare2019

  Haven worked on health-plan designs for employees of its founding companies rather than selling a conventional consumer insurance product. In 2019, it announced an arrangement involving Cigna and CVS Health's Aetna for approximately 30,000 JPMorgan Chase employees in Arizona and Ohio. Amazon also pursued related employee coverage in several states with an outside payer. These arrangements represented Haven's principal move from broad healthcare-reform objectives toward operational employer benefits.

• Wellness incentive programEmployee wellness2019

  The wellness plan associated with Haven's employer-healthcare work offered monthly financial rewards to employees who met defined health and fitness goals. It was intended to encourage preventive behavior and engagement with employer-sponsored healthcare benefits. Public reference material describes the incentive structure but does not establish a continuing standalone product after Haven ended its independent operations.

• Healthcare benefits and primary-care initiativesHealthcare navigation and access2018

  Haven's broader program focused on making primary care easier to access, prescription medicines more affordable, and insurance benefits less confusing. These were strategic areas of work and service-design objectives rather than clearly branded products sold independently in the market. The organization sought to test solutions within the workforces of Amazon, Berkshire Hathaway, and JPMorgan Chase, with the possibility that successful approaches could later have wider application.

• 2021End independent operationsStrategy

  Haven had not achieved sufficient scale or market influence to drive the broad healthcare changes envisioned at its formation, while the founding companies continued developing healthcare initiatives independently.

  What changed. Haven announced that it would cease independent operations at the end of February 2021.

  Aftermath. The organization was disbanded, ending the joint venture as an independent healthcare brand.

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• 2020Manage operations after the chief executive's departureOther

  Atul Gawande announced that he was leaving the chief executive position after Haven had experienced other senior-level departures.

  What changed. Mitch Betses assumed day-to-day operational responsibility while the founding companies searched for a new chief executive.

  Aftermath. The leadership transition preceded the announcement that Haven would end its independent operations.

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• 2019Introduce employer health-plan and wellness experimentsProduct launch

  Haven needed to translate its general healthcare-reform ambitions into programs that could be tested among employees of the founding companies.

  What changed. It announced health-plan arrangements involving Cigna and Aetna for JPMorgan Chase employees in Arizona and Ohio, along with related wellness incentives and separate Amazon coverage efforts in several states.

  Aftermath. The initiatives provided a more concrete operating focus, but they did not establish Haven as a national insurer or healthcare provider.

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• 2018Create a joint employer-healthcare ventureStrategy

  The three founding companies sought to address rising healthcare costs and improve the quality and usability of benefits for their combined employee populations.

  What changed. They formed Haven as a not-for-profit organization focused on primary care, prescription-drug affordability, benefits clarity, and potential system-wide innovation.

  Aftermath. The venture attracted considerable attention but struggled to convert its broad mission into a large-scale independent operating model.

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• 2021Haven announces end of independent operations

  Haven changed its website to announce that it would cease independent operations at the end of February 2021.

  Bankruptcy
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• 2020Atul Gawande leaves Haven Healthcare

  Gawande announced his departure as chief executive. Mitch Betses took responsibility for day-to-day operations while a successor search began.

  Leadership change
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• 2019Haven opens Manhattan technology and engineering office

  The organization announced a second location in Manhattan's Union Square area to support technology and engineering work.

  Other
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• 2019Haven announces employer health-plan arrangements

  Haven announced plans involving Cigna and CVS Health's Aetna for approximately 30,000 JPMorgan Chase employees in Arizona and Ohio, while Amazon pursued related coverage arrangements in several states.

  Product launch
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• 2018Amazon, Berkshire Hathaway, and JPMorgan Chase announce healthcare venture

  The three companies announced a jointly created healthcare organization intended to improve care quality and reduce costs for their employees and families.

  Other
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• 2018Atul Gawande appointed chief executive

  Physician and author Atul Gawande was selected to lead the newly formed healthcare venture.

  Leadership change
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1. Haven Healthcare