New Amazon Conglomeration Means Healthcare Players Must Adapt to Price Transparency or Face Extinction

PORTSMOUTH, N.H., April 10, 2018 — In America, the largest part of the health insurance market is employer-sponsored coverage.(1) But because the current system is more focused on providing results rather than saving money, rising healthcare costs have shifted a greater financial burden onto employers. In response, Amazon, Berkshire Hathaway and JPMorgan Chase have teamed up to create a new kind of healthcare company for their employees. And according to industry leader MyMedicalShopper, companies currently operating in the industry will have to make some drastic changes in order to stay competitive.

This new collaboration between the three corporate giants is the newest expression of frustration on the part of American employers and businesses over the current healthcare system. Healthcare costs for companies generally rise faster than inflation, eating up larger chunks of business budgets every year.(1) But if this new company is successful, American businesses will have the opportunity to offer their employees unprecedented choice in how much they pay for healthcare. If this happens, current industry players (including insurance carriers, brokerage firms and bill collectors) which have benefited tremendously from skyrocketing prices in the current system(2) will have to start behaving more reasonably, acting for consumer interests rather than their own bottom lines. If they don’t, certain segments of the industry—such as brokers and bill collection agencies—will become obsolete, says Mark Galvin, founder and CEO of MyMedicalShopper.

To stay relevant, current industry players must adapt to the changing healthcare marketplace:

For insurance carriers, this means advocating for legislative changes to current medical loss ratio rules that limit profits and lessen incentives for finding and paying for lower-cost healthcare services.
For brokers, changes may mean accepting payment based on how much they can save American companies, rather than being paid a percentage of each premium.
And if the new company runs like Amazon already does, there won’t be any outstanding bills to collect, putting bill collection agencies out of business.

For some industry players, the writing is on the wall. Some insurance brokers have already adopted a payment model that pays them based on how much money they save companies rather than collecting a percentage of every premium. And bill collection agencies already in-house at hospitals are making the switch to other customer service occupations. But insurance carriers that don’t adapt to offer price comparison shopping options—instead of traditional “in-network” and “out-of-network” prices—will see customers flock to other companies where set costs for procedures and medications are readily available.

While it isn’t clear exactly how the new company would operate, there’s speculation that it might offer a solution similar to Amazon’s consumer-goods-competitive-pricing model. Amazon already boasts the largest direct-to-consumer marketplace online today, utilizing sophisticated search technologies to match consumers with results based on price, delivery, and verified consumer ratings for products and vendors. In partnership with Berkshire Hathaway (whose portfolio company, Geico, provides billions in direct-to-consumer insurance) and JPMorgan Chase (already a depository for Medicare and Medicaid funds and a brokerage firm for reimbursement payments to healthcare facilities and providers), Amazon is poised to create an online healthcare shopping platform. Healthcare providers and facilities will act as vendors, submitting their prices for procedures, medications, tests and bundles, along with location information.

Galvin says that startups such as his can only move markets so far and so quickly—while a small number of medical price transparency tools exist, the consortium between Amazon, Berkshire Hathaway and JPMorgan Chase will be able to affect market change much faster. Galvin, whose background is software engineering, has innovated solutions and sold several companies. He initially founded MyMedicalShopper after 13 years of studying the employer-healthcare-cost issue to solve his own company’s healthcare-expense pains. Until such time as the consortium is in the market—and if it actually comes to market—MyMedicalShopper already does what the consortium does, just on a smaller scale. Since it started doing business, it’s been saving small to midsized employers more than 33% on health insurance premiums while improving employee benefits.

Galvin says, “Until we know what this new company will actually do, we can only speculate on the changes it may bring to the market. It may take a decade or more to see these changes. In the meantime, companies advocating for price transparency will continue to offer an invaluable service to employers and individual consumers—the knowledge they need to comparison shop for the best healthcare options at the lowest price.”

About MYMEDICALSHOPPER:

MMS Analytics, Inc., dba MyMedicalShopperTM, is a big data company with big dreams for healthcare. Co-founder and CEO Mark Galvin gave rise to the company out of the need to provide transparency to employers who provide healthcare benefits to their employees, providing employees with the leverage needed to make solid decisions on their healthcare and improve their quality of life. MyMedicalShopper uncovers price variations in procedures and testing utilizing real-time health insurance plan pricing information, making it possible to choose care based on price, quality and convenience. The company’s goal is to help slash costs and transform the healthcare industry into a fair market for both businesses and individual consumers. For more information, visit www.MyMedicalShopper.com

Published by Markets Insider here: https://markets.businessinsider.com/news/stocks/new-amazon-conglomeration-means-healthcare-players-must-adapt-to-price-transparency-or-face-extinction-1021091131

Published by California Broker Magazine here: https://issuu.com/californiabrokermagazine/docs/california_broker_june_2018/8

Sources:
Amazon, Buffett, JPMorgan Tackle US Health Care ‘Tapeworm’. U.S. News and World Report.
Health Care ‘Tapeworm’ Faces New Threat. Wall Street Journal.

Take
Flight.

Download the full Planning Guide
Ensuring Compliance with the No Surprises Act and Transparency in Coverage Rule