A blog covering the health/care ecosystem and people.

“It seemed like an odd pairing: shampoo and a throat swab,” observes a new report on the growth of retail health from Definitive Healthcare. But retail clinics are no longer, as the paper explains, “an experiment of a few grocery stores….they’re becoming a major force in the U.S. healthcare system,” asserts the thesis of Retailers in healthcare: A catalyst for provider evolution.                 While the use of emergency departments fell by 1% in the past five years, the use of retail clinics expanded by 70%, Definitive Healthcare calculated. Most retail clinics are owned by

Not all “retail health” sites are created equal, U.S. consumers seem to be saying in a new study from Wolters Kluwer Health, the company’s second Pharmacy Next: Consumer Care and Cost Trends survey. Specifically, consumers have begun to differentiate between health care delivered at a retail pharmacy versus care offered at a retail store — such as Target or Walmart (both named as sites that offer “health clinics in department stores” in the study press release). While 58% of Americans were likely to visit a local pharmacy as a “first step” when faced with a non-emergency medical situation and 79%

People have expanded their definitions of health in 2023, with mental health supplanting physical health for the top-ranked factor in feeling healthy. Welcome to the Edelman Trust Barometer Special Report: Trust and Health, released this week, with striking findings about how the economic, post-pandemic life, pollution and climate change all feed mis-trust among citizens living in 13 countries — and their eroding trust for health care systems.         While these factors vary by country in terms of relative contribution to citizen trust, note that in the U.S., social polarization plays an outsized role in factors that “make us

“The future of love is bound to the institutions that have historically shaped and defined it,” Ipsos’s What the Future: Love report begins. Consider: religion, government, financial institutions….and the health care ecosystem, as well. On this Valentine’s Day 14th February 2023, it is a good time to consider this convergence as health politics, financial well-being, and emerging technologies will be re-shaping institutions and consumers in the coming months and near-term.           The Ipsos researchers have been assessing the future of many aspects of our lives over the past couple of years, such as the future of wellness,

Consumers’ wellness life-flows and demands in 2023 will go well beyond exercise resolutions, eating more greens, and intermittent fasting as a foodstyle. It’s time for us to get the annual update on health consumers from the multi-faceted team who curated the Global Wellness Summit’s annual report on The Future of Wellness 2023 Trends.                   In this year’s look into wellness for the next few years, we see that health-oriented consumers are seeking solutions for dealing with loneliness and mental health, weight and hydration, travel-as-medicine as health destinations, and — not surprisingly —

More people in the U.S. than ever have put off medical care due to cost, according to Gallup’s latest poll of patients in America.             Gallup conducted the annual Health and Healthcare poll U.S. adults in November and December 2022. This was the highest level of self-rationing care due to cost the pollster has found since its inaugural study on the topic in 2001. This was also the most dramatic year-on-year increase of postponing treatment due to cost in the study’s history.             Note the substantial difference in women avoiding

Health is “made” where we live, work, play, pray, learn….and shop. I spend a lot of time these days in the growing health/care ecosystem where retail health is broadening to address social determinants and drivers of health – namely food, transportation, broadband access, education, environment, and financial wellness – all opportunities for self-care and health engagement. For many years, I have followed the activities of CHPA, the Consumer Healthcare Products Association, and have participated in some of their conferences. Their recent announcement of a collaboration with Dollar General speaks to the growing role of self-care for all people.    

Due to gender pay gaps, time away from the workforce for raising children and caring for loved ones, women in the U.S. face a risky retirement outlook according to Emerging from the COVID-19 Pandemic: Women’s Health, Money, and Retirement Preparations from the Transamerica Center for Retirement Studies (TCRS).               As Transamerica TCRS sums up the top-line, “Societal headwinds are undermining women’s retirement security.” Simply said, by the time a woman is looking to retire, she has saved less than one-half of the money her male counterpart has put away for aging after work-life. The

What happens to a health care ecosystem when the volume of patients and revenues they generate decline? Add to that scenario a growing consensus for a likely recession in 2023. How would that further impact the micro-economy of health care?                   A report from Trilliant on the 2022 Trends Shaping the Health Economy helps to inform our response to that question. Start with Sanjula Jain’s bottom-line: that every health care stakeholder will be impacted by reduced yield. That’s the fewer patients, less revenue prediction, based on Trilliant’s 13 trends re-shaping the U.S. health

Three in four people in America grade health care costs a #fail, at grade “D” or lower. This is true across all income categories, from those earning under $24,000 a year to the well-off raking in $180K or more, we learn in Gallup’s poll conducted with West Health, finding that Majorities of people rank cost and equity of U.S. healthcare negatively. Entering the fourth quarter of 2022, several studies were published in the past week which reinforce the reality that Americans are facing high health care costs, preventing many from seeking necessary medical services, and hitting under-served health citizens even harder

“The odds are against hospitals collecting patient balances greater than $7,500,” the report analyzing Hospital collection rates for self-pay patient accounts from Crowe concludes.       Crowe benchmarked data from 1,600 hospitals and over 100,00 physicians in the U.S. to reveal trends on health care providers’ ability to collect patient service revenue. And bad debt — write-offs that come out of uncollected patient bill balances after “significant collection efforts” by hospitals and doctors — is challenging their already-thin or negative financial margins.           The first chart quantifies that bad debt attributable to patients’ self-pay payments

There is a direct association between a person’s health status and patient outcomes and their financial health, quantified in original research published this week in JAMA Internal Medicine.                 Researchers from the University of Michigan (my alma mater) Medical School and Institute for Healthcare Policy and Innovation analyzed two years of commercial insurance claims data generated between January 2019 and January 2021, linking to commercial credit data from January 2021 for patients enrolled in a preferred providers organization in Michigan. The first chart illustrates the predicted probability of credit outcomes based on the

Two in three Americans disapproved of the Supreme Court’s decision to overturn the Roe v. Wade decision (aka the Dobbs case), the latest Kaiser Family Foundation Health Tracking Poll found. While inflation tops voters’ priorities, abortion access resonates for key voting blocs. KFF conducted this survey among 1,847 U.S. adults 18 and over between July 7 and 17, 2022.             KFF published the study findings this week on August 2, a day of political primaries and ballot considerations in several U.S. states. Consider Kansas: a majority of Kansans voted on Tuesday to protect abortion rights

I’ve returned to the U.S. for a couple of months, having lived in and worked from Brussels, Belgium, since October 2021 (save for about ten days in March 2022). Work and life slow down in Europe in July and August, giving us the opportunity to return to our U.S. home base, reunite with friends and family, and re-join life and living this side of the Atlantic. The timing of my return to the U.S. coincides with a retail health hurricane of big announcements shaking up the health/care ecosystem. Among these events are Amazon’s plan to acquire One Medical, Apple’s publication of

People whose sense of well-being shifted positively in the past two years are finding greater personal purpose and financial health, we see in Sharecare’s Community Well-Being Index – 2021 State Rankings Report.                   Sharecare has been annually tracking well-being across the 50 U.S. states since 2008. When the study launched, Well-Being Index evaluated five domains: physical, social, community, purpose, and financial. In 2020, Sharecare began a collaboration with the Boston University School of Public Health to expand the Index, including drivers of health such as, Healthcare access (like physician supply per 1,000

The most trusted institutions in the U.S. are small business and the military, the only two sectors in which a majority of Americans have confidence. Americans’ trust in institutions hit new historic lows in 2022, Gallup found in its latest poll of U.S. sentiment across all major sectors.                 Today, more Americans have faith in the police than in the medical system, according to a Gallup poll finding that Confidence in U.S. Institutions Down; Average at New Low. published this week of Independence Day 2022. Confidence runs from a higher of 68% for

On this July 4th holiday, Americans aren’t feeling quite so financially independent on Independence Day 2022. The cost of a cookout for your family and friend group of 10 rose over $10 this year, 17% higher than in 2021, based on the American Farm Bureau Federation’s annual assessment of BBQing Economics on the Fourth of July.             This estimate is based on a market-basket menu that includes cheeseburgers, pork chops, chicken breasts, homemade potato salad, strawberries and ice cream. Key factors driving up the cost of an All-American cookout include supply chain disruptions (a hangover

“Inflation is the big story,” the economics team at Morning Consult told us yesterday in a call on “How to Think Like An Economist.” While I already thought I did that, Team @MorningConsult updated us on the current state of consumers and what’s weighing most heavily on their minds…inflation being #1. An hour after the Morning Consult session, I brainstormed the topic of consumers-as-payers of medical bills and prescription drugs with GoodRx strategy leaders. In my data wonkiness, inflation certainly played a starring role in setting the stage for Mind, Body and Wallet — the title of one of the sources

Consumers continued to invest in and use several technologies that supported self-care at home in 2021, with plans to purchase connected health devices, sports and fitness equipment in the next year.                 But these purchases will be made with greater attention to budget and value consumer mindsets firmly focused on (and stressed by) inflation. The 24th Annual Technology Ownership & Market Potential Study from the Consumer Technology Association (CTA) tells us that Americans in 2022 will have to manage challenging economic headwinds, shopping for technology is preparing people for their new normal —

A new Chevy Equinox SUV, a year in an MS program in kinesiology at Pacific Lutheran U., or health care for a family of four. At $30,260, you could pick one of these three options.             Welcome to this year’s 2022 Milliman Medical Index, which annually calculates the health care costs for a median family of 4 in the U.S. I perennially select two alternative purchases for you to consider aligning with the MMI medical index. I have often picked a new car at list price and a year’s tuition at a U.S. institution of

We’re all about food and cars and our technology, looking at the 2022 Axios Harris Poll 2022 Reputation Rankings published this week.             I’ve curated the logos of the top 30 companies based on the Poll’s survey of 33,096 U.S. adults conducted in March and April 2022. The survey assessed peoples’ awareness of companies that either “excel or falter in society,” according to the study methodology. Here you see the top 30. The COVID-19 pandemic bolstered consumers’ awareness and call-to-action for peoples’ basic needs: food, working-from-home (thus, tech as a determinant of health and wellbeing),

A couple retiring in 2022 should budget $315,000 to cover their health care costs in retirement, based on the 21st annual Retiree Health Care Cost Estimate from Fidelity Investments. For context, note that the median sales price of a home in the U.S. in April 2022 was $391,200.             It’s important to understand what the $315,000 for “health care costs” in retirement does not cover, explained in Fidelity’s footnoted methodology: the assumption is that the hypothetical opposite-sex couple is enrolled in Original Medicare (not Medicare Advantage), and the cost estimate does not include other health-related expenses

Delivering health care during the heights of the COVID-19 pandemic proved to both patients and their clinicians that virtual care was not only a viable channel for care, but very often a preferable “place” to collaborate for treatment. Even before the coronavirus pandemic emerged in early 2020, telehealth and the hospital-to-home movement were beginning to become part of a portfolio of delivery modes across the continuum of care. Deloitte spells out the current and future prospects for the Hospital in the future “without” walls in a new report that spells out driving forces, future scenarios, and impacts on a business long

The rate of people in the U.S. skipping needed health care due to cost tripled in 2021. This prompted West Health (the Gary and Mary West nonprofit organizations’ group) and Gallup to collaborate on research to quantified Americans’ views on and challenges with personal medical costs. This has resulted in The West Health-Gallup Healthcare Affordability Index and Healthcare Value Index.               The team’s research culminated in the top-line finding that some 112 million people in the U.S. struggle to pay for their care. That’s about 4.5 in 10 health citizens. Furthermore, 93% of people

Too many dollars, stimulated by an influx of COVID-19 government stimulus, are chasing too few goods in economies around the world. Couple this will labor, material shortages, and disrupted supply chains, the exogenous shock of the Ukraine crisis amplifying cost increases and shortage driving higher prices for food and commodities, and global consumers are faced with strains in household budgets. This is impacting grocery stores and. through my lens, will impact health consumers’ spending, as well. In their discussion of Customer First Retailer Responses to Inflationary Times, dunnhumby, retail industry strategists, covered an update on inflation with the top-line that

The financial toxicity of health care costs in the U.S. takes center stage in Health Populi this week as several events converge to highlight medical debt as a unique feature in American health care. “Medical debt is the most common collection tradeline reported on consumer credit records,” the Consumer Financial Protection Bureau called out in a report published March 1, 2022. CFPB published the report marking two years into the pandemic, discussing concerns about medical debt collections and reporting that grew during the COVID-19 crisis. Let’s connect the dots on: A joint announcement this week from three major credit agencies,

s in the seventh annual 2022 Brand Relevance Index from Prophet. The research developed a list of 50 companies representing what Prophet characterizes “the brands that people can’t live without in 2022.” For the 7th year in a row, Apple tops the study. Following Apple, the nine companies rounding out the top ten most relevant brands were Peloton, Spotify, Bose, Android, Instant Pot, Pixar, Fitbit, TED, and USAA. There are relative newbies in this list, representing consumers’ collective response to the COVID-19 pandemic and new life-flows. Put Calm and AfterPay in that category, along with Beyond Meat, and Zelle. The

“Social distancing is great. Medical distancing? Not so much,” I observe in Medical Distancing in America: A Lingering Pandemic Side Effect., my essay published this week in Medecision’s Liberate Health blog. Since we learned to spell “coronavirus,” we also learned the meaning and risk-managing importance of physical distance early in the COVID-19 pandemic. But medical distancing became a corollary life-flow of the physical version, and for our collective health and well-being, it hasn’t been good for our health in ways beyond keeping our exposure to the virus at bay. For health care providers — physicians, hospitals, ambulatory clinics, diagnostic centers —

Aflac, our favorite duck-mascot-representing company, has launched the Close the Gap initiative featuring spokesman Deion Sanders, one of the good guys in the Football Hall of Fame. Recognizing the fact that nearly one-half of insured Americans don’t have enough in savings to pay for medical expenses, the company established the Aflac Care Index to educate and advocate for peoples’ health and financial security — including those people who have health care coverage. While U.S. consumers are facing historically high levels of inflation for household spending on food, petrol, and home goods, health consumers will be dealing with greater out-of-pocket spending based

One of my favorite Dr. Seuss characters is the narrator featured in the book, I Had Trouble In Getting to Solla-Sollew. I frequently use this book when conducting futures and scenario planning sessions with clients in health/care. “The story opens with our happy-go-lucky narrator taking  a stroll through the Valley of Vung where nothing went wrong,” the Seussblog explains. Then one day, our hero (shown here on the right side of the picture from the book) is not paying attention to where he is walking….thus admitting, “And I learned there are troubles of more than one kind, some come from

In the U.S., being covered by health insurance is one of the social determinants of health. Without a health plan, an uninsured person in America is far more likely to file for bankruptcy due to medical costs, and lack access to needed health care (and especially primary care). But even with health insurance coverage, most health-insured people are concerned about medical costs in America, found in a MITRE-Harris Poll on U.S. consumers’ health insurance perspectives published today. “Even those fortunate to have insurance struggle with bills that result from misunderstanding or underestimating costs of treatments and procedures,” Juliette Espinosa of

Two pharmaceutical companies bubble up among the 20 fastest-growing brands for 2021 in Morning Consult’s report on the Fastest-Growing Brands of 2021. But the surprise in this year’s top 20 brand rankings was that five of them addressed consumers’ financial flows: Coinbase, AfterPay. Cash App, Mastercard, Chime, and Bitcoin. One year ago when I covered this study, I found  that the fastest-growing brands of 2020 had everything to do with the pandemic. They dealt with home entertainment, digital connectivity, hygiene, and indeed, health (with Pfizer and AstraZeneca the two pharma brands top-of-mind for consumers). In this year’s update, exploring consumers’

Compared with the rest of the developed world, people living in the U.S. may be concerned about income inequality, but their demand for income redistribution is the lowest among peer citizens living in 31 other OECD countries. In their  latest report, Does Inequality Matter? the OECD examines how people perceive economic disparities and social mobility across the OECD 32 (the world’s developed countries from “A” Australia to “U,” the United Kingdom). Overall the OECD 32 average fraction of people who believe it is the government’s responsibility to reduce income differences among those who think disparities are too large is 80%

In the U.S., peoples’ expectations of their health care experience is melding with their best retail experience — and that’s taken a turn toward their digital and ecommerce life-flows. The American Customer Satisfaction Index Insurance and Health Care Study 2020-2021 published today, recognizing consumers’ value for the quality of health insurance companies’ mobile apps and reliability of those apps. Those digital health expectations surpass peoples’ benchmarks for accessing primary care doctors and specialty care doctors and hospitals, based on ACSI’s survey conducted among 12,274 customers via email. The study was fielded between October 2020 and September 2021. Year on year,

Most U.S. adults across political parties favor allowing the Federal government authority to negotiate for drug prices — even after hearing the arguments against the health policy. Drug price negotiation, say by the Medicare program, is a unifying public policy in the current era of political schisms in America, based on the findings in a special Kaiser Family Foundation (KFF) Health Tracking Poll conducted in late September-early October 2021. Overall, 4 in 5 Americans favor allowing the Federal government negotiating power for prescription drug prices, shown in the first chart from the KFF report. By party, nearly all Democrats agree

“CVS wants to be your therapist, too,” the Wall Street Journal reported on 31st August, discussing the plans of retail stores, Big Box and pharmacies, adding mental health services to their growing health/care portfolios. The coronavirus spawned an epidemic inside and beyond the pandemic throughout the U.S.: very clear and widespread mental and behavioral health impacts that have become a new and transparent normal in America. Enter CVS Health, joining retail health competitors such as Walgreens and Walmart, both of which have been growing services to help consumers access help to deal with anxiety, depression, and stress. The first chart

Simply put, is the equation, “Spend more, get less” a sustainable business model? Of course not. But that’s the simple math on U.S. health care spending and what comes from it, according to Mirror, Mirror 2021: Reflecting Poorly, a perennial report from The Commonwealth Fund that compares health system performance across eleven developed countries. The first table details the metrics that the Fund compares across the eleven peer nations, which included Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. The metrics compared were access to care, care process, administrative efficiency, equity,

While women continue to outlive men in the U.S. in terms of life expectancy, the COVID-19 pandemic revealed continued healthcare access, physical and mental health disparities, and economic inequities for women in America. I addressed the changing state of post-pandemic women’s health in my latest contribution to the Medecision Liberation blog. This first graphic illustrates how women interacted with the U.S. health system during the pandemic in 2020. These data come from Kaiser Family Foundation’s women’s health survey conducted from the beginning of the pandemic starting March 1, 2020, and discovered that women in poorer or fair more likely went

As the COVID-19 pandemic shifts to a more endemic phase — becoming part of peoples’ everyday life for months to come — impacts on peoples’ mental health will persist, according to new research from CVS Health in the company’s annual Health Care Insights Study. CVS conducted the annual Health Care Insights Study among 1,000 U.S. adults in March 2021. To complement the consumer study, an additional survey was undertaken among 400 health care providers including primary care physicians and specialists, nurse practitioners, physician assistants, RNs and pharmacists. CVS has been tracking the growing trend of health care consumerism in the

The FDA’s approval of the first therapy to treat Alzheimer’s Disease in over twenty years brought attention to a not-yet-convened debate of U.S. health care costs and spending, innovation, and return-on-the-investment (as well as “for whom” do the returns accrue). In my latest post for Medecision, I explore different angles on the Aduhelm and Alzheimer’s discussion, covering: The macro- and micro-economics of Alzheimer’s and the $56,000 list price for the drug The FDA regulatory process and aftermath U.S. consumers’ bipartisan support for drug price regulation through Medicare negotiation and private/commercial sector adoption Congressional legislation addressing the price of medicines in

One in two people in the U.S. with employer-sponsored health insurance worry that a major health event in their household could lead to bankruptcy, according to research gathered by West Health and Gallup in Business Speaks: The Future of Employer-Sponsored Insurance. Gallup and West Health presented their study in a webinar earlier this week; in today’s post, I feature a few key data points that particularly resonate as I celebrate/appreciate yesterday’s U.S. Supreme Court’s ruling on the Affordable Care Act (i.e., California v. Texas) combined with a new study published in JAMA Network Open, discussed below the digital fold in

The good news for health care costs for a family of four in America is that they fell, for the first time in like, ever, in 2020. But like a déjà vu all over again, annual health care costs for a family of four enrolled in a PPO will climb to over $28,000 in 2021, based on the latest 2021 Milliman Medical Index (MMI). The first chart shows how health care costs declined in our Year of COVID, 2020, by over $1,000 for that hypothetical U.S. family. But costs rise with a statistical vengeance this year, by nearly $2,200 per family–about

Spending on medicines, globally, will rebound this year and rise above pre-pandemic levels through 2025. Between 2021 and 2025, the annual growth global growth rate for prescription drugs spending is expected to range from 3% to 6%, a $1.6 trillion bill for the worlds’s total Rx medicines market. That relatively low single-digit growth rate is tempered by savings from biosimilars and the loss of brand exclusivity (that is, more generics coming to market). On the faster-growth side, we can expect two big therapeutic areas to drive spending upward: oncology and immunology, projected to expand by 9% to 12% each year

The United States has among the highest per capita incomes in the world. The U.S. also has sustained among the highest death rates per 100,000 people due to COVID-19, based on epidemiological data from the World Health Organization’s March 28, 2021, update. Higher incomes won’t prevent a person from death-by-coronavirus, but risks for the social determinants of health — exacerbated by income inequality — will and do. I have the good fortune of access to a study group paper shared by Paul Sheard, Research Fellow at the Mossaver-Rahmani Center for Business and Government at the Harvard Kennedy School. In reviewing

COVID-19 ushered in the era of our homes as safe havens for work, shopping, education, fitness-awaking, bread-baking, and health-making. In my latest essay written for Medecision, I weave together new and important data and evidence supporting the basic social determinant of health — shelter, housing, home — and some innovations supporting housing-as-medicine from CVS Health, UnitedHealth Group, AHIP, Brookings Institution, the Urban Land Institute, and other stakeholders learning how housing underpins our health — physical, mental, financial. Read about a wonderful development from Communidad Partners, working with the Veritas Impact Partners group, channeling telehealth to housing programs serving residents with

More Americans are happier in March 2021 than they’ve been for a year, based on consumer research from Civic Science polling U.S. adults in early March 2021. For the first time, a larger percent of Americans said they were better off financially since the start of the pandemic. This week, Civic Science shared their latest data on what they’re seeing beyond the coronavirus quarantine era to forecast trends that will shape a post-COVID America. Buoying peoples’ growing optimism was the expectation of the passage of the American Cares Act, which President Biden signed into effect yesterday. The HPA-CS Economic Sentiment Index

Expanding omni-channel, data-driven, cost-effective health care in the community, tailoring that care, and attending to mental health paint the picture of health through the lens of CVS Health. The company published the Health Trends Report 2021 today, calling out ten forces shaping health care this year. Those themes are, The Year of the Pharmacist The Next Step Forward in Cardiac Care Cancer Needs a Better Roadmap The EHR Hits Its Stride The Mental Health Shadow of COVID-19 Tailor Care to the Older Patient More Agents that Predict Disease Paying for the New Medical Miracle Virtual Care Goes Mainstream, and Diabetes

The COVID-19 pandemic forced consumers to define what were basic or essential needs to them; for most people, those items have been hygiene products, food, and connectivity to the Internet. There’s another good that’s essential to people who are patients: prescription drugs. A new report from CoverMyMeds details the current state of medication access weaving together key health care industry and consumer data. The reality even before the coronavirus crisis emerged in early 2020 was that U.S. patients were already making painful trade-offs, some of which are illustrated in the first chart from the report. These include self-rationing prescription drug

Nearly a year into the COVID-19 pandemic, the same percent of Americans say strengthening the U.S. economy and dealing with the coronavirus outbreak should be a top priority for President Biden and Congress to address this year, according to data from the Pew Research Center collected during the second week of January 2021. Two-thirds of people in the U.S. also want government leaders to prioritize improving the employment situation, defending against terrorism, and improving the political system, the study learned. At Americans’ low end of the priority list for the President and Congress are dealing with global trade, improving transportation,