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Twenty-plus years ago, Amazon began as an online bookseller. Today that part of the business has developed into the creative collection and use of data to drive consumer purchasing across an immense range of products and services.

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How might they apply similar techniques for the benefit of healthcare consumers? While many clinicians have adopted electronic medical records, a lack of standardization and incentives to share data has made it difficult to unlock the potential of that data to feed innovative analytics. Amazon has a history of finding ways to break tangled infrastructure problems down into manageable pieces with clear interfaces—in other words, to create simplicity out of complexity and make it easy for systems to talk to each other. The data collection process might also include information gathered from social media activity, online purchasing, and wearable devices or smartphones— just recently Apple announced it was bringing health records to the iPhone.

For instance, does your fitness tracker show a higher than usual heart rate after your weekly jog? Have you been buying an unusual amount of ibuprofen? You might receive a notification to stop by the employee health center at your earliest convenience for a free physical exam.

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The lack of competition and pricing transparency among healthcare providers contributes significantly to the high cost of healthcare. Imagine an online marketplace where providers and pharmacies compete for patients by leveraging cutting-edge technology to update their fees in real time while making it easy for patients to see and compare value across the providers that deliver the care they need. Patients and third-party sources could provide satisfaction and quality rankings to further inform decision-making.

The transparent cost network would facilitate innovative benefit designs and consumerism in healthcare where patients could get full coverage for the highest-value providers but would need to pay more for higher-cost providers. This solution would also significantly reduce the administrative costs associated with contracting with providers and paying claims.

Pharmacy spending represents a meaningful portion of total healthcare costs, and no area has been more intensely scrutinized in recent years. Large employers and employer coalitions have tried for some time to leverage their purchasing volumes to negotiate lower drug prices, and it is unlikely that the mere aggregation of three large companies would result in material further savings beyond what has already been achieved by large national pharmacy benefit managers and other successful coalitions. A more fundamental transformation of the drug purchasing process would be required.

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How might this occur? As financiers, they might develop creative value-based contracting solutions to provide pharmaceutical manufacturers with a more predictable profit stream over the life cycle of a specific drug—from the immense investment in research and development, to the high returns of a specialty drug under patent protection, to the much lower margins available once the drug becomes generic—all in exchange for improved pricing while the drug is under patent. The data management and predictive analytics capabilities of Amazon could help improve medication adherence, identify personalized medicine opportunities, and monitor medical outcomes.

This information is of immense value that could help bend the cost curve and be returned to drug manufacturers and other entities in the pharmacy supply chain, perhaps in exchange for favorable pricing terms or to hold manufacturers financially accountable for clinical outcomes.


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Other banks dealt with this problem by retaining these CDO layers on their books. But by mid, JPMorgan joined the herd. It hired bankers to expand its CDO team and got to work.

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A few months later -- in early -- Magnetar and JPMorgan banged out a deal. Unlike the earlier CDOs Magnetar helped create, this one wasn't named named after a constellation. Squared was filled in part with other CDOs Magnetar had helped create.

As it had on previous deals, Magnetar pushed the bankers to select riskier bonds. It was always going to be crappier. They all went into the deal. Magnetar also successfully pushed for Squared to include slices from one of the Abacus deals, a group of CDOs that, as the New York Times later reported , Goldman Sachs had created and bet against.

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JPMorgan's sales force fanned out across the globe. It sold parts of the CDO to 17 institutional investors, according to a person familiar with the transaction.

The deal closed in May , nearly a year after housing prices had peaked. Published: 24 Apr Published: 8 Apr Billionaire JP Morgan chief attacks socialism as 'a disaster'. Published: 4 Apr Jamie Dimon, spare us your crocodile tears about inequality Robert Reich.

Awards for Excellence 12222: This is the era of JPMorgan

Published: 26 Mar UK bankers on standby as City readies no-deal contingency plans. Published: 17 Mar Published: 6 Dec A European lender and two US banks alleged to be involved in money-laundering case. Published: 19 Nov Top US companies stand up to oppose Trump effort to roll back trans rights.