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See Me, Feel Me, Touch Me, Heal Me – What The Who’s Tommy Can Teach Healthcare

“See me, feel me, touch me, heal me,” is the lyrical refrain from The Who’s Tommy. These eight words summarize what Deloitte has learned from the firm’s latest look into healthcare consumers, published in the report, Health plans: What matters most to the health care consumer. U.S. consumers’ demands for health care are for: Personalization from doctors, hospitals, and other care providers — the most important priority; Economically rational coverage and care choices; Convenience-drive access and care experience; and, Digitally connected care. Personalization is Job 1: “Consumers want to be heard, understood, and given clear directions through a personalized health care

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1 in 3 Americans Still Self-Rations Healthcare

People in the U.S. are much more likely to go without health care they need compared with health citizens in 10 other wealthy countries, according to the Commonwealth Fund’s 2016 international survey. One-third of Americans did not seek care due to costs, including going without recommended care, failing to fill a prescription drug, and/or not seeing a doctor when sick. While this self-rationing proportion of Americans dropped from 37% in 2013, the U.S. still ranks #1 in foregoing necessary healthcare due to cost. “In comparison to adults in the other 10 countries, adult sin the U.S. are sicker and more

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The Patient Is The Best Sensor – Consumers At the Center of Health

“The patient is the best sensor,” asserted Jamie Heywood, founder of Patients Like Me, during the perennial meeting sponsored by PwC, the 180° Health Forum. This event featured several panels of PwC’s curated group of so-called “provocateurs” in healthcare, and I was grateful to be one of nine selected for the event. Heywood joined Dr. Leanna Wen, Baltimore City Health Commissioner, and me in a panel called, “Strange Bedfellows or Soul Mates? The New Dating Game in Health.” The theme of our collective brainstorm was how collaborations across the ecosystem could help make health and healthcare better. The drawing is

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Hospitals Need to Cross the Health Consumer Chasm

Most U.S. hospitals have not put consumerism into action, a new report from KaufmanHall and Caden’s Consulting asserts from the second paragraph. Patient experience is the highest priority, but has the biggest capability gap for hospitals, the report calls out. KaufmanHall surveyed 1,000 hospital and health system executives in 100 organizations to gauge their perspectives on health consumers and the hospital’s business. KaufmanHall points out several barriers for hospitals working to be consumer-centered: Internal/institutional resistance to change Lack of urgency Competing priorities Skepticism Lack of clarity (vis-a-vis strategic plan) Lack of data and analytics. The key areas identified for consumer centricity

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Consumers Feel More Respect from Personal Care and Grocery Brands Than Pharma or Insurance

People feel like get-no-respect Rodney Dangerfield when they deal with health insurance, government agencies, or pharma companies. Consumers feel much more love from personal care and beauty companies, grocery and fitness, according to a brand equity study by a team from C Space, published in Harvard Businss Review. As consumer-directed health care (high deductibles, first-dollar payments out-of-pocket) continues to grow, bridging consumer trust and values will be a critical factor for building consumer market share in the expanding retail health landscape. Nine of the top 10 companies C Space identified with the greatest “customer quotient” are adjacent in some way to health:

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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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How Value and Consumerism Will Reshape the $5 Trillion Healthcare Market

Existing healthcare industry players – the stakeholders of hospitals, physicians, pharma/life sciences, medical device manufacturers, and health plans – are operating in a whirlwind of change. While there are many uncertainties in this period of transition, there’s one operational certainty: learn to do more with less payment. That’s due to the growing pursuit of payors paying for value, not on the basis of volume or what’s “done” to a patient in care delivery. At the same time, another force re-shaping healthcare is interest and focus on wellness and health management. Combined with the growing health economic value proposition, wellness and

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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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Employers Changing Health Care Delivery – Health Reform At Work

Large employers are taking more control over health care costs and quality by pressuring changes to how care is actually delivered, based on the results from the 2017 Health Plan Design Survey sponsored by the National Business Group on Health (NBGH). Health care cost increases will average 5% in 2017 based on planned design changes, according to the top-line of the study. The major cost drivers, illustrated in the wordle, will be specialty pharmacy (discussed in yesterday’s Health Populi), high cost patient claims, specific conditions (such as musculoskeletal/back pain), medical inflation, and inpatient care. To temper these medical trend increases,

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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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Most US Doctors Say They Ration Patients’ Healthcare

Rationing has long been seen as a common practice in national, single-payer health systems like the UK’s National Health Service and Canada’s national health insurance program (known as “Medicare”).  However, over half of U.S. physicians say they ration care to patients. In a peer-reviewed column in the Journal of General Internal Medicine published in July 2016, Dr. Robert Sheeler and colleagues at the Mayo Clinic, University of Iowa, and University of Michigan, found that 53% of physicians surveyed personally “refrained” in the past six months from using specific clinical services that would have provided the “best patient care” due to cost.

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The Future of Retail Health in 2027

As consumers gain more financial skin in the game of paying for health care, we look for more retail-like experiences that reflect the Burger King approach to consuming: having it our way. For health are, that means access, convenience, transparency and fair costs, respect for our time, and a clear value proposition for services rendered. That doesn’t happen so much in the legacy health care system — in hospitals and doctors’ offices. It has already begun to happen in retail health settings and, especially, in the changing nature of pharmacies. Retail Health 2027, a special supplement to Drug Store News

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US Health Care Prices Would Be Sticker-Shocking For Europeans

The average hospital cost per day in the U.S. is $5,220. In Switzerland it’s $4,781, and in Spain that inpatient day looks like a bargain at $424. An MRI in the U.S. runs, on average, $1,119. In the UK, that MRI is $788, and in Australia, $215, illustrated in the first chart. Drug prices are strikingly greater in the U.S. versus other developed nations, as shown in the first chart for Xarelto. If you live in the U.S. and have a television tuned in during the six o’clock news, chances are you’ve seen an ad for this drug featuring Arnold

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Retail Clinics Continue to Shape Local Healthcare Markets

Retail clinics are a growing source of primary care for more U.S. health consumers, discussed in a review of retail clinics published by Drug Store News in July 2016. There will be more than 2,800 retail clinics by 2018, according to Accenture’s tea leaves. Two key drivers will bolster retail clinics’ relevance and quality in local health delivery systems: Retail clinics’ ability to forge relationships with legacy health care providers (physicians, hospitals); and, Clinics’ adoption and effective use of information technology that enables data sharing (e.g., to the healthcare provider’s electronic health records system) and data liquidity (that is, securely moving

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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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In Healthcare, Pharmacists and Doctors Most Trusted. Insurance Execs and Congress? Not.

When consumers consider the many stakeholder organizations in healthcare, a majority trust pharmacists first, then doctors and dentists. Hospital and health insurance execs, and members of Congress? Hardly, according to a survey from Meyocks, a marketing consultancy. Meyocks conducted the survey via email among 1,170 US adults, 18 years of age and older. This survey correspondends well with the most recent Gallup Poll on most ethical professions, conducted in December 2015. In that study, pharmacists, nurses and doctors come out on top, with advertisers (“Mad Men”), car salespeople, and members of Congress at the bottom, as shown in the second

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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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Accountable Care Will Happen Best When Patients Engage

Technology alone won’t improve health care in America, especially in people with chronic health problems don’t want to use it. Furthermore, too many clinicians who have invested in digital health technologies (namely, electronic health records systems), aren’t fully taking advantage of what they have. This and other health care realities are explored in Better Together: Patient Expectations and the Accountability Gap, based on a consumer survey conducted by Nielsen Strategic Health Perspectives for the Council of Accountable Physician Practices, an affiliate of the American Medical Group Foundation. The survey polled 30,007 consumers in March 2016, and combined physician data culled from Nielsen’s

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Healthcare Consumerism? Not So Fast, Alegeus Finds

Millions of U.S. patients have more financial skin in the American health care game. But are they behaving like the “consumers” they are assumed to be as members in consumer-directed health plans? Not so much, yet, explained John Park, Chief Strategy Officer at Alegeus, during a discussion of his company’s 2016 Healthcare Consumerism Index. This research is based on an online survey of over 1,000 U.S. healthcare consumers in April 2016. Alegeus looks at healthcare consumerism across two main dimensions: healthcare spending and healthcare saving. As the chart summarizes, consumers show greater engagement and focus on buying a TV or car, choosing

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PwC’s “Behind the Numbers” – Where the Patient Stands

The growth of health care costs in the U.S. is expected to be a relatively moderate 6.5% in 2017, the same percentage increase as between 2015 and 2016, according to Medical Cost Trend: Behind the Numbers 2017, an annual forecast from PwC. As the line chart illustrates, the rate of increase of health care costs has been declining since 2007, when costs were in double-digit growth mode. Since 2014, health care cost growth has hovered around the mid-six percent’s, considered “low growth” in the PwC report. What’s driving overall cost increases is price, not use of services: in fact, health care

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Will the Big Box Store Be Your Health Provider?

“Gas ‘N’ Health Care” is one of my most-used cartoons these days as I talk with health/care ecosystem stakeholders about the growing and central role of consumers in health care. You may be surprised to learn that the brilliant cartoonist Michael Maslin created this image back in 1994. That’s 22 years ago. When I first started using this image in my meetings with health care folks, they’d all giggle and think, ‘isn’t that funny?’ Legacy health care players — hospitals, doctors, Pharma, and medical device companies — aren’t laughing at this anymore. At a Costco a 20 minutes’ drive from

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Financial Toxicity: The High Cost of Cancer Drugs in the U.S.

Two news items published in the past week point to the yin/yang of cancer survivorship and the high prices of cancer drugs. The good news: a record number of people in the US are surviving cancer, according to the American Cancer Society. That number is 15.5 million Americans, according to a study in the cancer journal CA. Note the demographics of cancer survivors: One-half are 70 years of age and older 56% were diagnosed in the past ten years, and one-third in the past 5 years Women were more likely to have had breast cancer (3.5 mm), uterine cancer (757,000),

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Healthcare Costs for a Family of Four Will Be $25,826 in 2016

If you had exactly $25,826 in your pocket today, would you rather buy a new Chrysler 200 sedan, send a son or daughter to a year of college at Wake Forest University, or pay for your family’s health care in an employer-sponsored preferred provider organization? Welcome to the annual 2016 Milliman Medical Index (MMI), one of the most important health economic studies I’ve relied on for many years. This year’s underlying question is, “Who cooked up this expensive recipe?” posed in the report’s title. The key statistics in this year’s MMI are that: Healthcare costs for a typical family of four

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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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GoHealthEvents, An Online Source For Consumer Retail Health Opportunities

“Health comes to your local store,” explains the recently-launched portal, GoHealthEvents. This site is a one-stop shop for health consumers who are seeking health screenings and consults in local retail channels like big box stores, club stores, drug stores, and grocery stores. Events covered include cholesterol, diabetes, heart health, nutrition, osteoporosis, senior health, vaccinations and immunizations. By simply submitting a zip code, a health consumer seeking these kinds of services can identify where and when a local retailer will provide it. I searched on my own zip code in suburban Philadelphia, and found the following opportunities taking place in the

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Finding Affordable Care In a Deductible World: The Growing Role of Alternative Therapies

Faced with the increasing financial responsibility for healthcare payments, and a desire to manage pain and disease via “natural” approaches, more U.S. consumers are seeking and paying for non-conventional or naturopathic therapies — complementary and alternative medicine (CAM). Health and Healing in America, The Harris Poll conducted among U.S. adults, learned that two in three Americans see alternative therapies as safe and effective. 1 in 2 people see alternative therapies as reliable. And most people believe that some of these treatments, like chiropractic and massage therapy, should be reimbursed by health insurance companies. Seven in 10 Americans have used alternative

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Big and Bigger Pharma – Politics, Pricing and Patients

Pressures on the pharmaceutical industry are coming from every stakeholder touchpoint, driving companies to merge, set prices high for short-term gains, and (finally) put more resources toward providing patients services. Let’s call out just a few of the events from the past couple of weeks which, together, paint the current rocky landscape for pharma and life science companies: Last week on April 28th, termed “healthcare’s $45 billion day,” three big M&A deals hit the financial markets: Abbott sought to acquire St. Jude Medical (worth $30 bn alone), AbbVie looked to buy Stemcentrx for just under $6 bn, and Sanofi tagged

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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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Withings Inside: Nokia’s Digital Health Vision

The first health news I read this morning in my Google Alerts was a press release explaining that Nokia planned to acquire Withings for EU170 (about $190mm). As an early adopter and devoted user of the Withings Smart Body Analyzer, I took this news quite personally. “What will Nokia be doing with my beloved Withings?” I asked myself via Twitter early this morning. As if on cue, a public relations pro with whom I’ve been collegial for many years contacted me to see if I’d like to talk with the Founder and CEO of Withings, Cédric Hutchings, and Ramzi Haidamus,

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Digital Health Update from Silicon Valley Bank

Who better than a financial services institution based in Silicon Valley to assess the state of digital health? Few organizations are better situated, geographically and sector-wise, than SVB Analytics, a division of Silicon Valley Bank based in, yes, Silicon Valley (Santa Clara, to pinpoint). The group’s report, Digital Health: Opportunities for Advancing Healthcare, provides an up-to-date landscape on the convergence of healthcare and technology. SVB Analytics defines digital health as “solutions that use digital technology to improve patients’ health outcomes and/or reduce the cost of healthcare.” The report provides context for the digital health market in terms of health care costs,

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The Hospital of the Future Won’t Be a Hospital At All

In the future, a hospital won’t be a hospital at all, according to 9 in 10 hospital executives who occupy the c-suite polled in Premier’s Spring 2016 Economic Outlook. Among factors impacting their ability to deliver health care, population health and the ACA were the top concerns among one-half of hospital executives. 1 in 4 hospital CxOs think that staffing shortages have the biggest impact on care delivery, and 13% see emerging tech heavily impacting care delivery. Technology is the top area of capital investment planned over the next 12 months, noted by 84% of hospital execs in the survey.

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Expect Double-Digit Rx Cost Growth to 2020 – Implications for Oncology

In the U.S., spending on prescription medicines reached $425 bn in 2015, a 12% increase over 2014. For context, that Rx spending comprised about 14% of the American healthcare spend (based on roughly $3 trillion reported in the National Health Expenditure Accounts in 2014). We can expect double-digit prescription drug cost growth over the next five years, according to forecasts in Medicines Use and Spending in the U.S. – A Review of 2015 and Outlook to 2020 from IMS Institute of Healthcare Informatics. The biggest cost growth driver is specialty medicines, which accounted for $151 bn of the total Rx spend

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Patient Engagement – Secret In The Healthcare Sauce

Patient engagement is the new imperative in health care, writes Editor-in-chief Alan Weil in his introduction to the April 2016 issue of Health Affairs. It is appropriate and right that Judith Hibbard of the University of Oregon served as the theme adviser for the issue: she’s the innovator of the Patient Activation Measure and has frequently published her research in Health Affairs. Her own bottom-line: that the higher the patient activation, the less health care costs the health plan. (See a recent post on her research here on Health Populi). This issue of Health Affairs is a comprehensive primer on the

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People Want Healthcare Sherpas

8 in 10 Americans would like one trusted person to help them figure out their health care, according to the Accolade Consumer Healthcare Experience Index Poll, conducted by The Harris Poll. The study gauged how Americans feel about their healthcare, especially focusing on employer-sponsored health insurance. One-third of people (32%) aren’t comfortable with navigating medical benefits and the healthcare system; a roughly percentage of people aren’t comfortable with their personal knowledge to make financial investments, either (35%). Buying a car, a home, technology and electronics? Consumers are much more comfortable shopping for these things. Consumers say that the most onerous

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The Patient-Physician Experience Gap

As patients continue to grow health consumer muscles, their ability to vote with their feet for health care services and products grows. That’s why it’s crucial for health care providers to understand how patients perceive their quality and service levels, explained in Patient Experience: It’s Time to Rethink the Consumer Healthcare Journey, a survey report from GE Healthcare Camden Group and Prophet, a brand and marketing consultancy. 3 in 4 frequent healthcare consumers say they are frustrated with their services. One-half of less-frequent patients are frustrated. Patients and physicians are on different pages when it comes to evaluating the health care

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Consumers’ Growing Use of New Retail Health “Doors”

In the growing era of consumer-driven health, a growing list of options for receiving care are available to consumers. And people are liking new-new sites of care that are more convenient, cheaper, price-transparent, and digitally-enabled. Think of these new-new sites as “new front doors,” according to Oliver Wyman in their report, The New Front Door to Healthcare is Here. The traditional “doors” to primary and urgent care have been the doctor’s office, hospital ambulatory clinics, and the emergency room. Today, the growing locations for retail clinics and urgent care centers are giving consumers more visible and convenient choices for seeking

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The Rise and Rise of (Specialty) Prescription Drug Prices

Prices for the most commonly used branded prescription drugs grew from a base index of $100 in 2008 to to $264 in 2015, based on the Express Scripts 2015 Drug Trend Report. This is illustrated by the upwardly-sloping blue line in the chart. In contrast, the market basket of the most commonly used generic drugs fell from the $100 index in 2008 to $29.73, shown by the declining black line in the graph. The $112.05 is calculated from a market basket of commonly purchased household goods which cost $100 in 2008, a relatively flat line which puts the 264% rise in

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Being a Woman is a Social Determinant of Health – Happyish International Women’s Day

Today is International Women’s Day. Being a woman is a social determinant of health (for the worse). To mark the occasion of the Day, The International Labour Organization (ILO) published a report on women and work yesterday, finding that in the 178 countries studied, inequality between women and men persists across labor markets. And while there’s been progress in women’s education over the past twenty years, this hasn’t resulted in women advancing career paths and wage equality. It struck me this morning, reading both (paper versions of) the Wall Street Journal and the Financial Times that the latter had two FT-sponsored ads marking

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More Hospitals Connecting for Health: The HIMSS 2016 Connected Health Survey

One in 2 hospitals currently use three or more connected health technologies, according to the 2016 HIMSS Connected Health Survey released today at the annual HIMSS conference. The most commonly used connected health applications cited were: Patient portals, among 58% of providers Apps for patient education and engagement 48% Remote health monitoring, 37% Telehealth via fee-for-service, 34% SMS texting, 33% Patient-generated data, 32% Telehealth via concierge, 26%. 47% of health care providers plan to expand use of connected health technologies, especially for telehealth via concierge, patient-generated data, and SMS texting. HIMSS worked with the Personal Connected Health Alliance (PCHA) to

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Behavioral Economics in Motion: UnitedHealthcare and Qualcomm

What do you get when one of the largest health insurance companies supports the development of a medical-grade activity tracker, enables data to flow through a HIPAA-compliant cloud, and nudges consumers to use the app by baking behavioral economics into the program? You get Motion from UnitedHealthcare, working with Qualcomm Life’s 2net cloud platform, a program announced today during the 2016 HIMSS conference. What’s most salient about this announcement in the context of HIMSS — a technology convention — is that these partners recognize the critical reality that for consumers and their healthcare, it’s not about the technology. It’s about

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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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Improving the Patient Experience in Legacy Health Systems – My Start-Up Health Interview

The so-called legacy healthcare system are the incumbents in American health care — hospitals, physician practices, pharma, health plans, and other organizations that have long-served and been reimbursed by traditional volume-based payment. Patients, now morphing in to health consumers, look to these stakeholders to provide new levels of service, accessibility, convenience, transparency and value — the likes of which people find in their daily life in other market sectors. Those consumer demands are pressuring the health system as we know it in many new ways, which I discussed with Unity Stoakes, Co-Founder of Startup Health, at the Health 2.0 Conference in

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Health Consumers Happy With Doctor Visits, But Want More Technology Options

9 in 10 adults in the U.S. have visited a doctor’s office in the past year, and over half of these patients have been very satisfied with the visit; 35% have been “somewhat” satisfied. Being a highly-satisfied patient depends on how old you are: if you’re 70 or older, two-thirds of people are the most satisfied. Millennial or Gen X? Less than half. What underlies patient satisfaction across generations is the fact that younger people tend to compare their health care experience to other retail experiences, like visiting a bank, staying at a hotel, or shopping in a department store.

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Retailers will morph into health destinations in 2016

Retailers in the U.S. are morphing into health destinations in 2016. Members of Target’s management team attended the 2016 Consumer Electronics Show (CES) and shared their perspectives in the company blog. Among the Target teams observations came from the Chief Marketing Officer, Jeff Jones, who observed, “A tidal wave of newness is coming to fitness technology and many companies are on the cusp of changing the game. From nutrition and sleep to how you exercise, it’s all going to be measured, linked and tracked. Wearables are here to stay and getting smarter every year.” The Senior Vice President for Hardlines,

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The 2016 THINK-Health Health/Care Forecast

It’s time to get the tea leaves out and mash up trends in my world of health, health care, technology, policy and people for 2016. We’ll start with the central player: people, consumers, patients, caregivers all. Health consumerism on the rise.  People – call us patients, consumers, caregivers – will take on even more financial and clinical decision making risk in 2016. Growing penetration of high-deductible and consumer-driven health plans will push (not just nudge) people into the role of health care consumers, and the emerging businesses and programs serving the transparency market for price and quality will gain traction

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In 2016 Reaching For The Triple Aim Will Drive Health IT Spending

Adoption of telehealth, remote health monitoring, patient engagement platforms, mobile and digital health applications, and the emergence of the Internet of Things in health care will all be bolstered in 2016 based on health care providers’ having to do more with less (money, labor, resources). The value-based healthcare world — the migration of payment “from volume to value” — requires greater investment in information and communications technology that moves care to lower-cost sites, with lower-priced labor (as appropriate), and shifting greater clinical self-care and financial skin-in-the-game to patients. My annual health IT forecast was published yesterday in iHealthBeat, 2016: Technology

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Prescription Drug Costs Will Be In Health Benefits Bullseye in 2016

Prescription drug costs have become a front-and-center health benefits cost issue for U.S. employers in 2015, and in 2016 the challenge will be directly addressed through more aggressive utilization management (such as step therapy and prior authorization), tools to enable prescription intentions like DUR, and targeting fraud, waste and abuse. Consumers, too, will be more financially responsible for cost-sharing prescription drugs, in terms of deductibles and annual out-of-pocket limits, as described in the PBMI 2015-206 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda. The Pharmacy Benefit Management Institute has published this report for 15 years, which provides neutral, detailed survey

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The Internet of Healthy Things According to Dr. Kvedar

By 2020, according to the World Economic Forum, more than 5 billion people and 30 billion “things” will be connected to the Internet — cars, refrigerators, TVs, washing machines and coffeemakers, among those 5 bn folks’ electronic stuff. But so will medical devices, activity trackers, and a host of sensor-enabled “things” to help people and clinicians optimize health and manage illness. The Internet of Things (IoT) phenomenon, which is already penetrating households with energy management and security applications, is reaching health care. One of the pioneers in this connected health market is Dr. Joseph Kvedar, who leads the Center for

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The U.S. Will Cover the Bulk of Medicines Spending in 2020

U.S. spending on medicines will approach $590 billion in 2020, increasing 34% over 2015, IMS Institute for Healthcare Informatics projects in its forecast, Global Medicines Use in 2020. Growth in spending will be attributable to innovation (new products), price increases and some patent losses of exclusivity (e.g., branded drugs going generic). The U.S. will cover the bulk of drugs spending in 2020 at 41% of the world medicines market, shown in the first pie in the first chart. U.S. medicines spending dwarfs any other country or region in the world, including China which is expected to account for 11% of

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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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My Breakfast With Alain – On Health Consumers and the New Retail Health

My National Health Care Consumer Week, I’ll coin this, looking back on flying some 12,000 airmiles over six days, criss-crossing America from the City of Brotherly Love to Sacramento, back to Philly and then to Los Angeles. Finally, today, heading home to Philadelphia and my beloved, most necessary Tempur-Pedic bed, a loving husband and some therapeutic TV binge-watching. It’s Friday and I’m at LAX, reflecting on a week of meeting with three groups of healthcare executives and stakeholders who all wanted to hear my take on the evolution of patients, people, caregivers, all, morphing into health care consumers. The lens

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Getting to Connected Health Is A Marathon, Not A Sprint

Consumers may demand connected experiences in daily living, but there have been many barriers to health care industry stakeholders delivering on that expectation: among them, privacy and security concerns, and provider resistance. This demand-and-supply chasm is noted in Deloitte’s Center for Health Solutions’ latest look into the healthcare landscape, Accelerating the adoption of connected health. The objectives of connected health, or cHealth, are: To improve digital connectivity among consumers, providers, health plans and life sciences companies To facilitate self-managed care in a secure environment that protects privacy To deliver care outside of traditional institutional settings To enable chronic care management

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Health Care Costs Are #1 Pocketbook Issue, and Drug Prices Top the Line Items

Consumers are most concerned about health care costs among their kitchen table issues, above their ability to afford the utility bill, housing, food, or gas and transportation costs. The October 2015 Kaiser Family Foundation Health Tracking Poll finds 4 in 10 Americans finding it difficult to afford health care, including 16% of people earning $90,000 a year or more. Underneath that worrying healthcare cost umbrella are the price of prescription drugs, which the majority of Democrats, Independents, and Republicans all agree need to be “limited” by government regulation. Ensuring that the public have affordable access to high-cost drugs for chronic conditions

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Physical Healthcare Facilities Can Bolster Health Consumerism

Reluctantly accepting the Affordable Care Act, health executives and their architects now see opportunities for re-imagining the hospital and health care services, according to Healthcare Industry Trends, a publication that’s part of the 2015 Building & Development Leadership Series provided by Mortenson, a construction services firm that’s active with healthcare organizations. Mortenson conducted a survey at the 2015 ASHE Planning, Design, and Construction Summit, the results of which were published in this report. The over 300 respondents included healthcare executives, facilities managers, and healthcare architects. Thus the lens on the data in this survey is through the eyes of physical

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Growing Signs Of Consumer Health Engagement, Via Deloitte

A growing desire for shared decision making with doctors. Increasing trust and consumption of health care information online, in social media, and report cards. Reliance on technology for monitoring health adn wellness, and medical conditions. Together, these three signals converge, illustrating a growing sense of consumer engagement among U.S. patients, found in the 2015 Deloitte Center for Health Solutions Survey of US Health Care Consumers. In Deloitte’s research summary, the title states that “No ‘one-size-fits-all’ approach” will work, given diversity among American health consumers. The sickest health consumers, Deloitte notes, have higher levels of health engagement and index higher on

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The Tricky Journey From Volume To Value In Health Care – Prelude To Health 2.0

By 2018, 90% of health care delivered to people enrolled in Medicare will be paid-for on the basis of quality, not on the amount of services delivered (that is, volume). But as providers must up their game in that new value-oriented health payment world, they are bound up in work flows and organizational structures built for fee-for-service reimbursement. This changing future is discussed in Healthcare’s alternative payment landscape, PwC’s Healthcare Research Institute report on the volume-to-value shift. PwC notes that health care providers’ ability to adapt to changing payment regimes vary and fall into four categories: traditional, lagging, vanguard and

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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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Wellness Is In Target’s Bullseye

Health is where we live, work, play, pray, learn, and increasingly, shop. The new Retail Health goes well beyond the pure-play pharmacy. Part of Target’s re-imagined market positioning is in this expanding sweet-spot as healthcare morphs from institutional providers like hospitals and doctors’ offices to the community. Don’t think pharmacy’s not important: it will remain a core business and revenue center in retail health. But that business is fast-changing, as the role of pharmacy benefits management companies change, more (expensive) specialty drug benefits come out of pipeline and into the market, and health insurance continues to shift financial risk to

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Health consumers’ cost increases far outpace wage growth

American workers are working to pay for health care costs, having traded off wage increases for health premiums, out-of-pocket costs and growing high deductibles. Welcome to the 2015 Employer Health Benefits survey conducted annually by the Kaiser Family Foundation (KFF) and Health Research & Educational Trust (HRET). Premiums are growing seven times faster than wages.  The report calculates that high-deductibles for health insurance have grown 67% from 2010 to 2015. In the same period, wages grew a paltry 10%, while the Consumer Price Index rose 9%. The first chart illustrates that growing gap between relatively flat wages and spirally health

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U.S. Consumers’ View of Pharma Goes Negative in 2015

Americans’ views of the pharmaceutical industry have fallen in the past year, with negative perceptions outweighing positive ones, shown in the line graph from the Gallup Poll. Pharma’s low-lying reputation among consumers sits among others including the legal field, healthcare, oil and gas, and the Federal government which ranked lowest across all 25 sectors Gallup analyzed. Gallup surveyed 1,011 U.S. adults in in the first week of August 2015 via telephone. Since 2003, Gallup notes, the pharma industry has consistently ranked in the bottom third of industries operating in the U.S. Pharma respect is in the eye of the consumer-beholder

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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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Employers pushing consumerism for health benefits in 2016

This is the dawning of the Age of Consumer-Driven Health, the tipping point of which has been passed. The data point for this assertion comes from the National Business Group on Health‘s annual 2016 Large Employers’ Health Plan Design Survey. The tagline, “reducing costs while looking to the future,” suggests some of the underlying tactics employers will use to manage their financial burden of providing health insurance to workers. That burden will continue to shift to employees and their dependents in the form of greater cost-sharing: for premiums, co-pays and co-insurance, and the hallmark of consumer-driven health plans (CDHPs): high(er) deductibles.

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Coverage and price before brand for health plan shoppers

When Americans shop for health insurance (and they do – more, later in the post), they look most for covering major medical expenses, prescription drugs, preventive care, and price. Less important is the brand of the plan, or its high ratings. Valence Health surveyed 524 U.S. consumers in June 2015 to learn how healthcare shoppers feel about health insurance and health reform. The results are published in the report, U.S. Attitudes Toward Health Insurance and Healthcare Reform in August 2015. Key findings in the study were that: Price and coverage come before all other factors in evaluating health plans 73%

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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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Yelp For Health Grows With ProPublica

In addition to checking out local restaurants, auto repair shops, and dry cleaners, you can check out health care providers on a new-and-improving consumer review portal on Yelp. While Yelp has been serving up consumer comments on doctors, hospitals, clinical labs, nursing homes and dentists for several years, the review site is partnering with ProPublica, the journalism portal, to complement the data collected on health in local communities. Yelp’s CEO, Jeremy Stoppelman, made the announcement in the company blog on August 5 2015. Yelp has amassed over 1.3 million health reviews, and ProPublica will have access to those as part

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Entresto – model for future Rx?

The FDA approved Novartis’s new heart failure drug Entresto (LCZ696) on July 7, 2015. This product was approved under the FDA fast track program which prioritizes therapies that fill unmet needs for patients with life-threatening conditions. Heart failure affects over 5 million people in the U.S. and is often caused by heart attacks and high blood pressure. So heart failure impacts lots of people and, in aggregate, the CDC says represents about $32 bn of medical spending annually in the U.S. and is a factor in 1 in 9 deaths in America each year. Novartis is looking to price Entresto as much

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Collaboration in health/care drives value – in & beyond bio/pharma

“Tomorrow [drug makers] may not get paid for the molecule, they may only get paid for the outcome,” expects Brian Niznik of Qualcomm Life. He’s quoted in a report from PwC’s Health Research Institute, 21st Century Pharmaceutical Collaboration: The Value Convergence. What Brian’s comment recognizes is the growing value-based environment for healthcare, which couples purchasers driving down drug costs via discounts and stringent formulary (approved drug list) contracts, and growing patient responsibility for paying for prescription drugs — especially financially costly for specialty drugs that are new-new molecules. But as Brian points out, if the high-cost molecule doesn’t perform as

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The Internet of Things in Health: McKinsey Sees $1.6 T Value

‘Tis the summer of big, smart reports covering the Internet of Things (IoT) impact on health and fitness. Just this month, three of these missives have come to my inbox, and they all contribute sound thinking about the topic. Today, tomorrow and Friday, I’ll cover each of these here in Health Populi. We begin with McKinsey Global Institute’s The Internet of Things: Mapping the Value Beyond the Hype. [In full disclosure, I was an outside adviser to the MGI team members who focused on the human/health and fitness aspects of this report, and thank MGI for the opportunity to provide

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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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Bridging a Commercialization and Design Chasm, StartUp Health Allies With Aurora Health Care

Startup Health, the health/care entrepreneur development company which has helped launch over 100 health/tech companies since “starting up” in 2011, announced a collaboration with Aurora Health Care today. This is one of the first ventures of its kind, linking up health/tech entrepreneurs with a health care provider organization as a living lab, or in the words of Unity Stoakes, Startup Health Co-Founder, a “collaboratory.” I spoke with Unity before the announcement went public, and learned that Startup Health sought a partner with shared values focused on getting innovations into patient care that could transform the healthcare delivery system. “Every single

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How digital ‘everything’ and consumer expectations are re-shaping health care

Two forces are converging to shape a new era of “living services,” Accenture posits: the digitization of “everything” and consumers’ “liquid” expectations — which are demands for personalized, engaging and adaptable experiences. Accenture’s report on this phenomenon, The Era of Living Services, spans the broad range of consumers’ daily lives where these services will impact: homes, families, transportation, shopping, leisure time, jobs, finances, education, cities, and above all for Health Populi readers, “our bodies.” Living services are physically close to us, as Accenture sees them, “wrapping themselves around the everyday things we do.” They are digital services that are aware

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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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Telehealth goes retail

In the past couple of weeks, a grocery store launched a telemedicine pilot, a pharmacy chain expanded telehealth to patients in 25 states, and several new virtual healthcare entrants received $millions in investments. On a parallel track, the AMA postponed dealing with medical ethics issues regarding telemedicine, the Texas Medical Association got stopped in its tracks in a case versus Teladoc, and the Centers for Medicare and Medicaid Services (CMS) issued a final rule for the Medicare Shared Savings Program that falls short of allowing Accountable Care Organizations (ACOs) to take full advantage of telehealth services. These events beg the

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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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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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Purchase of wearable fitness trackers expected to grow in 2015, but one-half of Americans would “never” buy one

Headphones and smartphones are the top two electronics products U.S. consumers intend to purchase in 2015. But the emerging consumer electronics categories of wearable fitness trackers, smart watches, and smarthome devices (especially “smart” thermostats) are positioned to grow, too, in 2015, according to the 17th Annual CE Ownership and Market Potential Study from the Consumer Electronics Association (CEA). Wearable trackers have an installed base of about 17 million devices in the U.S., with 11% of U.S. households intending to purchase a tracker in 2015 — 6 percentage points up from 2014 (about a 50% increase over 2014). There are about 6 million smart

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Happy 25 million, MinuteClinic and CVS Health!

Call it a Silver Million Anniversary, if you will: The MinuteClinic just saw its 25 millionth patient. This is a milestone in the evolution and growth of retail health in America, a trend-marker in this growing health industry segment that will become increasingly used by consumers, patients, parents, and caregivers. CVS bought the MinuteClinic in 2006, when the organization treated seven illnesses. Today, MinuteClinic offers 65 services and vaccinations in nearly 1,000 clinics located in 31 states and Washington, DC. In addition, MinuteClinic will grow the number of clinic locations in both existing and new markets. The company will open

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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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Nurses are consumers’ trusted partners-in-health

The two most trusted health professionals in the eyes of U.S. consumers are nurses and pharmacists, and both of these health workers will be key partners for people wanting to engage in health/care. That was my introductory message kicking off the annual conference of ANIA, the American Nursing Informatics Association, in Philadelphia on April 24, 2015. Meeting in the City of Brotherly Love gave ANIA the opportunity to theme the meeting a “Declaration of Nursing Informatics,” carrying that theme through the exhibition hall with a Benjamin Franklin lookalike walking the floor availing himself of attendees’ requests for selfie-taking with the

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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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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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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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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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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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Building the health ecosystem: new bedfellows coming together

2015 is already becoming a year where bedfellows of different stripes are joining together to build a health care ecosystem well beyond hospitals, doctors and health plans. Announcements launched last week at the 2015 Consumer Electronics Show in Las Vegas, and coming out this week at the J.P. Morgan Conference in San Francisco, the first two weeks of 2015 reveal that new entrants and legacy health stakeholders are crossing corporate and cultural chasms to (try and) solve challenges that prevent us from getting to that Holy Grail of The Triple Aim: improving health care outcomes, driving down per capita costs,

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Health and wellness at CES 2015 – trend-weaving the big ideas

Health is where we live, work, play and pray — my and others’ mantra if we want to truly bend (down) the cost curve and improve medical outcomes. If we’re serious about achieving the Triple Aim — improving public health, lowering spending, and enhancing the patient/health consumer experience (which can drive activation and ongoing engagement) — then you see health everywhere at the 2015 Consumer Electronics Show in Las Vegas this week. With this post, I’ll share with you the major themes I’m seeing at #CES2015 related to health, wellness, and DIYing medical care at home. The meta: from health care to self-care.

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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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Power to the health care consumer – but how much and when?

Oliver Wyman’s Health & Life Sciences group names its latest treatise on the new-new health care The Patient-to-Consumer Revolution, subtitled: “how high tech, transparent marketplaces, and consumer power are transforming U.S. healthcare.” The report kicks off with the technology supply side of “Health Market 2.0,” noting that “the user experience of health care is falling behind” other industry segments — pointing to Uber for transport, Amazon for shopping, and Open Table for reserving a table. The authors estimate that investments in digital health and healthcare rose “easily ten times faster” than the industry has seen in the past. Companies like

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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 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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Health on the 2014 Gartner Hype Cycle

Remote health monitoring is in the Trough of Disillusionment. Wearables are at the Peak of Inflated Expectations, with Big Data leapfrogging wearables from the 2013 forecast — both descending toward the Disillusionment Trough. Mobile (remote) health monitoring, however, has fallen into that Trough of Disillusionment as RHM has been undergoing reality checks in the health care system especially for monitoring and patient self-management of heart disease (most notably heart failure) and diabetes. Welcome to the 2014 edition of the Gartner Hype Cycle, one of my most-trusted data sources for doing health industry forecasts in my advisory work. Compared with last year’s

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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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