WellnessThe notion of consumers’ greater skin in the game of U.S. health care — and the underlying theory of rational economic men and women that would drive people to greater self-care — permeated the agenda of the 2nd annual Consumer Health & Wellness Innovation Summit, chaired by Lisa Suennen of Psilos Ventures.

Lisa kicked off the meeting providing a wellness market landscape, describing the opportunity that is the ‘real’ consumer-driven health care: people getting and staying well, and increasing participation in self-management of chronic conditions. The U.S. health system is transforming, she explained, with payors beginning to look like computer companies, hospital re-forming into payor groups (e.g., Accountable Care Organizations), and technology companies wrapping health services into their bundles. The industry has been built on throughput, not personalization and people, she said; “we have a system designed around financial incentives giving little credence to consumer desires.” This un-consumer health system is ticking like a time bomb, Lisa asserted — not like a Swiss watch. That’s because of the negative drivers of increasing costs along with public policy that un-does public health in the form of corn and soy subsidies, and a skewed food system that encourages Big Soda where “soda and sugar are a bigger security threat than Al Qaeda,” in the politics according to Lisa (and I agree with that assessment), But on the positive side, Psilos has found that U.S. consumers have been doing more to enhance their health in the past year, and employers are offering more wellness programs which aim to help reinforce consumers’ individual good intentions.

The day featured a gathering of the investment community, consumer advocates, mobile and digital health innovators, retail health players, health plans and consumer goods companies. Pepsico was a sponsor along with AARP, Cooley LLP, and Qualcomm, among other partners.

Say what? Pepsico? Indeed, and very appropriate. The food system is an integral part of the larger health ecosystem, so having Pepsi at the health and wellness table is as appropriate as a pharmaceutical manufacturer, an employer benefits planner, and a mobile health strategist. This ecosystem underpins the consumer skin-in-the-game scenario: health is, as our Surgeon General Dr. Regina Benjamin has said, where we live, work, play and pray.

Witness a few of the programs mentioned during the day:

  • Walgreens’ new “pharmacy 2.0” model of Well at Walgreens, bringing fresh food to food deserts and moving some of their 27,000 pharmacists in front of the counter, described by Dr. Jay Rosan, innovator at the pharmacy chain.
  • Zipongo, a food-health start-up trying to “make it easy to eat well,” working with Google’s wellness group and other clients to drive healthy food choices for people shopping national grocery chains (tagline: “Health Yourself”).
  • SoloHealth kiosks, located in retailers like grocery and Big Box stores, where Lisa said she saw people waiting in line to use at a Giant supermarket last week.
  • Mayo “outside the Clinic,” discussed by Jeff Cross as the organization’s strategy to attract consumers who aren’t affiliated with the Clinic. In Jeff’s words, the goal is to “help with interactions with the health system, including how to stay away from it.”

Another theme discussed throughout the day was the role of brands in the era of consumer-driven health. Do consumers view health brands the way they do consumer goods? AARP’s John Santa observed that “Atul Gawande [the physician-turned-New Yorker columnist) has established himself as a brand. Dr, Peter Provonost at Johns Hopkins involved in hospital safety has his own brand separate from” Hopkins. But the most important health brand to patients, Kim Goodwin of PatientsLikeMe asserted, is “other patients.”

Although Google is well-used for health searches – as in “Paging Dr. Google” — the jury is out on whether it is a trusted brand for health. Amanda Goltz of Aetna thought it ironic that Google is a trusted search engine in health, but works on the proposition of people giving the company “all of your data.” Yet on the health plan side, consumers are deeply suspicious of giving an insurance company “a little of your data, which is protected by HIPAA and in return we’ll give you tools to manage health.”

Another successful consumer brand, Virgin, was represented at the conference by Chris Boyce of Virgin HealthMiles, who said that Richard Branson (Virgin’s founder) pushes the promise of health and changing behavior for the long-term. “For 6 years,” Boyce said, “Virgin has fought to find its place” in the siloed health market of the U.S. His experience working with Virgin HealthMiles in the employer market has led him to believe that “it’s tough to align across silos,” so Virgin has begun with employers to move the needle of workers’ health. Some companies working with Virgin have appreciated the organization’s ability to change employee health so they’ve asked Virgin to move into other employee benefit areas, such as financial wellness and social good.

Cautioning the use of branding in health was Malcolm Bohm of Liquid Grids whose business it is to observe online discussions among health consumers and make sense out of the billion-plus mentions of health online. Malcolm’s team believe that of the 1 bn consumer conversations, only 2% are about ‘brand.’ Instead, Malcolm noted that health consumers talk about health experiences: “from a brand perspective, you have to appear to what the dialogue is about — it’s not about brand, it’s about ‘them.'”

Confirming that approach was Bryce Williams of Blue Shield of Calironia, who believes that “health and wellness are the ultimate meritocracy. We can be field guides,” he counseled — “that’s what I aspire to.”

Health Populi’s Hot Points: The meta-message of the day is that consumers – people – are already part of the health system. But the system isn’t designed for consumers, as manifested by:

  • Cumbersome and logistically difficult navigation for health insurance, care and diagnostic services
  • Uninspired tools and products that don’t motivate initial adoption and ongoing engagement and use by well people and sick patients and their caregivers
  • An employer sector, one-half of the key funding source for health insurance in America, that lacks innovative and novel approaches to inspiring employees’ total health and wellness, continuing to use Old School health plan designs (even though “value-based benefits” are in vogue).

A popular channel strategy cited by most of the companies serving the wellness market at the conference was marketing to and through employers. But with so many vendors going after employers, finding traction may be challenging. I recognize that most employers are now focusing on wellness as a cost-bending strategy – covered often in Health Populi, most recently here and here.

But the evidence for employer-sponsored wellness programs (1) improving workers’ health outcomes and (2) reducing health claims costs is sparse. The RAND Study on the topic, published in 2012, found little proof of the ROI for wellness in the workplace.

“Wellness is the new kid on the block,” observed Erin Rech of Ridgeview Medical Center. They’re forming a joint venture with a senior housing provider, deploying technologies in that facility to keep people out of the emergency department 2 miles down the road. This is the right move, bringing together a health provider with consumer technology and a housing developer. Health – where we live, work, play, pray, as Surgeon General Dr. Regina Benjamin has said.

Lisa talked about the original Fortune 500, when only 2% of companies operated in health care. By 2013, 25% are solidly in health, and 50% have aspirations in serving some aspect of the health market: Apple, Verizon, and Walmart among many others. This is the future of wellness and the real consumer-directed health — if the siloes that are the burdensome legacy of U.S. health care can be broken.