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Fix the ACA, Most Americans Say

  61% of Americans hold negative views of repealing-and-replacing the Affordable Care Act, according to the July 2017 Health Tracking Poll from the Kaiser Family Foundation. This month’s survey focused on Americans’ views on Republican legislative efforts to repeal and replace the Affordable Care Act (ACA). As of the writing of this post, the majority of the Senate rejected the full repeal of the ACA, but the situation is very fluid. Note that this poll was conducted by phone between July 5-10, 2017, among 1,183 U.S. adults ages 18 and older. The column chart here illustrates that the proportion of people

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Costs of Healthcare Top Americans’ Financial Concerns: It’s Financial Health Matters Day

Americans are most worried about healthcare costs among all financial concerns; most people in the U.S. also believe the Federal government should ensure that all people have health coverage. Two polls published in the past week point to the fact that most U.S. health citizens are concerned about health care for themselves and their families, driving a growing proportion of people to favor a single-payer health system. The first line chart illustrates a dramatic trajectory up of the number of American identifying healthcare costs as their #1 financial problem, rising from 10% of people in 2013 to 17% in 2017.

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Americans Say Healthcare is the Nation’s #1 Problem – Tied with Dissatisfaction with Government

Healthcare tops the list of Americans’ concerns, tied with a dissatisfaction for government, this month (May 2017). According to a Gallup poll published 12 May, poor government leadership and healthcare are together the most important problem currently facing the U.S. Immigration, the economy, jobs, and race relations are distance 3rd places in this survey, which was conducted during the first week of May 2017 among 1,011 U.S. adults 18 years and older. The highest percent of Americans citing healthcare as America’s most important problem was 26%, found in August/September 2008 when town hall meetings round the country were protesting healthcare

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Most Physicians Say Patients, Doctors and Hospitals Are All Losers Under Trump

“Overall, Council members express pessimism about the health are landscape in the wake of the Trump administration’s proposed plans, citing no clear winners, only losers: patients, clinicians, and provider organizations.” This is the summary of the Leadership Survey report, Anticipating the Trump Administration’s Impact on Health Care, developed by the New England Journal of Medicine‘s NEJM Group. The first chart illustrates the “biggest healthcare losers” finding, detailed on the bottom three bars of patients, clinicians, and provider organizations. The stakeholders that will fare best under a President Trump healthcare agenda would be drug companies, payers, and employers. The biggest loser

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One-Half of Privately-Insured Americans Are Dissatisfied With Healthcare Costs

A plurality of Americans, 4 in 10, are dissatisfied with the healthcare costs they face. The level of dissatisfaction varies by a consumer’s type of health insurance, while overall, 42% of people are dissatisfied with costs… 48% of privately insured people are dissatisfied with thei healthcare costs 29% of people on Medicare or Medicaid are dissatisfied 62% of uninsured people are dissatisfied. Gallup has polled Americans on this question since 2014 every November. Dissatisfaction with healthcare costs is up from 38% from the period 2011-2013. As the line chart illustrates, the current levels of cost-dissatisfaction are similar to those felt

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Building the Primary Care Dream Team

“Today’s primary care won’t work tomorrow,” given the shortage of primary care providers (PCPs) and the need to do more in healthcare with fewer resources in the emerging value-based economy. So let’s re-imagine primary care models, PwC asserts, and makes the case in their report, ROI for primary care: Building the dream team. What’s the financial impact of this dream team on healthcare providers? It’s potentially $1.2 million in savings for every 10,000 patients served, PwC calculates. Historically, physicians have been loath to share their work with non-physicians because of how doctors have been paid — on the basis of fee-for-service,

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Aging America Is Driving Growth in Federal Healthcare Spending

Federal healthcare program costs are the largest component of mandatory spending in the U.S. budget, according to An Update to the Budget and Economic Outlook: 2016 to 2026 from the U.S. Congressional Budget Office (CBO). Federal spending for healthcare will increase $77 billion in 2016, about 8% over 2015, for a total of $1.1 trillion. The CBO believes that number overstates the growth in Medicare and Medicaid because of a one-time payment shift of $22 bn to Medicare (from 2017 back into 2016); adjusting for this, CBO sees Federal healthcare spending growing 6% (about $55 bn) this year. The driver

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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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Health Care Reform: President Obama Pens Progress in JAMA

“Take Governor John Kasich’s explanation for expanding Medicaid: ‘For those that live in the shadows of life, those who are the least among us, I will not accept the fact that the most vulnerable in our state should be ignored. We can help them.’” So quotes President Barack Obama in the Journal of the American Medical Association, JAMA, in today’s online issue. #POTUS penned, United States Health Care Reform: Progress to Date and Next Steps. The author is named as “Barack Obama, JD,” a nod to the President’s legal credentials. Governor Kasich, a Republican, was one of 31 Governors who

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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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More chronically ill people use online health resources – but they’re not so social, Pew finds

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

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10 Reasons Why ObamaCare is Good for US

When Secretary Sebelius calls, I listen. It’s a sort of “Help Wanted” ad from the Secretary of Health and Human Services Kathleen Sebelius that prompted me to write this post. The Secretary called for female bloggers to talk about the benefits of The Affordable Care Act last week when she spoke in Chicago at the BlogHer conference. Secretary Sebelius’s request was discussed in this story from the Associated Press published July 25, 2013. “I bet you more people could tell you the name of the new prince of England than could tell you that the health market opens October 1st,” the

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Urgent care centers: if we build them, will all patients come?

Urgent care centers are growing across the United States in response to emergency rooms that are standing-room-only for many patients trying to access them. But can urgent care centers play a cost-effective, high quality part in stemming health care costs and inappropriate use of ERs for primary care. That’s a question asked and answered by The Surge in Urgent Care Centers: Emergency Department Alternative or Costly Convenience? from the Center for Studying Health System Change by Tracy Yee  et. al. The Research Brief defines urgent care centers (UCCs) as sites that provide care on a walk-in basis, typically during regular

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1 in 5 US consumers asks a doctor for a lower-cost Rx

  With U.S. health consumers spending $45 billion out-of-pocket for prescription drugs in 2011, pharmaceutical products are morphing into retail health products. As such, as they do with any other consumer good, consumers can vote with their feet by walking away from a product purchase or making the spend based on the price of the product and its attributes, along with whether there are substitutes available in the marketplace. When it comes to prescription drugs, it’s not as clear-cut, according to the Centers for Disease Control‘s analysis of data from the 2011 National Health Interview Survey titled Strategies Used by

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The Not-So-Affordable Care Act? Cost-squeezed Americans still confused and need to know more

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

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Bill Clinton’s public health, cost-bending message thrills health IT folks at HIMSS

In 2010, the folks who supported health care reform were massacred by the polls, Bill Clinton told a rapt audience of thousands at HIMSS13 yesterday. In 2012, the folks who were against health care reform were similarly rejected. President Clinton gave the keynote speech at the annual HIMSS conference on March 6, 2013, and by the spillover, standing-room-only crowd in the largest hall at the New Orleans Convention Center, Clinton was a rock star. Proof: with still nearly an hour to go before his 1 pm speech, the auditorium was already full with only a few seats left in the

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Butter over guns in the minds of Americans when it comes to deficit cutting

Americans have a clear message for the 113th Congress: I want my MTV, but I want my Medicare, Medicaid, Social Security,   health insurance subsidies, and public schools. These budget-saving priorities are detailed in The Public’s Health Care Agenda for the 113th Congress, conducted by the Kaiser Family Foundation, Robert Wood Johnson Foundation, and the Harvard School of Public Health, published in January 2013. The poll found that a majority of Americans placed creating health insurance exchanges/marketplaces at top priority, compared with other health priorities at the state level. More people support rather than oppose Medicaid expansion, heavily weighted toward 75%

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Improving health care through Big Data: a meeting of the minds at SAS

Some 500 data analytics gurus representing the health care ecosystem including hospitals, physician practices, life science companies, academia and consulting came together on the lush campus of SAS in Cary, North Carolina, this week to discuss how Big Data could solve health care’s Triple Aim, as coined by keynote speaker Dr. Donald Berwick: improve the care experience, improve health outcomes, and reduce costs. Before Dr. Berwick, appointed as President Obama’s first head of the Centers for Medicare & Medicaid Services, Clayton Christensen of the Harvard Business School, godfather of the theory of disruptive innovation in business, spokee about his journey

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Wellness Ignited! Edelman panel talks about how to build a health culture in the U.S.

Dr. Andrew Weil, the iconic guru of all-things-health, was joined by a panel of health stakeholders at this morning’s Edelman salon discussing Wellness Ignited – Now and Next. Representatives from the American Heart Association, Columbia University, Walgreens, Google, Harvard Business School, and urban media mavens Quincy Jones III and Shawn Ullman, who lead Feel Rich, a health media organization, were joined by Nancy Turett, Edelman’s Chief Strategist of Health & Society, in the mix. Each participant offered a statement about what they do related to health and wellness, encapsulating a trend identified by Jennifer Pfahler, EVP of Edelman. Trend 1: Integrative

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The self-care economy: OTC medicines in the U.S. deliver value to the health system

U.S. health consumers’ purchase and use of over-the-counter medicines (OTCs) generate $102 billion worth of value to the health system every year. Half of this value accrues to employers who sponsor health insurance for their workforce; 25% goes to government payers (e.g., Medicare, Medicaid); and, 25% returns to self-insured and uninsured people. For every $1 spent on OTCs, $6.50 is saved by the U.S. health system, shown by the chart. For millions of health consumers, OTCs substitute for a visit to a doctor’s office: most cost-savings generated by OTC use are in saved costs of not visiting a clinician, as discussed

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Addressing chronic illness can help cure the U.S. budget deficit

Chronic illness represents $3 of every $4 of annual health spending in the U.S. That’s about $1.5 trillion. Living Well With Chronic Illness, a report from The Institute of Medicine (IOM), issues a “call for public health action” to address chronic illness through: – Adopting evidence-based interventions for disease prevention – Developing new public policies to promote better living with chronic disease – Building a comprehensive surveillance system that integrates quality of life measures, and – Enhancing collaboration among health ecosystem stakeholders: health care, health, and community non-healthcare services. The IOM recognizes the social determinants that shape peoples’ health status

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Hey, Big Spender: 1% of US health citizens consume 20% of costs

Cue up the song “Hey Big Spender” from the Broadway hit, Sweet Charity, when you read the January 2012 AHRQ report with the long-winded title, The Concentration and Persistence in the Level of Health Expenditures over Time: Estimates for the U.S. Population, 2008-2009.” The report’s headline is that 1% of the U.S. population consumed 20% of all health costs spent in the U.S. in 2008 and 2009, illustrated by the chart. These Big Health Spenders tend to be in poor or fair health, older, female, non-Hispanic whites and people with only publicly-provided health insurance. Their mean expenditure was $90,061. The top 10%

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Health insurance: employers still in the game, but what about patient health engagement?

U.S. employers’ health insurance-response to the nation’s economic downturn has been to shift health costs to employees. This has been especially true in smaller companies that pay lower wages. As employers look to the implementation of health reform in 2014, their responses will be based on local labor market and economic conditions. Thus, it’s important to understand the nuances of the paradigm, “all health care is local,” taking a page from Tip O’Neill’s old saw, “all politics is local.” The Center for Studying Health System Change (HSC) visited 12 communities to learn more about their local health systems and economies, publishing their

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Where have all the doctors gone? What physician supply means for health reform

The good news that was packaged in the Patient Protection and Affordable Care Act (PPACA), that is, health reform, was that millions of uninsured Americans would receive health insurance coverage through the Medicaid program. But insurance doesn’t equal access; there’s a limiting factor that’s a formidable obstacle in many of these millions of newly-insured people getting care: the physician supply in the U.S., which varies from region to region of the U.S. There’s both a quantitative aspect to this challenge along with a qualitative one. The U.S. has long had a maldistribution of physicians in both urban cores and rural towns; that’s the quantitative challenge.

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What health care IT holds for 2011: politics vs. market realities

The one issue in health politics that’s got bipartisan support is health care IT. While Republicans in the House may try to pick away parts of the Affordable Care Act, the HITECH Act — part of the 2009 stimulus package formally known as the American Recovery and Reinvestment Act — will stay intact, according to most industry analysts (including me). However, political agreement doesn’t equal market adoption. So forecasting what 2011 will mean for health information technology requires some deeper analysis of additional issues. For today’s Health Populi, take a look at my annual health IT forecast in California HealthCare Foundation‘s

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Medicaid, the new-new health plan – is it ready for prime-time?

“The impending Medicaid expansion will be the single biggest change in the program since its inception in 1965,” according to an analysis in the New England Journal of Medicine dated November 24, 2010. The Patient Protection and Affordable Care Act (PPACA, or ACA for short) will newly-insure 32 million Americans through dual strategies of (1) mandating uninsured people to buy into a health plan, via subsidies and health insurance exchanges; and, (2) expanding Medicaid to cover uninsured people with lower incomes. The CBO estimates that each of these tactics will add 16 million, for the total of 32 million people entering insurance plans

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