A blog covering the health/care ecosystem and people.

Madame Onassis got nothing on you, Rod Stewart complimented in his hit You Wear It Well in 1972. Now we can all wear it well, based on the fashion-meets-health-mashups at the 2014 Consumer Electronics Show. Several events underline this observation at the CES this year: – Fitbit has signed up Tory Burch to put her mark accessorizing the company’s activity trackers – The CSR Bluetooth smart pendant was designed with the chic jeweler Cellini; the device can receive alerts from an iPhone (think: medication adherence, or a message from mom in Florida). This is featured in the first photo. –

We who are charged with forecasting the future of health and health care live in a world of scenario planning, placing bets on certainties (what we know we know), uncertainties (what we know we don’t know), and wild cards — those phenomena that, if they happen in the real world, blow our forecasts to smithereens, forcing a tabula rasa for a new-and-improved forecast. There are many more uncertainties than certainties challenging the tea leaves for the new year, including the changing role of health insurance companies and how they will respond to the Affordable Care Act implementation and changing mandates

  See the yellow highlighted rows? That single yellow bar at the top, that’s hospitals; at the bottom, you’ll see pharma, health insurance, and managed care. Hospitals, trusted; pharma, insurance, managed care? Down south on the trust barometer with oil, tobacco, phone companies and social media. The Harris Poll has gauged U.S. consumers’ views on honesty and trustworthiness across industries for the past ten years. Over those ten years, trust in these industries has eroded, from huge falls-from-grace for banks (a 17 point fall), packaged food (falling 12 points), and computer hardware and software substantially falling, as well. Hospitals are

The 2013 Mobile Health Summit was hosted by HIMSS at The Gaylord Resort in suburban Washington DC, taking place over 4 days during the mid-atlantic region’s iciest conditions in years. But inside the cocoon of this convention space, 5,000 conveners took in demonstrations of innovations using mobile platforms and standards that extend health services, knowledge and self-help tools to people and providers. Several themes emerged out of the meeting… Lots of apps, too few business models.  There are too many apps and not enough companies, Esther Dyson noted in a keynote session during which she dialogued with two Steve’s: Steven

Employers who sponsor health insurance in America are at a fork on a cloudy road: they know that they’re in the midst of changes happening in the U.S. health system. Except for one certainty: that health care costs too much. So employers’ plans for health benefits in 2014 strongly focus on getting a return-on-investment from health spending in an uncertain climate, according to Deloitte’s 2013 Survey of U.S. Employers. Key findings are that: Employers will grow their use of workers’ cost-sharing, continuing to shift more financial responsibility onto employees They will expand other tactics they believe will help address cost

People who are diagnosed with at least one chronic medical condition are more likely to seek information online, use social media to understand peer patients’ reviews on drugs and treatments, and learn from other patients about their personal health experiences. While that’s encouraging news for a health empowerment headline, the underlying challenge that should prevent congratulatory fist-bumps among patient-engagement proponents is that people living with chronic disease are less likely to have internet access. Why? Because chronically ill people tend to be older and less educated, and they’re also less likely to be working. Simply put, “People living with chronic

While working people in the U.S. are feeling better about the nation’s economy, Americans aren’t putting much money into savings for retirement. The reasons for this are many, but above all is what Mercer calls “the specter of health care costs in retirement” in the Mercer Workplace Survey for 2013. In addition to peoples’ concerns about future health care costs, reasons for not putting money away for the future include flat personal income, slow economic growth and financial literacy challenges around how much 401(k) savings can be tax-deferred. On the slow economic growth perception, Mercer found that, on the upside, people

4 in 5 U.S. patients – 81% of them – want an equal say in health care decisions with their care provider, according to a 2013 Institute of Medicine study. At the same time, patients choose to take “drug holidays,” opting out of taking three or more doses of medicines in a row, or adopt “trail mix” approaches to taking prescriptions, casually and inappropriately mixing Rx drugs. Welcome to your world, pharma industry: where people say they want control, but somehow don’t exercise it in the way you — drug companies — define as “compliance” or “adherence.” Customer experience in

People who received health care in the U.S. between the second quarters of 2012 and 2013 faced 38% higher out-of-pocket costs, growing from $1,862 to $2,568 in just one year. These were payments for common procedures like joint replacements, Caesarean sections, and normal births. At the same time, consumers’ access to revolving credit lines fell by $1,000 over the twelve months. (Credit lines here include bank-issued credit cards, store credit cards, and home equity loans). The TransUnion Healthcare Report from TransUnion, the credit information company, paints a picture of tightening money for all consumers in the face of rising household

Patient and health engagement is the flavor du jour in health circles these days, from the corridors of hospitals to the caffeinated marketing meetings in Big Pharma’s east coast meet-ups. But there’s no standard agreement on what we mean by peoples’ health engagement, whether by patient or well consumer. In Market Insights: The Evolution of Consumer Engagement in Health Care, Porter Research endeavors to deepen our understanding of this important concept. In the introductory section of the paper, “Understanding Engagement,” Porter proffers that industry – providers, payers and employers – consider engagement as “changing consumer behavior through increased participation in consumers’ own health

The current role of health insurance at work is that it’s the “benefits” part of “compensation and benefits.” Soon, benefits will simply be integrated into “compensation and compensation.” That is, employers will be transferring risk to employees for health care. This will translate into growing defined contribution and cost-shifting to employees. Health care sponsorship by employers is changing quite quickly, according to the 2013 Aon Hewitt Health Care Survey published in October 2013. Aon found that companies are shifting to individualized consumer-focused approaches that emphasize wellness and “health ownership” by workers to bolster behavior change and, ultimately, outcomes. The most

Online shopping for health care can drive costs down, according to research conducted by HealthSparq, a company that works with health insurance companies to channel health cost information to plan members (that is, consumers). Healthsparq partnered with one of the company’s health insurance company clients to conduct this study, which demonstrated that, over two years, consumers who used an online treatment cost estimator saved money on care for hernia conditions, digestive conditions, and women’s health issues. It’s early days for health care price transparency in health care, but HealthSparq’s findings demonstrate positive evidence that when consumers are offered a tool

Women and binge drinking…job and financial stress…sleeplessness…caregiving challenges…sex…these were the topics covered in Health 2.0 Conference’s session aptly called “The Unmentionables.” The panel on October 1, 2013, was a rich, sobering and authentic conversation among 7 women and 1 man who kept it very real on the main stage of this mega-meeting that convenes health technology developers, marketers, health providers, insurers, investors, patient advocates, and public sector representatives (who, sadly, had to depart for Washington, DC, much earlier than intended due to the government shutdown). The Unmentionables is the brainchild of Alexandra Drane and her brilliant team at the Eliza

By 2022, $1 in every $5 worth of spending in the U.S. will go to health care in some way, amounting to nearly $15,000 for each and every person in America. From biggest line item on down, health spending will go to payments to: Hospitals, representing about 32% of all spending Physicians and clinical costs, 20% of spending Prescription drugs, 9% of spending Nursing, continuing care, and home health care, together accounting for over 8% of health spending (added together for purposes of this analysis) Among other categories like personal care, durable medical equipment, and the cost of health insurance.

Mobilising Healthcare, a new report from Juniper Research, segments the mobile health sector into “healthcare” and “health & fitness” segments. The research summary notes that fitness is a relatively new market compared with health “care,” which has been around for eons. Fitness, the analysts say, “is exempt from government intervention.” Mobile healthcare (“mHealth”) applications explored include SMS health messaging, remote health provision such as cardiac monitoring, electronic health records and personal health records. In mFitness, Juniper looks into mobile tech for athletes and fitness conscious people, and activity tracking including heart function, distance, respiration, and perspiration, among other parameters. mHealth

Since the advent of the so-called consumer-directed health care era in the mid-2000s, there’s been a love-gap between health plan members of traditional plans, living in Health Plan World 1.0, and people enrolled in newer consumer-driven plans – high-deductible health plans (HDHPs) and consumer-directed health plans (CDHPs). That gap in plan satisfaction continues, according to the Employee Benefits Research Institute (EBRI)’s poll of Americans’ consumer engagement in health care. The survey was conducted with the Commonwealth Fund. As the bar chart illustrates, some 62% of members in traditional plans were satisfied (very or extremely) with their health insurance in 2012.

Only 1 in 4 U.S. adults over 30 know what “personalized medicine” (PM) really is, and only 8% of people feel very knowledgeable about the concept based on Consumer Perspectives on Personalized Medicine from GfK, published online in August 2013. GfK surveyed 602 online adults 30 years and over between February and March 2013 drawn from the company’s KnowledgePanel sample of U.S. adults. Only 4% of people who have heard of personalized medicine describe it accurately as “medicine based on genome/genetic make up.” About one-half of people (52%) defined PM as medical care, treatment, or medicine geared toward individual needs. The poll

Insurance premium costs grew 4% for families between 2012 and 2013, with workers now bearing 39% of health premiums in 2013 compared with only 26% ten years ago, in 2003. That’s a 50% increase in health plan premium “burden” for working families, by my calculation. This snapshot of health insurance in 2013 comes to us from the 2013 Employer Health Benefits Survey, provided by the Kaiser Family Foundation (KFF) and the Health Research & Educational Trust (HRET). This research is one of the most important annual reports to hit the health care industry every year, and this year’s analysis provides strategic context

Consumers misunderstand health insurance, according to new research published in the Journal of Health Economics this week. The study was done by a multidisciplinary, diverse team of researchers led by one of my favorite health economists, George Loewenstein from Carnegie Mellon, complemented by colleagues from Humana, University of Pennsylvania, Stanford, and Yale, among other research institutions. Most people do not understand how traditional health plans work: the kind that have been available on the market for over a decade. See the chart, which summarizes top-line findings: nearly all consumers believe they understand what maximum out-of-pocket costs are, but only one-half do.

Consumers in America are spending more, and especially at the grocery store. Most people say they want to eat healthy — but, although they’re spending more at the food store, one-half of supermarket shoppers say cost is the main obstacle for healthy eating. 2 in 3 U.S. grocery shoppers define health and wellness as being physically fit and active, and over half believe that feeling good about yourself is another facet of health. Not being overweight equals health for about one-half of U.S. shoppers. The Why? Behind the Buy, from Acosta Sales & Marketing, explores buying patterns among U.S. consumers

There’s an issue that doctors and patients don’t discuss that’s among the most important contributors to ill health: it’s money, and it’s something Alexandra Drane calls an “Unmentionable.” Alex, Founder, Chief Visionary, and Board Chair at Eliza Corporation, coined Unmentionables as those aspects of daily living which everyone deals with, but few like to talk about: like sex (whether too much, too little), drugs (abusing), drinking (too much), toileting problems (such as incontinence or pooping problems), sleep trouble, and caring for others (not ourselves so much). These daily life challenges can negatively impact health, with financial stress being one of

Health consumers, meet a new player in your health care world: the bank. Financial services companies will play a growing role in U.S. health care as patients morph into health care consumers responsible for making more money-based decisions about their health care. This shift could make paying for health care just like paying other bills in the consumer retail market. And that’s a new role for health providers – doctors and hospitals – to fill. The Impact of Growing Patient Financial Responsibility on Healthcare Providers, prepared for Citi Enterprise Payments by Boundary Information Group, discusses what the impact of consumers’ payments in

While there is big uncertainty about how health reform will roll out in 2014, and who will opt into the new (and improved?) system, health cost growth will slow to 6.5% signalling a trend of moderating medical costs in America. Even though more newly-insured people may seek care in 2014, the costs per “unit” (visit, pill, therapy encounter) should stay fairly level – at some of the lowest levels since the U.S. started to gauge national health spending in 1960. That’s due to “the imperative to do more with less has paved the way for a true transformation of the

The number of retail health clinics will double between 2012 and 2015, according to a research brief from Accenture, Retail medical clinics: From Foe to Friend? published in June 2013. What are the driving market forces promoting the growth of retail clinics? Accenture points to a few key factors: Hospitals’ need to rationalize use of their emergency departments, which are often over-crowded and incorrectly utilized in cases of less-than-acute care. In addition, hospitals are now financially motivated under the Affordable Care Act (ACA, health reform) to reduce readmissions of patients into beds (particularly Medicare patients with acute myocardial infarction [heart attacks],

Giving health consumers more skin in the game doesn’t always lead to them making sound health decisions. Over four years in consumer-directed health plans, enrollees used one-quarter fewer visits to doctors every year and filled one fewer prescription drugs. CDHP members also received fewer recommended cancer screenings, and visited the emergency room more often. These rational health consumer theory-busting findings were published in the June 2013 issue of the Health Affairs article, Consumer-Directed Health Plans Reduce The Long-Term Use of Outpatient Physician Visits And Prescription Drugs by Paul Fronstin of the Employee Benefit Research Institute and colleagues from IBM and RxEconomics,

Nearly 100% of employers are likely to continue to provide health insurance benefits to workers in 2014, moving beyond a “wait and see” approach to the Affordable Care Act (ACA). As firms strategize tactics for a post-ACA world, nearly 40% will increase emphasis on high-deductible health plans with a health savings account, 43% will increase participants’ share of premium costs, and 33% will increase in-network deductibles for plan members. Two-thirds of U.S. companies have analyzed the ACA’s cost impact on their businesses but need to know more, according to the 2013 survey from the International Foundation of Employee Benefit Plans (IFEBP).

While the blockbuster erectile dysfunction (ED) drug has been shipped directly to consumer’s homes for years via pharmacy benefits management companies and specialty pharmacy retailers catering to the ED segment, Pfizer wants in on the transaction and has decided to get into the Direct-to-Consumer (DTC) distribution business for a prescription drug. Call this market development Direct-to-Home, or DTH. This is a kind of sentinel event signaling a pharmaceutical manufacturer cutting out the middle-man (read: retail pharmacy), and in this case getting up-close-and-personal with users of a drug that represents quality of life. Another motivation for Pfizer is trying to stem

Why has health cost growth in the U.S. slowed in the past few years? It’s mostly due to the economy, argues the Kaiser Family Foundation in Assessing the Effects of the Economy on the Recent Slowdown of Health Spending. The answer to this question is important because, as the American economy recovers, it begs the next question: will costs increase faster once again as they did in previous go-go U.S. economies, further exacerbating the budget deficit problems in the long-term? KFF worked with Altarum to develop an economic model to answer these questions. The chart illustrates the predicted vs. actual

Strange political bedfellows have come together to draft a formula for dealing with spiraling health care costs in the U.S. iin A Bipartisan Rx for Patient-Centered Care and System-Wide Cost Containment from the Bipartisan Policy Center (BPC). The BPC was founded by Senate Majority Leaders Howard Baker, Tom Daschle, Bob Dole, and George Mitchell. This report also involved Bill Frist, Pete Domenici, and former White House and Congressional Budget Office Director Dr. Alice Rivlin who together work with the Health Care Cost Containment Initiative at the BPC. The essence of the 132-page report is that the U.S. health system is

As a result of implementing the Affordable Care Act (health reform), most U.S. health executives crystal balls foresee health care insurance premiums will increase over 10% in the next three years. 4 in 10 predict premiums will grow over 25% over the next 3 years. This sobering forecast comes out of a Munich RE Health survey conducted among 326 health industry executives in March 2013. Those polled included representatives from health plans, managed care, disease management firms, and health insurance brokers and agents. How do health execs expect employers would deal with such fast-rising health premium costs? Why shift more

  Patient satisfaction survey scores have begun to directly impact Medicare payment for health providers. Health plan members are morphing into health consumers spending “real money” in high-deductible health plans. Newly-diagnosed patients with chronic conditions look online for information to sort out whether a generic drug is equivalent to a branded Rx that costs five-times the out-of-pocket cost of the cheaper substitute. While health care report cards have been around for many years, consumers’ need to get their arms around relevant and accessible information on quality and value is driving a new market for a Yelp, Travelocity, or Zagat in

While health care cost growth has slowed nationally, most Americans feel they’re going up faster than usual. 1 in 3 people believe their own health costs have gone up faster than usual, and 1 in 4 feel they’re going out about “the same amount” as usual. For only one-third, health costs feel like they’re staying even. As the second quarter of 2013 begins and the implementation of the Affordable Care Act (ACA, aka “health reform” and “Obamacare”) looms nearer, most Americans still don’t understand how the ACA will impact them. Most Americans (57%) believe the law will create a government-run health plan,

  As the Affordable Care Act, health reform, aka Obamacare, rolls out in 2013, American health insurance shoppers will look for sources of information they can trust on health plan quality and customer service satisfaction — as they do for automobiles, mobile phone plans, and washing machines. For many years, one of a handful of trusted sources for such insights has been J.D. Power and Associates. J.D. Power released its 2013 Member Health Plan Study (the seventh annual survey) and found that most consumers currently enrolled in a health plan have had a choice of only “one” at the time

Only two U.S. states have comprehensive health care price transparency regulations that ensure citizens’ access to clear and open health price information. While those two states, Massachusetts and New Hampshire, earn an “A” in the Report Card on State Price Transparency Laws, an addition five state earn a “B,” with the remainder of the United States garnering a “C” or less. The map illustrates that most states are red states, earning the lowest score of “F.” With the growth of high-deductible health plans (under the umbrella of so-called “consumer-directed” plans) where health consumers pay thousands of dollars to meet a spending

I endured what very few people could (or would) do in the past ten days: I traveled to New Orleans to the annual conference of HIMSS, the Health Information Management Systems Society, which features hundreds of suppliers to the health care information technology industry. I returned home to kiss my family hello and goodbye, and a day later flew to Austin for the annual South-by-Southwest conference for music, movie and digital folks. The health track at SXSW has grown over the past five years, and provides a start contrast to “health care” as embodied at HIMSS, and “health” translated through

  The U.S. economy is largely built on consumer purchasing (the big “C” in the GDP* – see note, below Hot Points). Americans have universally embraced their role as consumers in virtually every aspect of life — learning to self-rely in making travel plans, stock trades, photo development, and purchasing big-dollar hard goods (like cars and washing machines). Consumers transact these activities thanks to usable tools and information that empower them to learn, compare, and execute smarter decisions. That is, in every aspect of life but in health care. While the banner of “consumerism” in health care has been flown

This week, I had a conversation with a physician whom I consider quite patient-engaged, who uses an EHR, and who works with one of the most wired health organizations in the United States. I complained to her that my user-generated data from my Bodymedia armband, Fitbit, Withings scale, among other #QuantifiedSelf devices, can’t find their way through the cloud to my doctors’ electronic health records or my patient portal. Her reaction was surprising to me. She was not so keen on the idea, saying, “It’s the physician workflow” that’s the problem. The wordle on workflow comes from Dr. Chuck Webster

There are many ways to measure and express “patient engagement.” One such metric is “patient activation,” innovated by Dr. Judith Hibbard, long affiliated with the University of Oregon. Dr. Hibbard has written extensively about the Patient Activation Measure, PAM, first described in 2004. She and a team of researchers have determined that the higher a patient’s PAM score, the lower their health costs. Hibbard et. al. published these findings in the February 2013 issue of Health Affairs, which is entirely devoted to patient engagement – a top topic in Health Populi. The team analyzed the medical records of 33,163 patients

Health and wellness motivations among women cross all generations, driving them to purchase products that bolster health as they define it…not how media and stereotyping advertising have typically portrayed it, according to a survey report from Anthem Worldwide, What Women Really Want From Health and Wellness. Over all generations, 3 in 4 women say they make choices to benefit their health and wellness. Anthem asked women about the “external voices” of health/wellness messaging versus their “internal voice.” The external represent societal expectations: over 80% of women expect to take responsibility for their family’s health, and about 70% of women say the

U.S. consumers’ desire to take an active role in their health decisions is growing, according to the Altarum Institute Survey of Consumer Health Care Opinions. 61% of people want to make health decisions either on their own (26%) or with input from their doctor (38%). The proportion of people wanting to be “completely in charge of my decisions” rose 4 percentage points in one year, from 2011. This statistic skews younger, with 33% of people 25-34 and 31% of those 35-44 wanting to be “completely in charge.” Only 17% of those 55-64 felt like being totally in charge of their

1 in 3 U.S. adults have enough trust in online health resources that they’ve gone online to diagnose a condition for themselves or a friend. “For one-third of U.S. adults, the Internet is a diagnostic tool,” according to Health Online, the latest survey on online health from the Pew Internet & American Life Project. Nearly one-half of these people eventually sought medical attention. One-third did not. Women are more likely to do online medical diagnoses than men do, as do more affluent, college-educated people. When people perceive they’re ‘really’ sick, 70% get information and care from a health professional and

Reed Tuckson of UnitedHealthGroup was the first panelist to speak at the kickoff of the Digital Health Summit, the fastest-growing aspct of the 2013 Consumer Electronics Show (#2013CES). Tuckson implored the spillover audience to all, “self-deputize as national service agents in health,” recognizing that technology developers in the room at this show that’s focused on developers building Shiny New Digital Things have much to bring to health. As Andrew Thompson of Proteus Medical (the “invisible pill” company) said, “we can’t bend the health care cost curve; we have to break it.” This pioneering panel was all about offering new-new technologies

1 in 2 people wants to improve their financial situation in 2013; 1 in 5 wants to improve their health, and another 1 in 5 seeks more time with friends and family. Ipsos Open Thinking Exchange has polled 18,000 global citizens from 24 countries under the age of 64 in December 2012 to learn that it’s money that people want, first and foremost, in the new year. Health and time for friends and family roughly tie for second place, overall. Not surprisingly, as the data chart for the U.S. shows, more people at the lowest third of household income (HHI) polled

  41% of Americans are comfortable using websites that allow them to check health symptoms. Furthermore, 25% of people trust online symptom checkers, mobile apps and home-based vital sign monitors as much as they trust their doctor. In fact, roughly the same proportion uses these tools instead of going to see the doctor, according to a consumer survey from Royal Philips Electronics (Philips). The infographic illustrates some of Philip’s top-line findings from this poll, conducted among 1,003 U.S. adults 18 and over in November 2012. Over one-third of Americans also believe that technology allows them to monitor their health — a

People engage with social media as a matter of do-it-yourself (DIY) life. Increasingly, patients are engaging with social media for HealthcareDIY. As a member of the HIMSS eConnecting with Consumers Committee, we’re committed to seeing that people-patients engage more with their health and the health of their loved ones. At the same time, we advocate for health providers to engage in shared decision making, collaborative and participatory medicine and health. This is not only a key component for Meaningful Use under the HITECH Act, but greater patient engagement breeds greater health, better outcomes, and can bend the cost curve for

Reducing health care costs far outranks improving quality and safety, improving the public’s health, and upping the customer experience as Americans’ top priority for President Obama’s health care agenda, according to a post-election poll conducted by PwC’s Health Research Institute. In Warning signs for health industry, PwC’s analysis of the survey results, found that 7 in 10 Americans point to the high costs of health care as their top concern in President Obama’s second term for addressing health care issues. Where would cost savings come from if U.S. voters wielded the accountant’s scalpel? The voters have spoken, saying, Reduce payments

Without trust, health consumers won’t engage with organizations who want to cure them, sell to them, promote to them, help them. Here’s what I told a group of  pharmaceutical marketers at The DTC Annual Conference in Washington , DC, on April 9, 2010. Let’s start with the World Health Organization’s definition of health: that is, the state of complete physical, mental and social wellbeing, and not just the absence of disease. This definition is being embraced by health citizens long before the silos in the health industry – including pharma – get it. That’s an important mindset to take on as

And the pot will be from Costco, not Williams-Sonoma. The most telling point about health reform in President Obama’s budget is that, “Some researchers believe that healthcare costs could be reduced by a stunning 30 percent — or about $700 billion a year — without harming quality if we moved as a nation toward the proven and successful practices adopted by the lower-cost areas and hospitals.” That sentence gives us some grist for forecasting some of the elements of health reform — in particular, the last phrase which talks about moving from higher-cost, unproven health practices to lower-cost proven approaches.

Nearly 1 in 2 women put off seeking health care because the cost was too high. The kinds of services delayed included visits to the doctor, medical procedures, and filling prescription medications. The fourth annual T.A.L.K. Survey was released this week by the National Women’s Health Resource Center (NWHRC), focusing on the declining economy and its impact on women and three dimensions of their health — physical, emotional, and fiscal. 40% of women say that their health has worsened in the past five years due to increasing stress and gaining weight, according to the survey. One of the most interesting