It seemed an ideal partnership: Three of America’s most powerful companies were teaming up with one of its most celebrated physician writers to topple a health care system with out-of-control costs and mediocre patient outcomes.
But two years later, Atul Gawande is leaving the CEO role at Haven, the venture formed by Amazon, Berkshire Hathaway, and JP Morgan Chase & Co.
For all the fanfare, Haven has not made a dent in the dysfunction of US health care, or publicized any results from the few initiatives it has under way. And now Gawande’s departure, first reported in the Wall Street Journal, threatens to derail a company still in its infancy.
In announcing the venture in June 2018, the three corporate chieftains — Jeff Bezos of Amazon, Jamie Dimon of JP Morgan, and Warren Buffett of Berkshire Hathaway — made clear that recruiting Gawande was central. “Jamie, Jeff, and I are confident that we have found in Atul the leader who will get this important job done,” Buffett said.
But it wasn’t until nine months later that the venture even announced its name. And Gawande’s impending departure comes a year after the exit of chief operating officer, Jack Stoddard, who was only in the job for eight months. A replacement was never announced. Haven was also just beginning to make its first foray into the market, piloting a new insurance product designed to make health care more affordable and accessible for a subset of employees.
A spokesman for the venture said its founders remain committed to Haven, but declined to comment on Gawande, who is reportedly staying on as chairman but looking for someone to take on his day-to-day role. Gawande did not respond to a request for comment.
“I don’t know if this is a death knell, but it’s certainly a retardant,” said Robert Burns, a professor of health care management at the University of Pennsylvania’s Wharton School.
He explained: “When you have turnover like this at the senior level, it undermines the long-term play. Who knows how patient these three companies are going to be?”
Howard Forman, a physician and professor of health care management at Yale, said: “The idea behind (Haven) is amazing, but from the beginning this was a marriage that was never destined to last. I’ve never heard of a major company CEO having such divided loyalties.”
Gawande said the company would be his top priority when he was tapped to lead it in June 2018, but he also said he would continue his work as a surgeon and writer for the New Yorker. His appointment was another big splash for a company whose formation had already caused health care stocks to plunge, and spurred industry incumbents to circle their wagons against a well-funded upstart.
But its impact has not lived up to the expectations. Haven has struggled to balance its need to carefully guard its plans in a competitive market with the broader imperatives to build momentum, show progress, and rally support for its cause. Its biggest initiative made public to date is a health insurance offering for about 30,000 JP Morgan employees that aims to make coverage more affordable and comprehensible by providing a menu of fixed costs for medical services; it also offers financial incentives for hitting certain health targets, such as lowering blood pressure.
The rest of its work, which involves leveraging data and technology to provide more effective primary care and control chronic health conditions, has remained a closely guarded secret.
In recent weeks, Gawande has resumed his role as a health policy commentator, called into action by the coronavirus pandemic that has plunged his industry into crisis mode.
He came off the sidelines in mid-March as the pandemic picked up steam in the United States and began amplifying government dysfunction and inequities in health care access. On March 21, he wrote an article in the New Yorker about successful steps taken in Hong Kong and Singapore to control the spread of the illness and protect clinicians from becoming infected.
His forceful commentary has continued in recent days as the coronavirus commanded solutions from the industry’s leaders, presenting a level of urgency that contrasted sharply with his slow and methodical work at Haven. It is unclear how quickly Gawande’s work in policy and advocacy arenas will ramp up in coming weeks, or how much time he will be able to devote to the company in the role of chairman.
Business specialists said that this kind of transition is challenging in the early life of a company and is particularly so in the case of Haven.
Burns said of the Gawande departure, “It’s going to put the dampers on this. It will slow it down, and maybe they’ll take a different direction.”