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Healthcare Costs for a Family of Four Will Reach $27,000 in 2017

If you had $27,000 in your wallet, would you spend it on a 2017 Kia Optima sedan, 28 shares of Amazon stock, or healthcare? $26,944 is this year’s estimate of what healthcare will cost a family of four in the U.S., based on the 2017 Milliman Medical Index (MMI). This is based on the projected total costs of healthcare for a family covered by an employer-sponsored PPO plan. Milliman, the actuarial consulting firm, has conducted the MMI going back to 2001. I’ve watched the rise and rise of this index for years, explained annually in the Health Populi blog since its inception

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Financial Stress As A Health Risk Factor Impacts More Americans

A family in Orange County, California, paid a brother’s 1982 hospital bill by selling 50 pieces of their newly-deceased mother’s jewelry. “It’s what she wanted,” the surviving son told a reporter from The Orange County Register. The cache of jewelry fetched enough to pay the $10,000 bill. Patients in the U.S. cobble together various strategies to pay for healthcare, as the first chart drawn from a Kaiser Family Foundation report on medical debt attests. As health care consumers, people cut back on household spending like vacations and household goods. Two-thirds of insured patients use up all or most of their savings

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Medical Bill Toxicity: 53% of Americans Say A Big Bill Is As Bad As A Serious Diagnosis

3 in 4 Americans’ health care costs have risen in the past few years. Two-thirds of Americans want to lower their costs, but don’t know how to do that. A survey from Amino released this week, conducted by Ipsos, has found that one in five people could not afford to pay an unexpected medical bill without taking on debt, and another 18% of Americans could only afford up to $100 if presented with an unexpected medical bill. This medical debt side effect more likely impacts women versus men, the less affluent, the unmarried, and those with no college degree. While

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Will Republican Healthcare Policy “Make America Sick Again?” Two New Polls Show Growing Support for ACA

Results of two polls published in the past week, from the Kaiser Family Foundation and Pew Research Center, demonstrate growing support for the Affordable Care Act, aka Obamacare. The Kaiser Health Tracking Poll: Future Directions for the ACA and Medicaid was published 24 February 2017. The first line chart illustrates the results, with the blue line for consumers’ “favorable view” on the ACA crossing several points above the “unfavorable” orange line for the first time since the law was signed in 2010. The margins in February 2017 were 48% favorable, 42% unfavorable. While the majority of Republicans continue to be solidly

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Health Care Worries Top Terrorism, By Far, In Americans’ Minds

Health care is the top concern of American families, according to a Monmouth University Poll conducted in the week prior to Donald Trump’s Presidential inauguration. Among U.S. consumers’ top ten worries, eight in ten directly point to financial concerns — with health care costs at the top of the worry-list for 25% of people. Health care financial worries led the second place concern, job security and unemployment, by a large margin (11 percentage points) In third place was “everyday bills,” the top concern for 12% of U.S. adults. Immigration was the top worry for only 3% of U.S. adults; terrorism and

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Americans Far More Likely to Self-Ration Prescription Drugs Due To Cost

Americans are more than five times more likely to skip medication doses or not fill prescriptions due to cost than peers in the United Kingdom or Switzerland. U.S. patients are twice as likely as Canadians to avoid medicines due to cost. And, compared with health citizens in France, U.S. consumers are ten-times more likely to be non-adherent to prescription medications due to cost. It’s very clear that more consumers tend to avoid filling and taking prescription drugs, due to cost barriers, when faced with higher direct charges for medicines. This evidence is presented in the research article, Cost-related non-adherence to prescribed

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Medical Debt Is A Risk Factor For Consumers’ Financial Wellness

The top reason US consumers hear from a debt collector is due to medical bills, for 6 in 10 people in Americans contacted regarding a collection. This month, the Consumer Financial Protection Bureau (CFPB) published its report on Consumer Experiences with Debt Collection. Medical bill collections are the most common debt for which consumers are contacted by collectors, followed by phone bills, utility bills, and tax bills. The prevalence of past-due medical debt is unique compared with these other types because healthcare cost problems impact consumers at low, middle, and high incomes alike. Specifically: 62% of consumers earning $20,000 to

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Health Care For All — Only Better, US Consumers Tell Consumer Reports

Availability of quality healthcare, followed by affordable care, are the top two issues concerning U.S. consumers surveyed just prior to Donald Trump’s inauguration as the 45th U.S. President. Welcome to Consumer Reports profile of Consumer Voices, As Trump Takes Office, What’s Top of Consumers’ Minds? “Healthcare for All, Only Better,” Consumer Reports summarizes as the top-line finding of the research. 64% of people are confident of having access to good healthcare, but 55% aren’t sure they can afford healthcare insurance to be able to access those services. Costs are too high, and choices in local markets can be spotty or non-existent.

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Health Care Costs, Not the ACA, Rank #1 in Americans’ Minds As President Trump Assumes the Presidency

More Americans are worried about their out-of-pocket health care costs than they are about repealing the Affordable Care Act (ACA), according to the Kaiser Family Foundation (KFF) Health Tracking Poll published 6th January 2017, the first KFF poll for the new year. Cost worries fall into two buckets of concerns: the cost of health care, and the cost of prescription drugs. Managing the opioid epidemic falls in third place after health care costs. Repealing the Affordable Care Act? It’s #4 on Americans’ health care priorities as of mid-December 2016, followed by shrinking the Federal’s government’s role in and spending on

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Self-Care Is the Best Healthcare Reform

The greater a person’s level of health engagement, the better their health outcome will be. Evidence is growing on the return-on-investment for peoples’ health activation and how healthy they are. That ROI is both in survival (mortality) and quality of life (morbidity), as well as hard-dollar savings — personally bending-the-healthcare-cost-curve. But people are more likely to engage in “health” than “healthcare.” We’d rather ingest food-as-medicine than a prescription drug, use walking in a lovely park for exercise, and laugh while we’re learning about how to manage our health insurance benefits. Thus, Campbell’s Soup Company and Hormel are expanding healthy offerings,

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Americans Have Begun to Raid Retirement Savings for Current Healthcare Costs

While American workers appreciate the benefits they receive at work, people are concerned about health care costs. And consumers’ collective response to rising health care costs is changing the way they use health care services and products, like prescription drugs. Furthermore, 6 in 10 U.S. health citizens rank healthcare as poor (27%) or fair (33%). This sober profile on healthcare consumers emerges out of survey research conducted by EBRI (the Employee Benefit Research Institute), analyzed in the report Workers Like Their Benefits, Are Confident of Future Availability, But Dissatisfied With the Health Care System and Pessimistic About Future Access and

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43% of Americans Worry About How They’ll Pay for Health Care

4 in 10 Americans are worried about how they’ll pay for health care, according to Americans’ Views on Current Trade and Health Policies, a poll conducted jointly between the Harvard T.H. Chan School of Public Health and Politico. There are no significant party differences between Democrats and Republicans regarding peoples’ worrying about their ability to pay medical costs in the next year. But there are differences in geography, with 53% of people in the South significantly more worried about health care costs compared with other regions of the U.S. Who’s to blame for the high costs of health care that

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Let’s Go Healthcare Shopping!

Healthcare is going direct-to-consumer for a lot more than over-the-counter medicines and retail clinic visits to deal with little Johnny’s sore throat on a Sunday afternoon. Entrepreneurs recognize the growing opportunity to support patients, now consumers, in going shopping for health care products and services. Those health consumers are in search of specific offerings, in accessible locations and channels, and — perhaps top-of-mind — at value-based prices as defined by the consumer herself. (Remember: value-based healthcare means valuing what matters to patients, as a recent JAMA article attested). At this week’s tenth annual Health 2.0 Conference, I’m in the zeitgeist

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Older Couples Have Lower Out-of-Pocket Healthcare Costs Than Older Singles

It takes a couple to bend the health care cost curve when you’re senior in America, according to the EBRI‘s latest study into Differences in Out-of-Pocket Health Care Expenses of Older Single and Couple Households. In previous research, The Employee Benefit Research Institute (EBRI) has calculated that health care expenses are the second-largest share of household expenses after home-related costs for older Americans. Health care costs consume about one-third of spending for people 60 years and older according to Credit Suisse. But for singles, health care costs are significantly larger than for couples, EBRI’s analysis found. The average per-person out-of-pocket spending for

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PhRMA vs. Employers: Healthcare Costs In the Eye of the Beholder

In the past week, the Pharmaceutical Research and Manufacturers of America (PhRMA), the advocacy organization for the branded prescription drug industry, published Medicines: Costs in Context,” the group’s lens on the value of prescription drugs in the larger healthcare economy. Their view: that prescription drug costs comprise a relatively low share of health care spending in America, and a high-value one at that. PhRMA contends that 10% of the health care dollar was allocated to prescription drugs in 2015, the same proportion as in 1960. “Even with new treatments for hepatitis C, high cholesterol and cancer, spending on retail prescription

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U.S. Health Spending Will Comprise 20% of GDP in 2025

Spending on health care in America will comprise $1 in every $5 of gross domestic product in 2025, according to National Health Expenditure Projections, 2015-25: Economy, Prices, And Aging Expected to Shape Spending and Enrollment, featured in the Health Affairs July 2016 issue. Details on national health spending are shown by line item in the table, excerpted from the article. Health spending will grow by 5.8% per year, on average, between 2015 and 2025, based on the calculations by the actuarial team from the Centers for Medicare and Medicaid Services (CMS), authors of the study. The team noted that the Affordable Care

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More Patients Morph Into Financially Burdened Health Consumers

Health care payment responsibility continues to shift from employers to employee-patients, More of those patients are morphing into financially burdened health consumers, according to TransUnion, the credit agency and financial risk information company, in the TransUnion Healthcare Report published in June 2016. Patients saw a 13% increase in their health insurance deductible and out-of-pocket (OOP) maximum costs between 2014 and 2015. At the same time, the average base salary in the U.S. grew 3% in 2015, SHRM estimated. Thus, deductibles and OOP costs grew for consumers more than 4 times faster than the average base salary from 2014 to 2015.  In

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What Financial Health Means to Me: It’s Baked Into Wellness

Today is Financial Wellness Day. Do you know how financially well you are? Let me take a crack at that answer, even though I haven’t seen your bank account (which you may not even have as over 20% of people in the US are, as financial services companies would call you “un-banked” or “under-banked”.) You have some level of fiscal stress, ranging from a little to a lot. You aren’t taking all of your summer vacation your employer extends to you. You’re spending around $1 in every $5 of your household budget on health care. And your sleep isn’t as

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Happy Patients, Healthy Margins – the Hard ROI for Patient-Centered Care

Hospital margins can increase 50% if health providers offer patients a better customer experience, Accenture calculates in the paper, Insight Driven Health – Hospitals see link between patient experience and bottom line. Specifically, hospitals with HCAHPS scores of 9 or 10, the highest recommendations a patient can give in the survey, more likely enjoy higher margins (upwards of 8%). The Hospital Computer Assessment of Healthcare Providers and Systems (HCAHPS) survey is administered by the Centers for Medicare and Medicaid Services (CMS) and measures patients’ exeperiences in hospital post-discharge. The correlation, simply put, is “Happy Patients, Healthy Margins,” Accenture coined in

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For Healthcare Costs, Geography is Destiny

Where you live in America determines what you might pay for healthcare. In this health economic scenario, as Napoleon is rumored to have said, “geography is destiny.” If you’re searching for low-cost health care, Ohio may just be your state of choice. The map illustrates these health care disparities across the U.S. in 2015, when the price of a single service could vary by more than 200% between one state and another: say, Alaska versus Arizona, or Wisconsin compared to Florida. Even within states, like Ohio, the average price of a pregnancy ultrasound in Cleveland ran nearly three times that received in

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Money, Stress and Health: The American Worker’s Trifecta

Financial stress impacts health, relationships, and work productivity and attendance for employees in the U.S. It’s the American worker’s trifecta, a way of life for a growing proportion of people in the U.S. PwC’s 2016 Employee Financial Wellness Survey for 2016 illustrates the reality of fiscally-challenged working women and men that’s a national epidemic. Some of the signs of the financial un-wellness malaise are that, in 2016: 40% of employees find it difficult to meet their household expenses on time each month 51% of employees consistently carry balances on their credit cards (with a large increase here among Baby Boomers

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Financial Wellness Declines In US, Even As Economy Improves

American workers are feeling financial stress and uncertainty, struggling with health care costs, and seeking support for managing finances. 75% of employees feel financially insecure, with 60% feeling stressed about their financial situation, according to the 2016 Workplace Benefits Report, based on consumer research conducted by Bank of America Merrill Lynch. The overall feeling of financial wellness fell between 2013 and 2015. 75% of U.S. workers don’t feel secure (34% “not very secure” and 41% “not at all secure”), with the proportion of workers identifying as “not at all secure” growing from 31% to 41%. Financial wellness was defined for this

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Tying Health IT to Consumers’ Financial Health and Wellness

As HIMSS 2016, the annual conference of health information technology community, convenes in Vegas, an underlying market driver is fast-reshaping consumers’ needs that go beyond personal health records: that’s personal health-financial information and tools to help people manage their growing burden of healthcare financial management. There’s a financial risk-shift happening in American health care, from payers and health insurance plan sponsors (namely, employers and government agencies) to patients – pushing them further into their role as health care consumers. The burden of health care costs weighs heavier on younger U.S. health citizens, based on a survey from the Xerox Healthcare

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Rural Hospitals in America – Health Disparities, Hospital Disparities

Rural hospitals operating in the U.S. have a higher risk of mortality — closure — than other hospitals in America. The U.S. health care landscape is littered with examples of health disparities among the nation’s health citizens – for example, women’s lower access to heart-health care, Latinos’ higher rates of Type 2 Diabetes, and African-Americans’ greater risks of stroke, many cancers, maternal mortality, and many other causes of mortality and diminished health. A report from iVantage, Rural Relevance – Vulnerability to Value, documents the fiscally challenging environment for rural hospitals in America. There are at least 673 facilities at-risk of closure

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Getting Beyond Consumer Self-Rationing in High-Deductible Health Plans

The rising cost of health care for Americans continues to contribute to self-rationing care in the forms of not filling prescriptions, postponing necessary services and tests, and avoiding needed visits to doctors. Furthermore, health care costs are threatening the livelihood of most American families, according to the Pioneer Institute. “What Will U.S. Households Pay for Health Care in the Future?” asks the title of a study by the Institute, noting that health care costs for an American family of average income could increase annually to $13,213 by 2025 — and as high as $18,251. Pioneer calculates that this forecasted spend will

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The Average Price of a New Specialty Drug Exceeds Median U.S. Annual Income; and a Tweet from Pam Anderson

The average price for a specialty drug was $53,384 in 2013; the average household income was $52,250. Thus, even allocating 100% of a family’s annual earnings to pay for a drug wouldn’t stretch far enough to cover it in 2013, nor would it do so today in 2015. This sober health economic artifact comes from the latest Rx Price Watch Report from the AARP, detailing cost trends for prescription drugs across all segments — generics, brands and specialty drugs.  Contrast, as well, the $53K for the average specialty drug with the median 2013 Social Security benefit payout of $15,526 and median Medicare

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In 2016 Prescription Drugs Will Be The Fastest-Growing Component of Healthcare Costs

In 2016, prescription drug trend will rise over 11%. In contrast, medical trend growth for high-deductible health plans is expected to be 8%, hospital services 8.2%, and physician services 5.5%,   according to the 2016 Segal Health Plan Cost Trend Survey released in September 2015. By definition, “trend” is the forecast of per capita health insurance claims cost increases that incorporate many factors include price inflation, utilization, government-mandated benefits, and new therapies and technologies. Consider the upper right portion of the infographic which illustrates Segal’s data: the 3 “capsule” diagrams show that specialty drug trend is anticipated to be 18.9% in

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A Company’s Healthy Bottom Line Requires Healthy Employees

“What is the meaning of health to our businesses?” asked Dr. Thomas Parry of the Integrated Benefits Institute (IBI) at a dinner last night, convened by the Pittsburgh Business Group on Health on the eve of the organization’s annual meeting being held today in Steel City. I was fortunate to attend the dinner and hear Dr. Parry speak; I will be addressing the meeting today on the topic, “Building a Better Health Consumer.” The IBI is researching the direct link between the top line of a healthy employee base and healthy workers’ impacts on the bottom line. A report will be

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How value will impact the business of pharma

The top 25 life science companies grew a paltry 1% in 2014, and 70% of recent brand launches underperformed analysts’ expectations. The introductory page of a new report from KPMG describes, in a single sentence, the very challenging market environment for bio/life sciences: “The pharmaceutical industry is caught between a blockbuster-driven past and a future comprising precision medicine, curative therapies, and payment for outcomes. The years of consistent double-digit growth and unconstrained pricing power are fading into memory.” The assertively titled, “Change in pharma? Not optional,” offers 10 “integrated imperatives” for the pharma industry to follow to best respond to

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Medicare Makes the Case for Outcomes, As Increasing Costs Loom

Health costs in America will grow faster (again), and health outcomes have improved in the past decade. This week, two of the most important health journals feature health economics data and analyses that paint the current landscape of the U.S. health care system – the good, the warts, and the potential. Health Affairs provides the big economic story played out by the forecasts of the Centers for Medicare and Medicaid Services (CMS) in National Health Expenditure Projections, 2014-24: Spending Growth Faster Than Recent Trends. The topline of the forecast is that health spending growth in the U.S. will annually average

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What the SCOTUS ACA ruling means for health consumers

Now that the Affordable Care Act is settled, in the eyes of the U.S. Supreme Court, what does the 6-3 ruling mean for health/care consumers living in America? I wrote the response to that question on the site of Intuit’s American Tax & Financial Center here. The top-line is that people living in Michigan, where the Federal government is running the health insurance exchange for Michiganders, and people living in New York, where the state is running the exchange, are considered equal under the ACA’s health insurance premium subsidies: health plan shoppers, whether resident New Yorkers or Michiganders, can qualify for

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Most Americans say drug prices are unreasonable and blame company profits

Three-quarters of U.S. adults say the cost of prescription drugs are unreasonable, and blame high medication prices set by profitable pharmaceutical companies according to the Kaiser Family Foundation Health Tracking Poll for June 2015. Profits made by drug companies are the #1 reason Americans cite among major factors that contribute to the price of prescription drugs (among 77% of people), followed by the cost of medical research (64%), the cost of marketing and advertising (54%), and the cost of lawsuits (49%). Regardless of the cost, 71% of people say that health insurance should “always” pay for high-cost drugs. At the same

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The 3 tectonic forces shaping patients – it’s BIO week

Patients in the U.S. are transforming into health care consumers, and in 2015 there are 3 underlying forces shaping that new consumer. This week kicks off the annual BIO conference in Philadelphia, and today Klick Health, the digital communications firm, convenes a group of thought leaders in healthcare to brainstorm markets, financing, and the state of pharmaceutical and life science innovation. An underlying theme throughout this meet-up is patient’s role in health/care. Patients are people, consumers, caregivers, mothers, fathers, sisters, brothers, friends, neighbors, community members, taxpayers, all. We’re old, we’re young, we’re mobile and not-so-much, we’re amputees, we’re migraneurs, we’re cancer

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It’s still the prices, stupid – health care costs drive consumerism

“It’s the prices, stupid,” wrote Uwe Reinhardt, Gerald F. Anderson and colleagues in the May 2003 issue of Health Affairs. Exactly twelve years later, three reports out in the first week of June 2015 illustrate that salient observation that is central to the U.S. healthcare macroeconomy. Avalere reports that spending on prescription drugs increased over 13% in 2014, with half of the growth attributable to new product launches over the past two years. Spending on pharmaceuticals has grown to 13% of overall health spending, and the growth of that spending between 2013-14 was the fastest since 2001. In light of

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Employers go beyond physical health in 2015, adding financial and stress management

Workplace well-being programs are going beyond physical wellness, incorporating personal stress management and financial management. Nearly one-half of employers offer these programs in 2015. Another one-third will offer stress management in the next one to three years, and another one-fourth will offer financial management to workers, according to Virgin Pulse’s 2015 survey of workplace health priorities, The Busness of Healthy Employees. The survey was published June 1st 2015, kicking off Employee Wellbeing Month, which uses the Twitter hashtag #EWM15. It takes a village to bolster population health and wellness, so Virgin Pulse is collaborating with several partners in this effort

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How Growing Income Inequality Hurts Everyone, and Especially Our Health

Income inequality has increased in most developed countries, and especially in the U.S., according to the OECD’s report, In It Together: Why Less Inequality Benefits All, published in May 2015. The red arrow in the first chart shows where the U.S. ranks versus other developed nations in income inequality, which is defined as the wealth gap between rich and poor people. The U.S. has the greatest income inequality in the developed world. The second chart shows data for the U.S. on benefits provided to low-wage workers (the bottom 25% of wage earners) versus high-wage workers (the top 25% of earners).

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Health care costs for a family of four in the U.S. reach $24,671 in 2015

The cost of a PPO for a family of four in America hits $24,671 in 2015, growing 6.3% over 2014’s cost. The growth in health care costs will be driven by high specialty prescription drug costs. The 6.3% growth rate in health costs is a stark increase compared with the twelve month April 2014-March 2015 decline in the Consumer Price Index of -0.1%. Welcome to the 2015 Milliman Medical Index, subtitled “Will the typical American family of four be driving a ‘Cadillac plan’ by 2018?” The MMI gauges the average cost of an employer-sponsored preferred provider organization (PPO) health plan and includes all

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Supersize Rx: the impact of specialty drug spending and Hep C in 2014

The number of people in the U.S. spending over $100,000 a year on prescription drugs tripled in 2014, according to Super Spending: U.S. Trends in High-Cost Medication Use, from The Express Scripts Lab. Express Scripts is a pharmacy benefits management company that manages over one billion prescriptions a year. The company analyzed prescription drug claims for 31.5 million health plan members for this study, in commercially insured, Medicare, and Medicaid plans. The big-dollar story in 2014 was Hepatitis C, with a relatively small patient population but a super-sized drug spend as the first chart shows: a very tall blue bar (Rx

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Consumers seek retail convenience in healthcare financing and payment

Health care consumers face a fragmented and complicated payment landscape after receiving services from hospitals and doctors, and paying for insurance coverage. People want to “view their bills, make a few clicks, pay…and be done,” according to Jamie Kresberg, product manager at Citi Retail Services, a unit of Citibank. He’s quoted in Money Matters: Billing and payment for a New Health Economy from PwC’s Health Research Institute. The healthcare service segment most consumers are satisfied with when it comes to billing and payment is pharmacies, who score well on convenience, affordability, reliability, and seamless transactions – with only transparency being

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The Consumer in the New Health Economy: Out-of-Pocket

The costs of healthcare in the U.S. have trended upward since 2000, with a slowdown in cost growth between 2009 to 2013 due to the impact of the Great Recession. That’s no surprise. What stands out in the new U.S. News & World Report Health Care Index is that people covered by private health insurance through employers are bearing more health care costs while publicly-covered insureds (in Medicare and Medicaid) are not. Blame it on the fast-growth of high-deductible health plans, the Index finds, resulting in what U.S. News coins as a “massive increase in consumer cost.” U.S. News &

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Capital investments in health IT moving healthcare closer to people

In recent weeks, an enormous amount of money has been raised by organizations using information technology to move health/care to people where they live, work, and play… This prompted one questioner at the recent ANIA annual conference to ask me after my keynote speech on the new health economy, “Is the hospital going the way of the dinosaur?” Before we get to the issue of possible extinction of inpatient care, let’s start with the big picture on digital health investment for the first quarter of 2015. Some $429 mm was raised for digital health in the first quarter of 2015,

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No relief for consumers’ healthcare costs

U.S. consumers are spending $1 in every $5 dollars in the household on health care, and personal cost curves aren’t going to bend down anytime soon. Three surveys published in April confirm my financially unwell forecast for American health citizens. Kaiser Family Foundation’s April 2015 Health Tracking Poll finds most people say health care costs or going up or holding flat, shown in the first diagram from the KFF survey. U.S. adults told KFF the top health care priorities for the President and Congress should focus on health costs, such as: Making sure high-cost drugs for chronic conditions, such as HIV,

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Health is where we live, work, and shop…at Walgreens

Alex Gourley, President of The Walgreen Company, addressed the capacity crowd at HIMSS15 in Chicago on 13th April 2015, saying his company’s goal is to “make good health easier.” Remember that HIMSS is the “Health Information and Management Systems Society” — in short, the mammoth health IT conference that this year has attracted over 41,000 health computerfolk from around the world. So what’s a nice pharmacy like you, Walgreens, doing in a Place like McCormick amidst 1,200+ health/tech vendors?  If you believe that health is a product of lifstyle behaviors at least as much as health “care” services (what our

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John Hancock flips the life insurance policy with wellness and data

When you think about life insurance, images of actuaries churning numbers to construct mortality tables may come to mind. Mortality tables show peoples’ life expectancy based on various demographic characteristics. John Hancock is flipping the idea life insurance to shift it a bit in favor of “life” itself. The company is teaming with Vitality, a long-time provider of wellness tools programs, to create insurance products that incorporate discounts for healthy living. The programs also require people to share their data with the companies to quality for the discounts, which the project’s press release says could amount to $25,000 over the

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Consumers trust retailers and techs to manage their health – as much as health provider

40% of U.S. consumers trust Big Retail to manage their health; 39% of U.S. consumers trust healthcare providers to manage their health. What’s wrong with this picture? The first chart shows the neck-and-neck tie in the horse race for consumer trust in personal health management. The Walmart primary care clinic vs. your doctor. The grocery pharmacy vis-a-vis the hospital or chain pharmacy. Costco compared to the chiropractor. Or Apple, Google, Microsoft, Samsung or UnderArmour, because “digitally-enabled companies” are virtually tied with health providers and large retailers as responsible health care managers. Welcome to The Birth of the Healthcare Consumer according

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Transparency in health care: not all consumers want to look

Financial wellness is integral to overall health. And the proliferation of high-deductible health plans for people covered by both public insurance exchanges as well as employer-sponsored commercial (private sector) plans, personal financial angst is a growing fact-of-life, -health, and -healthcare. Ask any hospital Chief Financial Officer or physician practice manager, and s/he will tell you that “revenue cycle management” and patient financial medical literacy are top challenges to the business. For pharma and biotech companies launching new-new specialty drugs (read: “high-cost”), communicating the value of those products to users — clinician prescribers and patients — is Job #1 (or #2,

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The Affordable Care Act As New-Business Creator

While there’s little evidence that the short-term impact of the Affordable Care Act has limited job growth or driven most employers to drop health insurance plans, the ACA has spawned a “cottage industry” of health companies since 2010, according to PwC. As the ACA turned five years of age, the PwC Health Research Institute led by Ceci Connolly identified at least 90 newcos addressing opportunities inspired by the ACA: Supporting telehealth platforms between patients and providers, such as Vivre Health Educating consumers, such as the transparency provider HealthSparq does Streamlining operations to enhance efficiency, the business of Cureate among others

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Value is in the eye of the shopper for health insurance

While shopping is a life sport, and even therapeutic for some, there’s one product that’s not universally attracting shoppers: health insurance. McKinsey’s Center for U.S. Health System Reform studied people who were qualified to go health insurance shopping for plans in 2015, covered by the Affordable Care Act. McKinsey’s consumer research identified six segments of health insurance plan shoppers — and non-shoppers — including 4 cohorts of insured and 2 of uninsured people. The insureds include: Newly-insured people, who didn’t enroll in health plans in 2014 but did so in 2015 Renewers, who purchased health insurance in both 2014 and

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Americans are spending $1 in $5 on health care

People in the U.S. are spending over 20.6% of their income on health care, according to data published by the U.S. Department of Commerce on March 2, 2015. This is up from 15% of personal income in 1990. Note the slope of this curve, moving up the X-Y axes from southwest to northwest. Now note the slope of the curves in the second chart, which illustrates consumer spending on other household goods and services: cars, housing, clothing, education, groceries, and eating outside of the home. Spending on these home budget line items remained relatively flat over the 25 year period 1990-2015,

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Fiscal and physical fitness: TD Bank makes the link

What does a bank have to do with health? Plenty, if you listen to 70% of consumers who say that financial health has a positive impact on physical health. TD Bank released the Fiscal Fitness survey this week, finding that consumers make a direct connection between fiscal and physical fitness. That’s what we here at THINK-Health refer to as financial wellness. TD learned that 80% of consumers made a health resolution in the New Year and 69% of people made a financial resolution 40% of people want to save more and spend less, and 42% want to get healthy and

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Telehealth is in demand, driven by consumer convenience and cost – American Well speaks

Evidence of the rise of retail health grows, with the data point that on-demand health care is in-demand by 2 in 3 U.S. adults. American Well released the Telehealth Index: 2015 Consumer Survey, revealing an American health public keen on video visits with doctors as a viable alternative to visiting the emergency room. Virtual visits are especially attractive to people who have children living at home. [For context, this survey defines “telehealth” as a remote consultation between doctor and patient]. Convenience drives most peoples’ interest in telehealth: saving time and money, not leaving home if feeling unwell, and “avoiding germs

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Health care costs still top financial problems for Americans

“Health care spending grows at lowest-ever rate,” USA Today celebrated in their December 3, 2014 headline. The announcement was drawn from national health spending data gleaned from an annual report from the Centers for Medicare and Medicare Services (CMS), which tallied U.S. health spending at $2.9 trillion. From the bird’s-eye view, slowing healthcare cost growth is indeed good news. But from the point-of-view of consumers’ own pockets, health care costs are rising. And, a survey published today by Gallup points to this reality: that people in American say the most important financial problem they face is healthcare costs, tied for first place

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People in consumer-directed health plans are — surprise! — getting more consumer-directed

People with more financial skin in the health care game are more likely to act more cost-consciously, according to the latest Employee Benefits Research Institute (EBRI) poll on health engagement, Findings from the 2014 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey published in December 2014. Health benefit consultants introduced consumer-directed health plans, assuming that health plan members would instantly morph in to health care consumers, seeking out information about health services and self-advocating for right-priced and right-sized health services. However, this wasn’t the case in the early era of CDHPs. Information about the cost and quality of health care services was scant,

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The Internet of Healthy Me – putting digital health in context for #CES2015

Men are from Mars and Women, Venus, when it comes to managing health and using digital tools and apps, based on a poll conducted by A&D Medical, who will be one of several hundred healthcare companies exhibiting at the 2015 Consumer Electronics Show this week in Las Vegas. Digital health, connected homes and cars, and the Internet of Things (IoT) will prominently feature at the 2015 Consumer Electronics Show in Las Vegas this week. I’ll be attending this mega-conference, meeting up with digital health companies and platform providers that will enable the Internet of Healthy “Me” — consumers’ ability to self-track,

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Trend-weaving the 2015 health care trends

‘Tis the season for annual health trendcasting, which is part of my own business model. Here’s a curated list of some of my favorite trend reports for health care in the new year, with my Hot Points in the conclusion, below, summarizing the most salient trends among them. TechCrunch’s Top 5 Healthcare Predictions for 2015: In this succinct forecast, Walmart grows its presence as a health plan, startups get more pharm-funding, hospitals channel peer-to-peer lending, Latinos emerge as a “most-desired” health care segment, and Amazon disrupts the medical supply chain. Experian 2015 Data Breach Forecast: Healthcare security breaches will be

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Health IT Forecast for 2015 – Consumers Pushing for Healthcare Transformation

Doctors and hospitals live and work in a parallel universe than the consumers, patients and caregivers they serve, a prominent Chief Medical Information Officer told me last week. In one world, clinicians and health care providers continue to implement the electronic health records systems they’ve adopted over the past several years, respond to financial incentives for Meaningful Use, and re-engineering workflows to manage the business of healthcare under constrained reimbursement (read: lower payments from payors). In the other world, illustrated here by the graphic artist Sean Kane for the American Academy of Family Practice, people — patients, healthy consumers, newly insured folks,

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Health care costs, access and Ebola – what’s on health care consumers’ minds

The top 3 urgent health problems facing the U.S. are closely tied for first place: affordable health care/health costs, access to health care, and the Ebola virus. While the first two issues ranked #1 and #2 one year ago, Ebola didn’t even register on the list of healthcare stresses in November 2013. Gallup polled U.S. adults on the biggest health issues facing Americans in early November 2014, and 1 in 6 people named Ebola as the nation’s top health problem, ahead of obesity, cancer, as well as health costs and insurance coverage. Gallup points out that at the time of

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Live from the 11th annual Connected Health Symposium – Keeping Telehealth Real

Dr. Joseph Kvedar has led the Center for Connected Health for as long as I’ve used the word “telehealth” in my work – over 20 years. After two decades, the Center and other pioneers in connected health have evidence proving the benefits, ROI (“hard” in terms of dollars, and “soft” in terms of patient and physician satisfaction), and technology efficacy for connecting health. The 11th Annual Connected Health Symposium is taking place as I write this post at the Seaport Hotel in Boston, bringing health providers, payers, plans and researchers together to share best practices, learnings and evidence supporting the

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Rationing health care, driven by high deductibles

Concerns about Death Panels and government restricting health services for people that have been key arguments used against the Affordable Care Act’s (ACA) detractors and, even before the advent of the ACA, proposed health reforms under President Clinton. But it’s peoples’ self-rationing in the U.S. health system that’s causing true rationing — driven by high deductible health plans (HDHPs) that are fast-growing in the health insurance market, and by the high cost of specialty drugs and prescriptions. There are plenty of data demonstrating the consumer health rationing trend being collected and reviewed by think tanks like RAND here, and by The

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Health care as a retail business

The health care industry is undergoing a retail transformation, according to Retail Reigns in Health Care: The rise of consumer power and its organization & workforce implications from Deloitte. Deloitte’s report published in October 2014 focuses on the health insurance business, which is newly-dealing with uninsured people largely unfamiliar with how to evaluate health plan options. This by any definition requires new muscles for both buyers and sellers on a health insurance exchange: new product access + uninformed consumer = retail challenge. Deloitte notes another supply and demand challenge, and that’s with the health insurance company workforce: while 93% of health

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Health and financial well-being are strongly linked, CIGNA asks and answers

The modern view on wellness is “having it all” in terms of driving physical, emotional, mental and financial health across one’s life, according to CIGNA’s survey report, Health & Financial Well-Being: How Strong Is the Link?  The key elements of whole health, as people define them are: – Absence of sickness, 37% – Feeling of happiness, 32% – Stable mental health, 32% – Management of chronic disease, 15% – Financial health, 14% – Living my dreams, 9%. 1 in 2 people (49%) agree that health and wellness comprise “all of these” elements, listed above. This holistic view of health is

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Specialty pharmaceuticals’ costs in the health economic bulls-eye

This past weekend, 60 Minutes’ Leslie Stahl asked John Castellani, the president of PhRMA, the pharmaceutical industry’s advocacy (lobby) organization, why the cost of Gleevec, from Novartis, dramatically increased over the 13 years it’s been in the market, while other more expensive competitors have been launched in the period. (Here is the FDA’s announcement of the Gleevec approval from 2001). Mr. Castellani said he couldn’t respond to specific drug company’s pricing strategies, but in general, these products are “worth it.” Here is the entire transcript of the 60 Minutes’ piece. Today, Health Affairs, the policy journal, is hosting a discussion

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$1 in $5 will go to health care in 2023 – the new health engagement is health cost engagement

National health spending will comprise 19.3% of U.S. gross domestic product in 2023, nearly $1 in $5 of all American spending. This statistic includes the expenditure categories for health spending as defined by the Centers for Medicare and Medicaid Services (CMS), Office of the Actuary. The number includes hospital care, personal health care, professional services (physicians and other professionals), home health, long term care, retail sales of prescription drugs and durable medical equipment, and investment in capital equipment, among other line items. The forecast was published in Health Affairs article, National Health Expenditure Projections, 2013-23: Faster Growth Expected With Expanded

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NephCure – a rare disease community that’s patient-powered

The burden of chronic kidney disease (CKD) is growing, with one in 10 U.S. adults having some level of CKD.  End-stage renal disease (ESRD) is the last phase of CKD, when dialysis or an organ transplant are required. Nephrotic syndrome is one of the most common forms of CKD, and focal segmental glomerulosclerosis — FSGS — is the fastest-growing cause of nephrotic syndrome in children, and the second-leading cause of kidney failure in children. I spoke with Gigi Peterkin, a longtime colleague of mine who has helped guide my own digital footprint in health. Gigi is Global Director of Marketing at

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Understanding the patient journey – using real-world data

It’s de rigueur for any organization marketing a product or service in health care to be “patient-centered” these days. “Patient engagement” and “health engagement” are phrases found on health conference agendas, whether pitching to attendees in pharma and life sciences, health IT, health insurance, or healthcare (to hospitals and physicians, alike). One paradigm for patient-centricity that’s more mature than most is IMS Health’s Patient Journey construct, which the data-driven company has been talking about since 2012. While the concept focused mainly on pharmaceutical marketing and medication adherence, it’s useful for all industry segments looking to motivate behavior change in health

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Health economics in the exam room: doctors and patients discussing the costs of health care

A new conversation has begun between doctors and patients: talking about money and health care, and what treatments cost — specifically, what a particular treatment will cost a patient, out-of-pocket. Over a dozen physician professional societies are proponents of these discussions, and are providing support to doctors in their networks. Doctors already engaging in the topic of the cost of care with patients aren’t being altruistic about spending this precious time in the already-time-constrained patient encounter: these discussions are increasingly relevant to physicians’ financial outcomes. I’ll be addressing this new feature in the doctor’s office at the upcoming Point-of-Care conference,

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Employers engaging in health engagement

Expecting health care cost increases of 5% in 2015, employers in the U.S. will focus on several tactics to control costs: greater offerings of consumer-directed health plans, increasing employee cost-sharing, narrowing provider networks, and serving up wellness and disease management programs. The National Business Group on Health’s Large Employers’ 2015 Health Plan Design Survey finds employers committed to health engagement in 2015 as a key strategy for health benefits. More granularly, addressing weight management, smoking cessation, physical activity, and stress reduction, will be top priorities, shown in the first chart. An underpinning of engagement is health care consumerism — which

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Blurred lines: health, pharmacy, food and care

In the past few weeks, several events bolster the reality that health and health care are in Blurred Lines mode. Not Robin Thicke Blurred Lines, mind you, but the Venn Diagram overlapping kind. Walmart launched real primary care clinics in South Carolina and Texas. These will provide services beyond urgent care, charging $4 a visit for company employees and $40 a visit for other people The U.S. Department of Agriculture issued a report promoting “nudges” to grocery shoppers enrolled in the Supplemental Nutrition Access Program (SNAP) to buy healthy foods Apple is talking with Cleveland Clinic, Johnson Hopkins, and Mount Sinai Medical

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Novel concept: people + health pricing information = market competition

In the post-Recession American economy, people shop for value in all things. And that includes health care services like MRIs — when patients are informed of pricing differences among imaging facilities and given free rein to pick-and-choose among them. In addition to lowering imaging costs in a community, price transparency also generated competition between providers. Health Affairs published this research detailed in Price Transparency for MRIs Increased Use of Less Costly Providers And Triggered Provider Competition in August 2014. An Economics 101 course teaches us that a well-oiled (perfect) market depends on lots of sellers of a product and lots of

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Consumer healthcare spending is up, and “fun spending” is down

This is the summer of big spending leaps for groceries, gas and health care. Here’s hoping that food, energy and visits to doctors make us happy, because we won’t be getting much joy from travel, dining out, leisure activities, or consumer electronics purchases, all of which are declining in terms of consumer spending. The Gallup survey published July 12, 2014, finds that 59% of people are spending more on groceries, 58% on gas/fuel, and 42% on health care. Net spending on each of those spending categories increased 49%, 46%, and 34% respectively this week compared with one year ago. Personal

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The Milliman Medical Index at $23,215: A Toyota Prius, a tonne of tin, or health insurance for a family?

It costs $23,215 to cover a family of four for health care, according to the 2014 Milliman Medical Index (MMI), the annual gauge of healthcare costs from the actuarial firm. The growth rate of 5.4% from 2013 is the lowest annual change since Milliman launched the Index in 2002. This is equivalent to a new Toyota Prius or a tonne of tin. While employers cover most of these costs, the portion employees bear continues to increase. This year, insured workers will take on 42% of the total, or on average, $9,695. This is up by $552 over 2013, or 6%

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We are all self-insured until we get sick – especially if we are women

During my conversation with a prominent pharma industry analyst yesterday, he observed, “As a consumer, you are self-insured until you get sick.” My brain then flashed back to a graph from the 2013 Employer Health Benefits Survey conducted annually by the Kaiser Family Foundation (KFF). The chart is shown here. It illustrates the upward line indicating that in 2013, 4 in 5 workers were enrolled in a health plan that included an annual deductible. That’s the “self-insurance” part of the observation my astute conversationalist noted. Simply put, when you are enrolled in a high-deductible health plan, You, The Consumer, are responsible for

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The Season of Healthcare Transparency – Chaos, then Creation, Part 5

The consumer demand side for healthcare transparency is hungry for the light to shine on health care costs, quality and information that’s relevant and meaningful to the individual. The supply side is fast-growing, with websites and portals, government-sponsored projects, commercial-driven start-ups, and numerous mobile apps. These tools endeavor to: Help people find and access services Schedule appointments Compare peer consumers’ reviews for those providers Calculate and prepare for out-of-pocket co-payments deriving from their health plan Negotiate prices with providers Pay for the services, and Reconcile the payment with a high-deductible health plan or health savings account. On the demand side, consumers

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The Season of Healthcare Transparency – Consumer Payments and Tools, Part 4

“The surge in HDHP enrollment is causing patients to become consumers of healthcare,” begins a report documenting the rise of patients making more payments to health providers. Patients’ payments to providers have increased 72% since 2011. And, 78% of providers mail paper statements to patients to collect what they’re owed. “HDHPs” are high-deductible health plans, the growing thing in health insurance for consumers now faced with paying for health care first out-of-pocket before their health plan coverage kicks in. And those health consumers’ expectations for convenience in payment methods is causing dissatisfaction, negatively affecting these individuals and their health providers’

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The Season of Healthcare Transparency – Will Your Health Plan Be Your Transparency Partner? – Part 3

Three U.S. health plans cover about 100 million people. Today, those three market-dominant health plans — Aetna, Humana and UnitedHealthcare — announced that they will post health care prices on a website in early 2015. Could this be the tipping point for health care transparency so long overdue? These 3 plans are ranked #1, #4 and #5 in terms of market shares in U.S. health insurance. Together, they will share price data with the Health Care Cost Institute (HCCI), a not-for-profit organization dedicated to research on U.S. health spending. An important part of the backstory is that the HCCI was

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The Season of Healthcare Transparency – Shopping in a World of High Cost and High Variability – Part 2

Yesterday kicked off this week in Health Populi, focusing on the growing role of transparency in health care in America. Today’s post discusses the results from Change Healthcare’s latest Healthcare Transparency Index report, based on data from the fourth quarter of 2013, published in May 2014. Charges for health services — dental, medical and pharmacy – varied by more than 300% in Q42013 — even within a single health network. Change Healthcare found this, based on their national data on 7 million health-covered lives. The company analyzed over 180 million medical claims. The company built the Healthcare Transparency Index (HCTI)

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The Season of Healthcare Transparency – HFMA’s Price Transparency Manifesto – Part 1

As Big Payors continue to shift more costs onto health consumers in the U.S., the importance of and need for transparency grows. 39% of large employers offered consumer-directed health plans (CDHPs) in 2013, and by 2016, 64% of large employers plan to offer CDHPs.  These plans require members to pay first-dollar, out-of-pocket, to reach the agreed deductible, and at the same time manage a health savings account (HSA). In the past several weeks, many reports have published on the subject and several tools to promote consumer engagement in health finance have made announcements. This week of posts provides an update on

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Health costs in retirement: the standard of living

On their list of top financial worries, 1 in 2 Americans is most concerned about not having enough money for retirement, not being able to pay medical costs if they get sick, and not being able to maintain a desired standard of living. Gallup’s annual Economy and Personal Finance poll, conducted in early April 2014, finds that even in the wake of a healthier economy, people feel health-finance insecure. While ability to pay medical bills ranked #2 on the list of 9 fiscal worries, the proportion of Americans with this concern fell from a high of 62% in 2012 to

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Doctors become health economists

The rising costs of health care in America, and consumers’ growing cost burdens, has many impacts on the U.S. health ecosystem. In particular, patients have been self-rationing due to costs, without necessarily paying attention to quality or medical outcomes. Doctors have begun to pay more attention to costs and their impacts on patients in their practices, addressed in today’s New York Times article, Treatment costs could influence doctors’ advice to patients. Andrew Pollack writes in the Times about the morphing role of doctors, some of whom are taking on the mantle of being a “steward of society,” as characterized by

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The New Chief Patient Officer

There’s a new member in the C-suite in health care, and her name is the Chief Patient Officer (CPO). That new role in health-town is filled by Dr. Anne Beal, appointed by Sanofi, the global biopharma company, to fill this new job description. Here she is, shaking hands with Colin Powell in one of the many awards ceremonies where Dr. Beal’s work in public health has been lauded. But what is a CPO? Because it’s a new job, Dr. Beal can create the role, at least within the environment and mission of Sanofi and the larger life sciences world. Some

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FICO scores for health – chatting with a #BigData pioneer

I had the pleasure of spending quality time brainstorming with Mikki Nasch, co-founder of AchieveMint, yesterday. Mikki worked on the early days of building the FICO score with Fair Isaac, so has been involved in Big Data well before it became the well-#hashtagged buzzword it is today. In our conversation, we talked about the history of FICO and how it took about a decade for consumers to understand it, accept it, and use it as a tool for bettering their credit ratings. When a FICO score was below an acceptable threshold to a lender – say, for a new car

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People want to DIY with pharma

In our increasingly-DIY society, most consumers expect high levels of access and customer service from the organizations with whom we engage. With more consumers reaching into their pockets to pay for health services and products, the health industry is increasingly a retail-facing environment. So expect quality service levels from their healthcare touch points. The pharmaceutical and prescription drug touch point is not exempt from this expectation, as learned by an Accenture survey analyzed in Great Expectations: Why Pharma Companies Can’t Ignore Patient Services. As the first picture shows, 70% of patients think pharma companies are responsible for bundling information and services

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Risk-shift: employers continue to push more risk to employees and families for health costs

With health costs increase increasing at 4.4% in 2014, a slightly higher rate of growth than the 4.1% seen in 2013. While this is lower than the double-digit increases U.S. employers faced in 2001-2004, it’s still twice the rate of general consumer price inflation. That’s what the first graph shows, based on the The 19th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care.  Employers generally want to continue to provide health insurance…for the time being. 92% of companies expect to make changes in health plan provisions in 2014, with 1 in 2 anticipating “significant

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The new retail health: Bertolini of Aetna connects dots between the economy and health consumers

3 in 4 people in America will buy health care at retail with a subsidy within just a few years, according to Mark Bertolini, CEO of Aetna. Bertolini was the first keynote speaker this week at the 2014 HIMSS conference convened in Orlando. Bertolini’s message was grounded in health economics 101 (about which frequent readers of Health Populi are accustomed to hearing). A healthy community drives a healthy local economy, and healthier people are more economically satisfied, Bertolini explained. The message: health care can move from being a cost driver to being an economic engine. But getting to a healthy

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Patients play a starring role at #HIMSS14 – Best In Show

Even before stepping into the Orlando Convention Center on Sunday 23 February 2014, my clairvoyant powers know the forecast of the Best in Show: the growing role of patients in health care, reflected in both the education session at the annual 2014 meeting of HIMSS as well as the product/service mix being proffered on the convention show floor. As a member of HIMSS Connected Patient Committee, I know first-hand the conscious effort and energy that the organization has committed to getting real about patients’-peoples’-caregivers’ central role in health care. The organization was built on providers and technology. When I first

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Health Axioms – inspiring self-care in patients and people

Most people face constraints in following a healthier lifestyle, according to new research from Bain & Company. Stress, time constraints, difficulty changing habits, getting enough sleep, and financial issues all militate against people project managing their health on a daily basis. Enter The Health Axioms, 32 mantras for simplifying healthcare DIY to empower and engage people in self-health. Conceived by health/tech designer Juhan Sonin, who teaches at MIT and is part of the team at Involution Studios, Health Axioms are 32 messages each designed on a 2×3 inch card and packaged as a deck to inspire and support health outside

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Managing cost and utilization are top goals for specialty pharmacy buyers

While the prescription drug bill makes up about 10% of U.S. national health spending, the fastest-growing component of pharmacy spending is specialty medications. These are categorized as “specialty” drugs because they rarely have generic equivalents, and treat serious or life-threatening diseases (such as cancer, MS, and rheumatoid arthritis). They are also “special” because specialty pharmaceuticals average $3,000 per patient per month and can surpass $100,000 a year for certain products. As a result, the top two goals for managing specialty medications among employers are #1, to reduce inappropriate utilization, and #2, to reduce drug acquisition costs, based on a survey

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A CT for $300 or $2,781 – why health price transparency matters

  Charges for medical, pharmacy and dental services can vary by more than 300%. This means that in one place, a procedure that costs $100 can cost $300 for the same treatment in another location or practice, discovered by Change Healthcare in their latest Healthcare Transparency Index 2013 Q3 Report, published in January 2014. The 300% is the average overall across dozens of health services used by the 67,000 plan members Change Healthcare analyzed based on health plan enrollees’ health care utilization in the third quarter of 2013. These health care services include office visits (behavioral health, physical therapy and

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Health costs and wellness: can digital tools bridge the gap? Altarum’s Fall 2013 consumer survey

  More than twice as many people value the opinions of friends and family for health care provider choices than turn to online ratings for doctors’ bedside manner, waiting times, or clinical quality, according to the Altarum Institute Survey of Consumer Health Care Opinions, Fall 2013, released on January 8, 2014. 1 in 3 consumers also looks into the cost and quality of services recommended by nurses, doctors, labs and hospitals before choosing a provider. However, most people (4 in 5) say they are comfortable asking their doctor about how much treatment will cost: 43% are “very comfortable,” and 38% somewhat comfortable,

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3 Things I Know About Health Care in 2014

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

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A certain forecast: health consumers will be more cost-squeezed in 2014 for Rx and insurance

Gird your wallets, U.S. consumers: watch the dollars flow out-of-pocket for prescription drugs in 2014, as predicted by the 2013-2014 Prescription Drug Benefit Cost and Plan Design Report published by the Pharmacy Benefit Management Institute (PBMI) this week. Constraints covering most plan members are: Step therapy Prior authorization (to get approvals to fill high-cost drugs, notably growth hormones, injectables, controlled substances, Retin-A, and medications for sleep disorders, and Compulsory 90 day refills at retail (90-day dispensing for chronic meds). This Report, sponsored by Takeda, is the gold standard of drug benefit trends, having been published since 1995. Average 30-day copayments

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Investing in technology that lowers health costs – the growing role of mobile

At the Venture+ Forum at the 2013 Mobile Health Summit yesterday, Lisa Suennen, Managing Director of Psilos Ventures was asked what she and her venture capital fund look for in choosing new investments for their health care portfolio. She succinctly said, “technologies that lower costs.” With nearly $1 in $5 of the U.S. economy attributable to health spending, Lisa’s got a point. Technology in U.S. health care has been mostly additive and expense-inducing, not reducing: fax machines and printers, for example, continue to proliferate in health care settings as part of “networking,” and once you add a new clinical technology

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Color us stressed – how to deal

Coast-to-coast, stress is the modus vivendi for most Americans: 55% of people feel stressed in every day life, according to a study from Televox. A Stressful Nation: Americans Search for a Healthy Balance paints a picture of a nation of physically inactive people working too hard and playing too little. And far more women feel the stress than men do. 64% of people say they’re stressed during a typical workday. 52% of people see stress negatively impacting their lives. And nearly one-half of people believe they could better manage their stress. As a result, physicians say that Americans are experiencing negative

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There’s fear of health care costs in peoples’ retirement visions

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

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Health, love and saving money in the recession – insights from ING Direct

Americans love their cars, their houses, and their food. Based on a survey by ING Direct, the financial services company, these are the last 3 things we would sacrifice to save money. On the other hand, the most dispensable things for Americans include day care/nannies, cleaning services, education, and gifts. Women would be more likely to sacrifice health and fitness than men in the U.S. The ING survey compares the U.S. with eight other nations including Australia, Austria, Canada, France, Germany, Italy, Spain, and the United Kingdom. Health and fitness appear more highly valued by people in France and Spain;

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Nearly 1 in 2 women delayed health care in the past year due to costs – the economic impact on a woman’s physical, emotional, and fiscal health

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

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