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Jonathan Gruber on Athenahealth Sale

ACA Architect Jonathan Gruber On Athenahealth Sale

Athenahealth Sale
A logo for athenahealth is displayed on a computer Monday, Nov. 12, 2018, in New York. Athenahealth shares soared Monday after the struggling medical billing software maker received a $5.7 billion cash buyout offer. (AP Photo)
Jenny Kane/AP
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Jonathan Gruber on Athenahealth Sale

Watertown-based Athenahealth is being sold. The company, which builds record-keeping systems for medical facilities, employs about 2000 people in the greater Boston area. Dr. Jonathan Gruber is an economist from M.I.T. He is best known as an architect of the Affordable Care Act, also known as Obamacare. Gruber spoke with WGBH All Things Considered host Barbara Howard about what the sale of Athenahealth means. The following transcript has been edited for clarity.

Barbara Howard: Where does Athenahealth fit in the broader healthcare landscape?

Jonathan Gruber: It's quite fascinating. If you think about the delivery of healthcare, it generates a huge amount of data. They take all your vital signs. They ask what you've been doing lately, what drugs you take, things like that. And for years, we just sort of threw that data away. And what companies like Athenahealth have done is said no, let's keep that data and use it and use it to hopefully potentially improve healthcare.

Howard: And that data can be monetized?

Gruber: Well, there are private companies trying to make money, and certainly that's why a private equity investor would be interested in buying Athenahealth is that that information is money and in today's knowledge economy from Facebook to healthcare companies, information is money. The difference one hopes is that this information can’t just be used to make money but to actually improve the efficiency with which healthcare is delivered.

Howard: Athenahealth is being bought by two New York-based financial firms, Veritas Capital and Elliott Management, and it's going to be rolled into a Seattle-based company called Virence Health, which Veritas bought from Boston-based General Electric earlier this year. Do you have a sense of how the sale of Athenahealth could impact doctor’s offices, hospitals, and medical facilities that rely on software made by Athena?

Gruber: I don't think there's an obvious immediate impact. I think for those doctors and those users, this can be pretty seamless. There is a potential upside and a potential downside. The potential upside is that by pooling Athenahealth with other companies, there's more prospects for using more of this data to go further, to coordinate and improve healthcare. The vast majority of healthcare spending comes from the chronically ill, who don't get their care appropriately coordinated. You can potentially deal with that if you had more data and used it appropriately. The downside is that the data could be used in a way to try to find the healthiest and most profitable people and focus on them, and try to avoid and not provide care to the less profitable services and people. Basically, the data could be used not to improve healthcare, but to improve the bottom line.

Howard: How will we know?

Gruber: That's a great question. I don't think we can know whether this particular transaction will lead to more or less of that. I don't think we can know. I think it's more generally a point for public policy to think about. So as a simple example, the major accomplishment of the Affordable Care Act was ending the ability of insurers to discriminate against the sick based on their health. Many opponents of the Affordable Care Act would like to reintroduce that. If you re-introduce that, that creates profit-making opportunities for companies to try to find healthy people and sign them up and avoid the sick. If you keep the system we have today, where companies cannot discriminate and cannot charge different prices for healthy and sick, then data will be less likely to be used for those pernicious purposes.

Howard: Will patients feel any effects of this sale?

Gruber: I don't think patients will feel any effects of the sale in at least the near-term. In the long-term, it's not really about this company, it's about the general direction that data use goes in healthcare. And I think it really does have parallels to the Facebook debate, which is, there are wonderful aspects of sharing our data in terms of making things available to our friends and sharing our lives, and there's pernicious effects of sharing our data in terms of exploiting privacy or exposures to ads we may be tired of seeing. And I think the same thing comes in healthcare. So I think it isn't really about this transaction, it’s about the general fact that private equity and for-profit companies are taking over more of the collection and delivering of our care and which way will that get used.

Howard: Thanks for joining us, Dr. Gruber.

Gruber: My pleasure.

Howard: That's M.I.T. economist Dr. Jonathan Gruber, best known as an architect of Obamacare, talking with us about the purchase of Watertown-based Athenahealth. The company employs about 2000 people in Greater Boston. It has been bought by two New York-based financial firms. This is WGBH’s All Things Considered.

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