HealthPopuli.com http://www.healthpopuli.com Health/Care is Everywhere Fri, 22 Jul 2016 20:05:21 +0000 en-EN hourly 1 Broadband – A Social Determinant of Health http://www.healthpopuli.com/2016/07/22/broadband-social-determinant-health/ http://www.healthpopuli.com/2016/07/22/broadband-social-determinant-health/#respond Fri, 22 Jul 2016 20:03:14 +0000 http://www.healthpopuli.com/?p=15401 The promise of digital, connected health to engage all health citizens cannot be fully realized until people have access to the new social determinant of health: broadband connectivity. The World Health Organization considers social determinants of health inputs like education, safe drinking water, nutritious food, safe neighborhoods for walking, employment and transportation access. Together, these factors bolster personal/individual and public health. See the map of the U.S., and note whee the concentrations of aqua blue are. These are areas that lack broadband access. Telehealth and other digital health tools can get health care to under-served people in under-served geographic areas….where broadband connectivity exists. Where it doesn’t, the very people who need health care services most can’t get them due to many of the other social determinants of health: transportation, distance, access to basic health care services (primary care shortages abound in rural America), health literacy challenges. I penned a column published today in The Huffington Post on this topic, Broadband Connectivity Is A Social Determinant of Health. See how Senator Al Franken (D-Minn.) submitted legislation this week on expanding health IT to rural areas (with broadband at the center). Note how Presidential hopeful Hillary Clinton has prioritized expanding broadband to 100% of American homes in her technology platform. Don’t assume that smartphones are the Nirvana for health care democratization. Data plans cost money that too many health citizens in America can’t afford in light of tight family budgets and growing health care costs. For more on that topic, see my paper written for California Healthcare Foundation, Digitizing the Safety Net.

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fcc_map_7jan2015The promise of digital, connected health to engage all health citizens cannot be fully realized until people have access to the new social determinant of health: broadband connectivity.

The World Health Organization considers social determinants of health inputs like education, safe drinking water, nutritious food, safe neighborhoods for walking, employment and transportation access. Together, these factors bolster personal/individual and public health.

See the map of the U.S., and note whee the concentrations of aqua blue are. These are areas that lack broadband access.

Telehealth and other digital health tools can get health care to under-served people in under-served geographic areas….where broadband connectivity exists. Where it doesn’t, the very people who need health care services most can’t get them due to many of the other social determinants of health: transportation, distance, access to basic health care services (primary care shortages abound in rural America), health literacy challenges.

I penned a column published today in The Huffington Post on this topic, Broadband Connectivity Is A Social Determinant of Health. See how Senator Al Franken (D-Minn.) submitted legislation this week on expanding health IT to rural areas (with broadband at the center). Note how Presidential hopeful Hillary Clinton has prioritized expanding broadband to 100% of American homes in her technology platform.

Don’t assume that smartphones are the Nirvana for health care democratization. Data plans cost money that too many health citizens in America can’t afford in light of tight family budgets and growing health care costs. For more on that topic, see my paper written for California Healthcare Foundation, Digitizing the Safety Net.

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Retail Clinics Continue to Shape Local Healthcare Markets http://www.healthpopuli.com/2016/07/20/retail-clinics-continue-shape-local-healthcare-markets/ http://www.healthpopuli.com/2016/07/20/retail-clinics-continue-shape-local-healthcare-markets/#respond Wed, 20 Jul 2016 01:01:11 +0000 http://www.healthpopuli.com/?p=15373 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 data from the retail clinic digital records system to the provider’s information system, based on information standards and sound business and data security practices). Clinics are growing in both number and in the roster of services offered, going beyond urgent care toward more population health and chronic disease management services. The Robert Wood Johnson Foundation noted that, “Some delivery systems seeking to improve primary care access and manage total cost of care are using retail clinics to reduce unnecessary emergency department (ED) visits,” given that retail clinics’ costs are lower than EDs and some hospital-based ambulatory departments. Drug Store News pointed out several clinic innovations in this special issue: CVS Health’s MinuteClinics number over 1,100 clinics (including 79 in Target stores). They are growing clinical affiliations with medical schools and teaching hospitals such as the Cleveland Clinic, University of Chicago Medical Center, and the University of Michigan Health System, among others. CVS Health’s clinics use an electronic health records system that can share information with health providers and collaborate between the retail health setting and health providers. Walgreens operates over Healthcare Clinics and 50 other clinics in stores run by other providers. The company is moving toward more coordinated care models beyond urgent care services, and has invested in an Epic EHR to build that communications/IT infrastructure for a vision of seamless care delivered in the community. The Little Clinic operates in Kroger grocery stores, which is a leader in grocery chains delivering healthcare services. The company makes the connection between health and healthy food, and engages dietitians in their care model in the Little Clinics. THINK: weight management, diabetes care, food allergies, and other consumer-facing health issues that can be self-managed. Clinics are also emerging in smaller, regional store chains that seek to partner with healthcare providers in local markets. Health Populi’c Hot Points:  “Retail health” used to mean “the pharmacy.” But today, “the pharmacy” isn’t just a prescription drug dispensary: CVS Health launched a healthy food kiosk in June 2016, and some Wegman’s grocery store pharmacies feature Withings and Higi kiosks for channeling wearable tech and supporting self-checks for blood pressure, pulse, weight, and BMI. (This is my personal photo taken in my local Wegman’s store in Malvern, PA). As grocers engage nutritionists and dietitians, retail clinics conduct full physical exams (for $40, in the case of Walmart’s new clinic model), and pharmacists take on the role of medication therapy management, consumers can readily access primary care in their close-by community. That convenience, accessibility and “close-by” neighborhood feeling can help bolster medication adherence, continuity of care, and more effective self-care if health care providers (hospitals, clinicians) — especially those taking on more value-based payment in all forms — are willing to collaborate. The new entrants are willing, ready, and able to do so. And as patients, now health care consumers, are learning to manage high-deductible health plans and health savings accounts, a $40 visit to a PCP is a high-value healthcare proposition.

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Retail clinics are a growing source of primary care for more U.S. health consumers, discussed Accenture retail clinics to 2017in 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 data from the retail clinic digital records system to the provider’s information system, based on information standards and sound business and data security practices).

Clinics are growing in both number and in the roster of services offered, going beyond urgent care toward more population health and chronic disease management services. The Robert Wood Johnson Foundation noted that, “Some delivery systems seeking to improve primary care access and manage total cost of care are using retail clinics to reduce unnecessary emergency department (ED) visits,” given that retail clinics’ costs are lower than EDs and some hospital-based ambulatory departments.

Drug Store News pointed out several clinic innovations in this special issue:

CVS Health’s MinuteClinics number over 1,100 clinics (including 79 in Target stores). They are growing clinical affiliations with medical schools and teaching hospitals such as the Cleveland Clinic, University of Chicago Medical Center, and the University of Michigan Health System, among others. CVS Health’s clinics use an electronic health records system that can share information with health providers and collaborate between the retail health setting and health providers.

Walgreens operates over Healthcare Clinics and 50 other clinics in stores run by other providers. The company is moving toward more coordinated care models beyond urgent care services, and has invested in an Epic EHR to build that communications/IT infrastructure for a vision of seamless care delivered in the community.

The Little Clinic operates in Kroger grocery stores, which is a leader in grocery chains delivering healthcare services. The company makes the connection between health and healthy food, and engages dietitians in their care model in the Little Clinics. THINK: weight management, diabetes care, food allergies, and other consumer-facing health issues that can be self-managed.

Clinics are also emerging in smaller, regional store chains that seek to partner with healthcare providers in local markets.

imageHealth Populi’c Hot Points:  “Retail health” used to mean “the pharmacy.” But today, “the pharmacy” isn’t just a prescription drug dispensary: CVS Health launched a healthy food kiosk in June 2016, and some Wegman’s grocery store pharmacies feature Withings and Higi kiosks for channeling wearable tech and supporting self-checks for blood pressure, pulse, weight, and BMI. (This is my personal photo taken in my local Wegman’s store in Malvern, PA).

As grocers engage nutritionists and dietitians, retail clinics conduct full physical exams (for $40, in the case of Walmart’s new clinic model), and pharmacists take on the role of medication therapy management, consumers can readily access primary care in their close-by community. That convenience, accessibility and “close-by” neighborhood feeling can help bolster medication adherence, continuity of care, and more effective self-care if health care providers (hospitals, clinicians) — especially those taking on more value-based payment in all forms — are willing to collaborate. The new entrants are willing, ready, and able to do so.

And as patients, now health care consumers, are learning to manage high-deductible health plans and health savings accounts, a $40 visit to a PCP is a high-value healthcare proposition.

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Health in America: Improving, But Disparities Need Policy Prescriptions http://www.healthpopuli.com/2016/07/19/socioeconomic-barriers-public-health-can-overcome-smart-health-policies/ http://www.healthpopuli.com/2016/07/19/socioeconomic-barriers-public-health-can-overcome-smart-health-policies/#respond Tue, 19 Jul 2016 13:20:13 +0000 http://www.healthpopuli.com/?p=15368 The bad news: mortality rates haven’t improved much and obesity rates rose in one-third of communities. The good news: public health gains can be made in resource-poor communities with the right health policies, based on research from The Commonwealth Fund, Rising to the Challenge, the Fund’s Scorecard on local health system performance for 2016. The top-line of this benchmark report is that health care in the U.S. has, overall, improved more than it’s declined. Among the big levers driving health care improvement in the past year have been the further expansion of health citizens covered with insurance through the Affordable Care Act, more people getting needed care and a lower-percentage of people self-rationing due to cost, fewer hospital readmission said, and higher-quality care. But underneath the macro positive view are some micro-factors that must be called out: An increase in the proportion of people who are obese in America Greater incidence of high-risk nursing home residents with pressure sores Challenges for many adults with a usual source of care, among others. It’s also clear that more local health system improvements benefiting lower-income residents have been realized in those states that expanded Medicaid for the Affordable Care Act. The darker-blue tones in the map illustrate the overall trends across states in health system performance for 2016. There’s a concentration of lower-performance in the south and southeastern states than in the north and northwest. I recently found similar trends for public health outcomes discussed in my Health Populi post discussing President Obama‘s column in the Journal of the American Medical Association (JAMA) on the progress of health reform. Note, too, that within states there can be huge variation in health outcomes: in Michigan, for example, premature deaths from treatable conditions varied over 2x from a low of 64 deaths per 100,000 in Traverse City to a high of 142 deaths per 100,000 in Dearborn, a suburb of Detroit. The Fund bases its annual community health Scorecard, launched in 2012, on four dimensions: access and affordability, prevention and treatment, avoidable hospital use and cost, and healthy lives. Details on these factors appear in the second (bar) chart on overall improvement by indicator. Under each of the indicators are specific indices of health system performance, such as level of uninsured and adults forgoing care due to cost (in access/affordability); hospital 30-day mortality and safety score (for prevention and treatment); hospital readmission said and avoidable ER visits (for avoidable hospital use and cost); and, breast cancer deaths per 100,000 people and adults who smoke (for healthy lives). Health Populi’s Hot Points:  The map and the health indicators, when put under the microscope of demographics and health system factors, point out the undeniable American reality that local health system performance is directly related to income. The Fund’s report points out that, “compared with residents of higher-income areas, those living in lower-income areas are more likely to report going without needed medical care because of cost (19% vs. 12%), more likely to receive a high-risk prescription medication (20% vs. 13% among Medicare enrollees),” among other health disparaties. This makes the case for public policies that can address the root, base cause that lower income areas lay the ground for worse health outcomes and sustained health disparities. One successful public policy, illustrated by the “access and affordability” factor, has been the Affordable Care Act. Note that the blue bars on the right side of the bar chart have relatively small  numbers for “worsened” situation for the uninsured, at-risk adults without a doctor visit, and adults who went without care due to cost in the past year. These dimensions improved under the ACA and Medicaid expansion in the 31 States and District of Columbia whose governors did so. On the other hand, see “healthy lives” and “prevention and treatment” indicators, where you find more blue bars of “worsened” situations for obesity, infant mortality, mortality amenable to health care, and adults with a usual source of care. Designing sound food and nutrition policies, expanding health education and education overall to promote literacy (general, health, digital, and financial), and supporting resilient local economies are the salvo to bolstering health outcomes and engaging health citizens for co-making health at home and in their communities.

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Rising to the challenge CMWF Public Health map 2016The bad news: mortality rates haven’t improved much and obesity rates rose in one-third of communities. The good news: public health gains can be made in resource-poor communities with the right health policies, based on research from The Commonwealth Fund, Rising to the Challenge, the Fund’s Scorecard on local health system performance for 2016.

The top-line of this benchmark report is that health care in the U.S. has, overall, improved more than it’s declined. Among the big levers driving health care improvement in the past year have been the further expansion of health citizens covered with insurance through the Affordable Care Act, more people getting needed care and a lower-percentage of people self-rationing due to cost, fewer hospital readmission said, and higher-quality care.

But underneath the macro positive view are some micro-factors that must be called out:

  • An increase in the proportion of people who are obese in America
  • Greater incidence of high-risk nursing home residents with pressure sores
  • Challenges for many adults with a usual source of care, among others.

It’s also clear that more local health system improvements benefiting lower-income residents have been realized in those states that expanded Medicaid for the Affordable Care Act.

The darker-blue tones in the map illustrate the overall trends across states in health system performance for 2016. There’s a concentration of lower-performance in the south and southeastern states than in the north and northwest. I recently found similar trends for public health outcomes discussed in my Health Populi post discussing President Obama‘s column in the Journal of the American Medical Association (JAMA) on the progress of health reform.

Note, too, that within states there can be huge variation in health outcomes: in Michigan, for example, premature deaths from treatable conditions varied over 2x from a low of 64 deaths per 100,000 in Traverse City to a high of 142 deaths per 100,000 in Dearborn, a suburb of Detroit.

CMWF improvement by indicator 2016The Fund bases its annual community health Scorecard, launched in 2012, on four dimensions: access and affordability, prevention and treatment, avoidable hospital use and cost, and healthy lives. Details on these factors appear in the second (bar) chart on overall improvement by indicator. Under each of the indicators are specific indices of health system performance, such as level of uninsured and adults forgoing care due to cost (in access/affordability); hospital 30-day mortality and safety score (for prevention and treatment); hospital readmission said and avoidable ER visits (for avoidable hospital use and cost); and, breast cancer deaths per 100,000 people and adults who smoke (for healthy lives).

Health Populi’s Hot Points:  The map and the health indicators, when put under the microscope of demographics and health system factors, point out the undeniable American reality that local health system performance is directly related to income. The Fund’s report points out that, “compared with residents of higher-income areas, those living in lower-income areas are more likely to report going without needed medical care because of cost (19% vs. 12%), more likely to receive a high-risk prescription medication (20% vs. 13% among Medicare enrollees),” among other health disparaties.

This makes the case for public policies that can address the root, base cause that lower income areas lay the ground for worse health outcomes and sustained health disparities.

One successful public policy, illustrated by the “access and affordability” factor, has been the Affordable Care Act. Note that the blue bars on the right side of the bar chart have relatively small  numbers for “worsened” situation for the uninsured, at-risk adults without a doctor visit, and adults who went without care due to cost in the past year. These dimensions improved under the ACA and Medicaid expansion in the 31 States and District of Columbia whose governors did so.

On the other hand, see “healthy lives” and “prevention and treatment” indicators, where you find more blue bars of “worsened” situations for obesity, infant mortality, mortality amenable to health care, and adults with a usual source of care. Designing sound food and nutrition policies, expanding health education and education overall to promote literacy (general, health, digital, and financial), and supporting resilient local economies are the salvo to bolstering health outcomes and engaging health citizens for co-making health at home and in their communities.

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U.S. Health Spending Will Comprise 20% of GDP in 2025 http://www.healthpopuli.com/2016/07/18/u-s-health-spending-will-comprise-20-gdp-2025/ http://www.healthpopuli.com/2016/07/18/u-s-health-spending-will-comprise-20-gdp-2025/#respond Mon, 18 Jul 2016 19:41:57 +0000 http://www.healthpopuli.com/?p=15353 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 Act’s impact in the short run has been to slow spending growth that has been a response to greater patient cost-sharing in both commercial/private health plans and in various Medicare payment regimes. The forecast to 2025 expects that prices for health care services will increase in the middle of the 10 year projection period, pointing to continued use of high-cost specialty drugs and faster drug price growth, in addition to continued growth of Boomers aging in Medicare, and of aging disabled enrollees in Medicaid. In the latter period of the forecast, 2020-2025, spending growth will be higher (around 6.0% per year), further spurred by the aging of America into Medicare. Per enrollee spending for Medicare will read $18,000 in 2025, CMS expects. Several key points by spending line item are worth noting: Hospital prices which typically drive up overall health care spending are expected to be lower than other spending segments Physician and clinical services will be impacted by growing cost-sharing for patients, such as higher copayments and deductibles, and new benefit-design changes, increasing consumers’ out-of-pocket spending for this category Prescription drug cost increases will be influenced upward by the growth of new specialty drug approvals, but some of the impact will be tempered by some approvals for biosimilars Legislative reforms for Medicare will impact spending, as doctors participate in bonus payment programs starting in 2019 toward alternate payment models Medicaid eligibility is expected to expand, since only 31 stats and the District of Columbia have thus far expanded Medicaid in response to the Affordable Care Act. One thing is certain: government payors at the Federal, State and local levels will be covering more health care spending. Health Populi’s Hot Points:  In 2016, the average U.S. family is spending about $1 in every $5 household dollars on health care. This is calculated based on the individual American’s expected $10,345 spending this year divided into the median family income of around $55,000. Looking to the next decade, CMS forecasts that the government, writ large – Federal, State, and local arms — will take on greater financial burden for health care spending. But from where do those public sector health spending dollars come? Answer: from U.S. taxpayers, who also wear the hat of health care consumers. Add into this additional health consumer financial burden other health/care spending that doesn’t get counted by CMS’s National Health Accounts methodology. Deloitte estimated the “hidden cost of healthcare” to be roughly another 20% of health spending on top of the National Health Expenditures, some $672 billion in 2012. That’s supervisory care for loved ones and friends, nutrition and supplements, complementary and alternative medicine services, and other non-reported spending on health-related care and activities. CMS projects that health spending will comprise 20% of GDP by 2025. For consumers’ personal home spending, it’s already hit 20% and will be a much greater share of the pocketbook, including all health/care outlays, by 2025.

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National Health Expenditures 2015-2025Spending 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 Act’s impact in the short run has been to slow spending growth that has been a response to greater patient cost-sharing in both commercial/private health plans and in various Medicare payment regimes.

The forecast to 2025 expects that prices for health care services will increase in the middle of the 10 year projection period, pointing to continued use of high-cost specialty drugs and faster drug price growth, in addition to continued growth of Boomers aging in Medicare, and of aging disabled enrollees in Medicaid.

In the latter period of the forecast, 2020-2025, spending growth will be higher (around 6.0% per year), further spurred by the aging of America into Medicare. Per enrollee spending for Medicare will read $18,000 in 2025, CMS expects.

Several key points by spending line item are worth noting:

  • Hospital prices which typically drive up overall health care spending are expected to be lower than other spending segments
  • Physician and clinical services will be impacted by growing cost-sharing for patients, such as higher copayments and deductibles, and new benefit-design changes, increasing consumers’ out-of-pocket spending for this category
  • Prescription drug cost increases will be influenced upward by the growth of new specialty drug approvals, but some of the impact will be tempered by some approvals for biosimilars
  • Legislative reforms for Medicare will impact spending, as doctors participate in bonus payment programs starting in 2019 toward alternate payment models
  • Medicaid eligibility is expected to expand, since only 31 stats and the District of Columbia have thus far expanded Medicaid in response to the Affordable Care Act.

One thing is certain: government payors at the Federal, State and local levels will be covering more health care spending.

Healthcare 1 dollar in 5 for US health consumers 2016Health Populi’s Hot Points:  In 2016, the average U.S. family is spending about $1 in every $5 household dollars on health care. This is calculated based on the individual American’s expected $10,345 spending this year divided into the median family income of around $55,000.

Looking to the next decade, CMS forecasts that the government, writ large – Federal, State, and local arms — will take on greater financial burden for health care spending. But from where do those public sector health spending dollars come?

Answer: from U.S. taxpayers, who also wear the hat of health care consumers.

Add into this additional health consumer financial burden other health/care spending that doesn’t get counted by CMS’s National Health Accounts methodology. Deloitte estimated the “hidden cost of healthcare” to be roughly another 20% of health spending on top of the National Health Expenditures, some $672 billion in 2012. That’s supervisory care for loved ones and friends, nutrition and supplements, complementary and alternative medicine services, and other non-reported spending on health-related care and activities.

CMS projects that health spending will comprise 20% of GDP by 2025. For consumers’ personal home spending, it’s already hit 20% and will be a much greater share of the pocketbook, including all health/care outlays, by 2025.

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Samsung and Garmin Beat Fitbit in JD Power Fitness Band Match-Up http://www.healthpopuli.com/2016/07/15/samsung-garmin-beat-fitbit-jd-power/ http://www.healthpopuli.com/2016/07/15/samsung-garmin-beat-fitbit-jd-power/#respond Fri, 15 Jul 2016 00:14:51 +0000 http://www.healthpopuli.com/?p=15341 J.D. Power, the company best known for evaluating consumers’ experiences with automobiles, published its 2016 Fitness Band Device Satisfaction Report this week. The bar chart summarizes overall satisfaction with activity tracking wristbands, led by Samsung with the highest index score, followed by Garmin. Below the average index were LG, Fitbit, and Jawbone. Samsung’s top grade translates into J.D. Power’s methodology as “among the best” fitness bands, based on a 1,000 point scale. Samsung’s high ranking was earned based on particularly strong scores for customer satisfaction in comfort, reliability, and ease of use. Garmin’s customer service was also highly rated, along with ease of use, strength/durability, and reliability. Consumers’ fitness band purchases are most influenced by information via online shopping websites (read: Amazon far and away the top e-commerce channel for the category) and recommendations of friends and family. J.D. Power evaluates fitness band trackers based on reliability, strength/durability, ease of use, battery life, price, variety of features, comfort, styling and appearance, display size, apps available, and customer service, in order of importance. The survey covered 2,949 consumers who purchased a fitness band in the past 12 months, fielded in May-June 2016. Health Populi’s Hot Points:  The signs that wearable technology for health and fitness is reaching the mass middle are in many places across retail touch points: Target has launched a connected home store concept to test shoppers’ demand for “smartening up” their living spaces Fossil is expanding wearable tech with “Misfit Wearables” inside Withings is marketing its portfolio of products in kiosks in grocers such as my local Wegmans store UnitedHealthcare recently announced its purpose-made tracker, the Motion, for the company’s new wellness program launched with Qualcomm. Note that J.D. Power’s practice in telecom, media and technology did the research into fitness bands. That’s a technology focus — not a health or fitness focus. It’s the hardware, not the outcomes, that are the emphasis of this study. Gartner’s 2015 Hype Cycle for emerging technology shows wearables falling down from the peak of inflated expectations and into the trough of disillusionment, expecting the category to mature over the next five to ten years. This may correspond well with the growth of value-based health payments, which focus on patient outcomes. Fitbit has begun to talk with the FDA about medicalizing the company’s products, and increasingly the brand of devices appears in peer-reviewed medical journals and technology trade publications. For example, in the past month, the use of the Fitbit Aria in a breast cancer trial at Dana-Farber was featured in Wareable. So is a fitness tracker a telecom technology, a media platform, or a medical device? It may be all three, making J.D. Power’s choice to locate this study in its telecom/media group as good as any other research division at the organization. Consumers see health engagement everywhere, from healthcare to entertainment, financial services to consumer electronics. Over the next decade, the market segment will find its fit….chaos before creation.

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J.D. Power 2016 Fitness Band Device Satisfaction Report (PRNewsFoto/J.D. Power)

J.D. Power, the company best known for evaluating consumers’ experiences with automobiles, published its 2016 Fitness Band Device Satisfaction Report this week. The bar chart summarizes overall satisfaction with activity tracking wristbands, led by Samsung with the highest index score, followed by Garmin. Below the average index were LG, Fitbit, and Jawbone. Samsung’s top grade translates into J.D. Power’s methodology as “among the best” fitness bands, based on a 1,000 point scale.

Samsung’s high ranking was earned based on particularly strong scores for customer satisfaction in comfort, reliability, and ease of use. Garmin’s customer service was also highly rated, along with ease of use, strength/durability, and reliability.

Consumers’ fitness band purchases are most influenced by information via online shopping websites (read: Amazon far and away the top e-commerce channel for the category) and recommendations of friends and family.

J.D. Power evaluates fitness band trackers based on reliability, strength/durability, ease of use, battery life, price, variety of features, comfort, styling and appearance, display size, apps available, and customer service, in order of importance. The survey covered 2,949 consumers who purchased a fitness band in the past 12 months, fielded in May-June 2016.

Health Populi’s Hot Points:  The signs that wearable technology for health and fitness is reaching the mass middle are in many places across retail touch points:

  • Target has launched a connected home store concept to test shoppers’ demand for “smartening up” their living spaces
  • Fossil is expanding wearable tech with “Misfit Wearables” inside
  • Withings is marketing its portfolio of products in kiosks in grocers such as my local Wegmans store
  • UnitedHealthcare recently announced its purpose-made tracker, the Motion, for the company’s new wellness program launched with Qualcomm.

Note that J.D. Power’s practice in telecom, media and technology did the research into fitness bands. That’s a technology focus — not a health or fitness focus. It’s the hardware, not the outcomes, that are the emphasis of this study.

imageGartner’s 2015 Hype Cycle for emerging technology shows wearables falling down from the peak of inflated expectations and into the trough of disillusionment, expecting the category to mature over the next five to ten years. This may correspond well with the growth of value-based health payments, which focus on patient outcomes. Fitbit has begun to talk with the FDA about medicalizing the company’s products, and increasingly the brand of devices appears in peer-reviewed medical journals and technology trade publications. For example, in the past month, the use of the Fitbit Aria in a breast cancer trial at Dana-Farber was featured in Wareable.

So is a fitness tracker a telecom technology, a media platform, or a medical device? It may be all three, making J.D. Power’s choice to locate this study in its telecom/media group as good as any other research division at the organization. Consumers see health engagement everywhere, from healthcare to entertainment, financial services to consumer electronics. Over the next decade, the market segment will find its fit….chaos before creation.

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In Healthcare, Pharmacists and Doctors Most Trusted. Insurance Execs and Congress? Not. http://www.healthpopuli.com/2016/07/14/healthcare-pharmacists-doctors-trusted-insurance-execs-congress-not/ http://www.healthpopuli.com/2016/07/14/healthcare-pharmacists-doctors-trusted-insurance-execs-congress-not/#respond Thu, 14 Jul 2016 00:26:20 +0000 http://www.healthpopuli.com/?p=15326 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 chart. Health Populi’s’ Hot Points:  Poor Congressfolk: their cred when it comes to American healthcare needs help from the likes of Meyocks to re-brand their trust levels among US health citizens. This, at a time when the Democratic platform has moved to the left, incorporating the issue of healthcare as a human right which was part of Senator Sanders’ Presidential campaign mantra. Trust and authenticity are precursors to consumer/patient health engagement, we found in the Edelman Health Engagement Barometer. Pharmacists are under-utilized for consumer health engagement, yet these professionals are highly trusted by consumers, patients and caregivers, and they are readily found in the community where people live and shop in their everyday lives. The likes of CVS health, Walgreens, Walmart, Costco, Target, and pharmacies co-located in grocery stores have the opportunity to effectively engage consumers in their health in sustainable ways through well-designed programs. Increasingly, these retail health touch points will be partners in everyday peoples’ health, wellness, and chronic disease management. Information technology — that is, data liquidity supported by standards-based health IT between health care providers’ electronic health records and the retailers’ own digital health records systems — must underpin this scenario for it to be meaningful.

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img_2857.jpgWhen 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.

imageThis 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 chart.

Health Populi’s’ Hot Points:  Poor Congressfolk: their cred when it comes to American healthcare needs help from the likes of Meyocks to re-brand their trust levels among US health citizens. This, at a time when the Democratic platform has moved to the left, incorporating the issue of healthcare as a human right which was part of Senator Sanders’ Presidential campaign mantra.

imageTrust and authenticity are precursors to consumer/patient health engagement, we found in the Edelman Health Engagement Barometer.

Pharmacists are under-utilized for consumer health engagement, yet these professionals are highly trusted by consumers, patients and caregivers, and they are readily found in the community where people live and shop in their everyday lives. The likes of CVS health, Walgreens, Walmart, Costco, Target, and pharmacies co-located in grocery stores have the opportunity to effectively engage consumers in their health in sustainable ways through well-designed programs. Increasingly, these retail health touch points will be partners in everyday peoples’ health, wellness, and chronic disease management. Information technology — that is, data liquidity supported by standards-based health IT between health care providers’ electronic health records and the retailers’ own digital health records systems — must underpin this scenario for it to be meaningful.

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Most Wired Hospitals Spending on Cybersecurity, Telehealth and Population Health http://www.healthpopuli.com/2016/07/13/wired-hospital-matters/ http://www.healthpopuli.com/2016/07/13/wired-hospital-matters/#respond Wed, 13 Jul 2016 01:10:31 +0000 http://www.healthpopuli.com/?p=15294 Investing information technology dollars in telehealth and mobile platforms, patient engagement, and cybersecurity are major focuses for leading IT-savvy hospitals in America, according to the 2016 Most Wired survey of healthcare organizations, released in July 2016 sponsored by Hospitals and Health Networks and Health Forum, a division of the American Hospitals Association. This survey, in its 18th year, has become an important benchmark measuring the adoption of information technology tools and services among American hospitals and health systems. The complete list of Most Wired hospitals for 2016 can be found here. The most popular telehealth services offered by the Most Wired hospitals are virtual consultations and office visits, among 61% of Most Wired vs. 43% of all hospitals; remote stroke care for 49% of Most Wired compared to 39% of all hospitals; and, telemental health (remote psych examination and psychotherapy) for 47% of Most Wired vs. 34% of all hospitals. The first chart details the telehealth service utilization for 2016 Most Wired compared with all hospitals. A growing population-health among health providers is driving adoption of IT tools for value-based care, according to the research. 62% of Most Wired hospitals are stratifying patients according to risk, 59% integrating clinical and claims data, and 53% interfacing EHR data with population health tools, shown in the second graphic. Revenue-cycle management is an important competency in a growing value-based payment era, with 74% of Most Wired aggregating and measuring cost of care across settings; 50% reconciling charges and patient accounts to a monthly premium payment and other charges based on insurance contracts; and, 39% managing distribution for bundled payments to providers in their system (doctors, hospitals, non-acute facilities). See the second chart for details comparing Most Wired and all U.S. hospitals. Cybersecurity is top-of-mind for the vast majority of hospitals, both uber-Wired and overall: 93% of Most Wired hospitals are using mobile-device encryption, 89% adopting mobile-device management systems, 78% employing two-factor authentication, and 68%, digital signatures. This issue has hospital board-level oversight among 90% of the Most Wired. And, a majority of both Most Wired and all hospitals are engaging third-party security audits to risk-manage cybersecurity. The AHA’s press release noted that, “In redefining the way that they provide care in their communities, Most Wired hospitals are using technology to build patient engagement with the individual’s lifestyle in mind, which includes electronic access to their care team” via patient portals, mobile e-visits, and social media for patient support groups. The survey was conducted between January and March 2016 among 680 participants representing 2,146 hospitals – about one-third of all hospitals in the U.S. Health Populi’s Hot Points:  Hospitals are moving outside of their traditional four walls, providing care where and when patients need it, according to AHA’s CEO and President Rick Pollack. As such, health providers are investing more capital dollars in technology to manage virtual care between providers, and providers and their patients; geographically disparate teams (the “liquid labor force”); deeper implementation of electronic health records to derive more benefits from that significant investment; and, big data analytics, among other projects covering the survey’s four focus areas: infrastructure, business and administrative management, clinical quality and safety, and clinical integration across provider communities (hospital, ambulatory, physician, patients, and community). What’s keeping hospitals’ CxOs up at night is the valuable hacker’s market for personal health record data. This year’s Most Wired survey demonstrates the near-universal acceptance of this new reality, and subsequent investments that the vast majority of U.S. hospitals are making to secure patients’ personal health information. The pace of growth of the threat is growing; there’s coverage on the issue discussed this week here in Health Data Management, talking about The Dark Overlord offering ransoms for EHR data. See the bar chart for details of where the so-called Dark Overlord has cyber-struck health care organizations. The challenge is getting coverage well beyond health-tech trade publications: for example, US News & World report covered this threat in April 2016. PBS News Hour asked, “Has health care hacking become an epidemic?” Ironically, it’s the very nature of the new-new technology – virtual care, telehealth, mobile platforms, digital health records – that provide the hacker their opportunity to breach security. Health information turns out to be a very valuable commodity: according to the Ponemon Institute, the average cost per stolen healthcare record is $355; the average global cost of a stolen record is $158.

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MostWired 2016 TelehealthInvesting information technology dollars in telehealth and mobile platforms, patient engagement, and cybersecurity are major focuses for leading IT-savvy hospitals in America, according to the 2016 Most Wired survey of healthcare organizations, released in July 2016 sponsored by Hospitals and Health Networks and Health Forum, a division of the American Hospitals Association.

This survey, in its 18th year, has become an important benchmark measuring the adoption of information technology tools and services among American hospitals and health systems. The complete list of Most Wired hospitals for 2016 can be found here.

The most popular telehealth services offered by the Most Wired hospitals are virtual consultations and office visits, among 61% of Most Wired vs. 43% of all hospitals; remote stroke care for 49% of Most Wired compared to 39% of all hospitals; and, telemental health (remote psych examination and psychotherapy) for 47% of Most Wired vs. 34% of all hospitals. The first chart details the telehealth service utilization for 2016 Most Wired compared with all hospitals.

MostWired 2016 Value based tools for careA growing population-health among health providers is driving adoption of IT tools for value-based care, according to the research. 62% of Most Wired hospitals are stratifying patients according to risk, 59% integrating clinical and claims data, and 53% interfacing EHR data with population health tools, shown in the second graphic.

Revenue-cycle management is an important competency in a growing value-based payment era, with 74% of Most Wired aggregating and measuring cost of care across settings; 50% reconciling charges and patient accounts to a monthly premium payment and other charges based on insurance contracts; and, 39% managing distribution for bundled payments to providers in their system (doctors, hospitals, non-acute facilities). See the second chart for details comparing Most Wired and all U.S. hospitals.

Cybersecurity is top-of-mind for the vast majority of hospitals, both uber-Wired and overall: 93% of Most Wired hospitals are using mobile-device encryption, 89% adopting mobile-device management systems, 78% employing two-factor authentication, and 68%, digital signatures. This issue has hospital board-level oversight among 90% of the Most Wired. And, a majority of both Most Wired and all hospitals are engaging third-party security audits to risk-manage cybersecurity.

The AHA’s press release noted that, “In redefining the way that they provide care in their communities, Most Wired hospitals are using technology to build patient engagement with the individual’s lifestyle in mind, which includes electronic access to their care team” via patient portals, mobile e-visits, and social media for patient support groups.

The survey was conducted between January and March 2016 among 680 participants representing 2,146 hospitals – about one-third of all hospitals in the U.S.

Health Populi’s Hot Points:  Hospitals are moving outside of their traditional four walls, providing care where and when patients need it, according to AHA’s CEO and President Rick Pollack. As such, health providers are investing more capital dollars in technology to manage virtual care between providers, and providers and their patients; geographically disparate teams (the “liquid labor force”); deeper implementation of electronic health records to derive more benefits from that significant investment; and, big data analytics, among other projects covering the survey’s four focus areas: infrastructure, business and administrative management, clinical quality and safety, and clinical integration across provider communities (hospital, ambulatory, physician, patients, and community).

The Dark Overload hostages EHR records July 2016What’s keeping hospitals’ CxOs up at night is the valuable hacker’s market for personal health record data. This year’s Most Wired survey demonstrates the near-universal acceptance of this new reality, and subsequent investments that the vast majority of U.S. hospitals are making to secure patients’ personal health information. The pace of growth of the threat is growing; there’s coverage on the issue discussed this week here in Health Data Management, talking about The Dark Overlord offering ransoms for EHR data. See the bar chart for details of where the so-called Dark Overlord has cyber-struck health care organizations. The challenge is getting coverage well beyond health-tech trade publications: for example, US News & World report covered this threat in April 2016. PBS News Hour asked, “Has health care hacking become an epidemic?”

Ironically, it’s the very nature of the new-new technology – virtual care, telehealth, mobile platforms, digital health records – that provide the hacker their opportunity to breach security. Health information turns out to be a very valuable commodity: according to the Ponemon Institute, the average cost per stolen healthcare record is $355; the average global cost of a stolen record is $158.

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Health Care Reform: President Obama Pens Progress in JAMA http://www.healthpopuli.com/2016/07/12/health-care-reform-president-obama-pens-progress-jama/ http://www.healthpopuli.com/2016/07/12/health-care-reform-president-obama-pens-progress-jama/#respond Tue, 12 Jul 2016 01:09:12 +0000 http://www.healthpopuli.com/?p=15271 “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 chose to expand Medicaid to cover health insurance for their states’ health citizens. 19 other Governors chose not to do so, and in their states, the health and health-economic impacts were negative. The first chart captures data on how the states expanding Medicaid have experienced larger reductions in the rate of uninsured in their states. Note the blue line and green line: the blue line represents Medicaid Expansion States, and the green, those states not expanding Medicaid. The rate of uninsured overall fell from 16.0% in 2015 to 8.1% in 2015, a decline of 43% nationally. A second positive impact of the Affordable Care Act was the reduction of hospital readmission rates for Medicare patients. The second chart illustrates the dramatic decline in readmissions. This resulted from incentives (more accurately, dis-incentives) for hospitals to prevent older Americans from being readmitted into hospital inpatient beds within 30 days of being discharged for acute myocardial infarction (heart attack), chronic heart failure, and pneumonia. The President also notes that there’s been an improvement in quality of care based on several measures: for example, the rate of hospital acquired conditions like adverse drug events and infections fell by 17%, from 145 per 1000 discharges in 2010 to 121 per 1000 discharges in 2014. In his JAMA article, President Obama notes that the ACA has also begun to change how health care providers are paid, with about 30% of Medicare payments now reimbursed through value-based payment systems such as bundled payment and accountable care organizations. In 2018, Medicare seeks to make 50% of payments through value-based models. There is still more work to do, the President writes, to improve the U.S. health care system. Insurance markets aren’t working as effectively or efficiently as the ACA envisioned, as some dramatically increasing premium rates will confront many health insurance consumers in 2017. Some local and state markets lack competition with only one or two health plans serving these areas. That is a risk for higher premium prices. The President argues for Congress to revisit a public plan to compete with the private insurers to promote competition (and lower prices). Furthermore, some uninsured consumers cannot afford or will not pay for premiums, driving the need for more education about premium assistance and additional increases for financial assistance to ensure true “affordability” as promised in the law’s name. Finally, prescription drug costs continue to challenge many consumers’ family budgets. Specifically, the President argues for giving the Federal government the authority to negotiate prices for “certain high-priced drugs,” he writes. In conclusion, President Obama talks about lessons for future policy makers. Among them, he calls out, “Hyperpartisanship,” with some politicians reversing course and rejecting their own ideas when the President supported them, thus foiling progress for certain aspects of health care reform The challenge of special interests as obstacles to change, especially the pharmaceutical industry which has been resistant to changes in drug pricing The importance of pragmatism, with simpler approaches to addressing health care challenges being better than complex solutions. You can read the President’s White House blog post here where he discusses this JAMA article. Health Populi’s Hot Points:  A lot of us are visual learners, and maps can help us connect the dots that raw data sometimes can’t. Here, I posted the first map from the Kaiser Family Foundation which indicates the states that have expanded Medicaid (31 plus DC) and those that have not. Note the prevalence of orange throughout the southern states; these are the non-expansion states. Now check out map #2, created by The Commonwealth Fund in their research into U.S. state’s health system performance. Note the predominant dark blue that is a remarkably similar footprint to the Medicaid non-expansion states. The Fund develops state-level scorecards for “health system performance” looking at state residents’ ability to: Access and afford health care Access prevention and treatment Avoid unnecessary hospital use and cost Live long and healthy lives Experience health equity. Those dark-blue states have lower “grades” than other states. There is up to an 8-fold difference between the highest-performing states and the lowest-performing ones, the Fund calculated. In 2014, Bill Moyers pointed out the growing gap between so-called red versus blue states. Political decisions have public health consequences, which are illustrated here with a proxy metric: that is, the CDC’s and NASA’s projections for the spread of the Zika virus. This, too, has a footprint akin to the maps illustrating Medicaid non-expansion and poor health system and state citizens’ health outcomes.  

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Obama JAMA expansion reduces uninsured rates Jul 2016

“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 chose to expand Medicaid to cover health insurance for their states’ health citizens. 19 other Governors chose not to do so, and in their states, the health and health-economic impacts were negative. The first chart captures data on how the states expanding Medicaid have experienced larger reductions in the rate of uninsured in their states. Note the blue line and green line: the blue line represents Medicaid Expansion States, and the green, those states not expanding Medicaid. The rate of uninsured overall fell from 16.0% in 2015 to 8.1% in 2015, a decline of 43% nationally.

Obama JAMA ACA reduced hospital readmissions for Medicare

A second positive impact of the Affordable Care Act was the reduction of hospital readmission rates for Medicare patients. The second chart illustrates the dramatic decline in readmissions. This resulted from incentives (more accurately, dis-incentives) for hospitals to prevent older Americans from being readmitted into hospital inpatient beds within 30 days of being discharged for acute myocardial infarction (heart attack), chronic heart failure, and pneumonia.

The President also notes that there’s been an improvement in quality of care based on several measures: for example, the rate of hospital acquired conditions like adverse drug events and infections fell by 17%, from 145 per 1000 discharges in 2010 to 121 per 1000 discharges in 2014.

In his JAMA article, President Obama notes that the ACA has also begun to change how health care providers are paid, with about 30% of Medicare payments now reimbursed through value-based payment systems such as bundled payment and accountable care organizations. In 2018, Medicare seeks to make 50% of payments through value-based models.

There is still more work to do, the President writes, to improve the U.S. health care system. Insurance markets aren’t working as effectively or efficiently as the ACA envisioned, as some dramatically increasing premium rates will confront many health insurance consumers in 2017. Some local and state markets lack competition with only one or two health plans serving these areas. That is a risk for higher premium prices. The President argues for Congress to revisit a public plan to compete with the private insurers to promote competition (and lower prices).

Furthermore, some uninsured consumers cannot afford or will not pay for premiums, driving the need for more education about premium assistance and additional increases for financial assistance to ensure true “affordability” as promised in the law’s name.

Finally, prescription drug costs continue to challenge many consumers’ family budgets. Specifically, the President argues for giving the Federal government the authority to negotiate prices for “certain high-priced drugs,” he writes.

In conclusion, President Obama talks about lessons for future policy makers. Among them, he calls out,

  • “Hyperpartisanship,” with some politicians reversing course and rejecting their own ideas when the President supported them, thus foiling progress for certain aspects of health care reform
  • The challenge of special interests as obstacles to change, especially the pharmaceutical industry which has been resistant to changes in drug pricing
  • The importance of pragmatism, with simpler approaches to addressing health care challenges being better than complex solutions.

You can read the President’s White House blog post here where he discusses this JAMA article.

current-status-of-the-medicaid-expansion-decisions-healthreform1Health Populi’s Hot Points:  A lot of us are visual learners, and maps can help us connect the dots that raw data sometimes can’t. Here, I posted the first map from the Kaiser Family Foundation which indicates the states that have expanded Medicaid (31 plus DC) and those that have not. Note the prevalence of orange throughout the southern states; these are the non-expansion states.

health-system-performanceNow check out map #2, created by The Commonwealth Fund in their research into U.S. state’s health system performance. Note the predominant dark blue that is a remarkably similar footprint to the Medicaid non-expansion states.

The Fund develops state-level scorecards for “health system performance” looking at state residents’ ability to:

  • Access and afford health care
  • Access prevention and treatment
  • Avoid unnecessary hospital use and cost
  • Live long and healthy lives
  • Experience health equity.

Those dark-blue states have lower “grades” than other states. There is up to an 8-fold difference between the highest-performing states and the lowest-performing ones, the Fund calculated.

Zika spread CDC NASA et alIn 2014, Bill Moyers pointed out the growing gap between so-called red versus blue states. Political decisions have public health consequences, which are illustrated here with a proxy metric: that is, the CDC’s and NASA’s projections for the spread of the Zika virus. This, too, has a footprint akin to the maps illustrating Medicaid non-expansion and poor health system and state citizens’ health outcomes.

 

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More Patients Morph Into Financially Burdened Health Consumers http://www.healthpopuli.com/2016/07/08/patients-morph-financially-burdened-health-consumers/ http://www.healthpopuli.com/2016/07/08/patients-morph-financially-burdened-health-consumers/#respond Fri, 08 Jul 2016 01:38:38 +0000 http://www.healthpopuli.com/?p=15257 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 2015, medical procedures with the highest out-of-pocket costs were: Dermatology, $2,451 Orthopedic surgery, $2,405 General surgery, $2,264 Psychiatry and neurology, $2,198 Plastic surgery, $2,195 Cardiology, $2,020. These out-of-pockets caused one-half of patients in the first quarter of 2016 to owe more than $1,000 to health care providers. 77% of patients owed over $500 to their providers in Q1-16. Health Populi’s Hot Points: It’s noteworthy that TransUnion’s website positions the company’s mission, “to help people everywhere access the opportunities that lead to a higher quality of life.” Financial un-wellness can lead to stress that compromises health and that quality of life, along with poor fiscal outcomes for health care providers whose CFOs are challenged with growing patient receivables and bad debt burdens. The TransUnion survey demonstrates the opportunity for better service design and financial literacy programs that feature consumer-friendly bills, education programs on health costs and payments based on a person’s own health plan’s intricacies, and financial payback programs that suit a family’s budget. Check out the Healthcare Financial Management friendly billing project, along with Mad*Pow’s “A Bill You Can Understand” design project. Furthermore, for employees who have the opportunity to contribute to a health savings account, effective communications should inform people of the triple-tax advantaged nature of the HSA — allowing people to invest pre-tax dollars, grow the dollars without being taxed, and withdraw the monies without a tax. Most consumers with an HSA investment opportunity still do not understand the benefit of that benefit.

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TransUnion Patients experienced 13 pct growth in deductibles and OOP costs June 2016Health 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 2015, medical procedures with the highest out-of-pocket costs were:

  • Dermatology, $2,451
  • Orthopedic surgery, $2,405
  • General surgery, $2,264
  • Psychiatry and neurology, $2,198
  • Plastic surgery, $2,195
  • Cardiology, $2,020.

These out-of-pockets caused one-half of patients in the first quarter of 2016 to owe more than $1,000 to health care providers. 77% of patients owed over $500 to their providers in Q1-16.

Health Populi’s Hot Points: It’s noteworthy that TransUnion’s website positions the company’s mission, “to help people everywhere access the opportunities that lead to a higher quality of life.”

Financial un-wellness can lead to stress that compromises health and that quality of life, along with poor fiscal outcomes for health care providers whose CFOs are challenged with growing patient receivables and bad debt burdens.

The TransUnion survey demonstrates the opportunity for better service design and financial literacy programs that feature consumer-friendly bills, education programs on health costs and payments based on a person’s own health plan’s intricacies, and financial payback programs that suit a family’s budget. Check out the Healthcare Financial Management friendly billing project, along with Mad*Pow’s “A Bill You Can Understand” design project.

Furthermore, for employees who have the opportunity to contribute to a health savings account, effective communications should inform people of the triple-tax advantaged nature of the HSA — allowing people to invest pre-tax dollars, grow the dollars without being taxed, and withdraw the monies without a tax. Most consumers with an HSA investment opportunity still do not understand the benefit of that benefit.

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Workplace Wellness Goes Holistic, Virgin Pulse Finds http://www.healthpopuli.com/2016/07/07/workplace-wellness-goes-holistic-virgin-pulse-finds/ http://www.healthpopuli.com/2016/07/07/workplace-wellness-goes-holistic-virgin-pulse-finds/#respond Thu, 07 Jul 2016 01:16:18 +0000 http://www.healthpopuli.com/?p=15247 “Work is the second most common source of stress, just behind financial worries,” introduces The Business of Healthy Employees report from Virgin Pulse, the company’s 2016 survey of workplace health priorities published this week. Virgin Pulse collaborated with Workforce magazine, polling 908 employers and 1,818 employees about employer-sponsored health care, workers’ health habits, and wellness benefit trends. Workplace wellness programs are becoming more holistic, integrating a traditional physical wellness focus with mental, social, emotional and financial dimensions for 3 in 4 employers. Wearable technology is playing a growing role in the benefit package and companies’ cultures of health, as well as social media to inform and inspire plan members’ healthy lifestyles. In 2016, the top wellness programs offered to employees address physical activity, mental health, smoking cessation, health club memberships, health risk assessments, stress management, weight management, financial management, nutrition, and on-site gyms — the only category that grew over 2015. One-third of employees said their employers offered healthy food choice programs and on-site clinics and participate in these programs. Why do workers participate in health and wellbeing programs? The key reasons are… To improve health (97%) To earn incentives (95%) To increase energy (94%), and To manage stress (82%). Two-thirds of employees who participate in wellness programs reported improved activity levels (exercise) as a result of participation, 63% felt healthier and happier, and 63% also report improvement in overall wellbeing. There are some differences in employees’ wellness wants versus employers’ program offerings, shown in the second chart. The biggest gaps of wellness demand vs. supply are for: Nutrition, with 43% of employers offering and 37% of employees desiring the benefit Physical activity, offered by 53% of companies and wanted by 35% of workers Weight management, offered by 45% of employers and desired by 32% of employees. Wearable tech is “primed for growth,” Virgin Pulse asserts in the report. While 54% of companies aren’t yet using wearable tech nor plan to do so, 22% currently use wearable tech and 24% are interested in implementing wearable devices in wellness programs. Health Populi’s Hot Points:  As competition for workplace talent gets more acute, companies will compete on the basis of benefits in addition to wages. It’s clear that workers are keen on wellness programs, but may be on different pages from their employers on certain wellness programs received in the workplace versus those accessed outside of work. As much as consumers desire health food choices in their daily life (frequently discussed in Health Populi, such as in this recent post on food-as-medicine), workers may be more comfortable dealing with weight issues, nutrition and physical exercise “elsewhere” in the health/care ecosystem. This suggests the importance of employers in collaborating with other health/care stakeholders, like grocery stores, retailers, gyms, YMCA organizations, and other places where employees live out their lives outside of the workplace. The importance of financial wellness was mentioned at the start of the report, but no deeper dive was made into employees’ interest in receiving such support through workplace wellness programs in this study. However, other surveys have found workers’ keen interest in receiving financial wellness support, and there is a growing list of programs addressing this issue for emerging areas such as student loan support, wedding expenses, and Tesla leases covered here in the Washington Post.

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Top wellness programs offered to employees Virgin Pulse 2016“Work is the second most common source of stress, just behind financial worries,” introduces The Business of Healthy Employees report from Virgin Pulse, the company’s 2016 survey of workplace health priorities published this week.

Virgin Pulse collaborated with Workforce magazine, polling 908 employers and 1,818 employees about employer-sponsored health care, workers’ health habits, and wellness benefit trends.

Workplace wellness programs are becoming more holistic, integrating a traditional physical wellness focus with mental, social, emotional and financial dimensions for 3 in 4 employers. Wearable technology is playing a growing role in the benefit package and companies’ cultures of health, as well as social media to inform and inspire plan members’ healthy lifestyles.

In 2016, the top wellness programs offered to employees address physical activity, mental health, smoking cessation, health club memberships, health risk assessments, stress management, weight management, financial management, nutrition, and on-site gyms — the only category that grew over 2015.

One-third of employees said their employers offered healthy food choice programs and on-site clinics and participate in these programs.

Why do workers participate in health and wellbeing programs? The key reasons are…

  • To improve health (97%)
  • To earn incentives (95%)
  • To increase energy (94%), and
  • To manage stress (82%).

Two-thirds of employees who participate in wellness programs reported improved activity levels (exercise) as a result of participation, 63% felt healthier and happier, and 63% also report improvement in overall wellbeing.

Employee and employer gap in wellness wants vs offeirngs Virgin Pulse 2016There are some differences in employees’ wellness wants versus employers’ program offerings, shown in the second chart. The biggest gaps of wellness demand vs. supply are for:

  • Nutrition, with 43% of employers offering and 37% of employees desiring the benefit
  • Physical activity, offered by 53% of companies and wanted by 35% of workers
  • Weight management, offered by 45% of employers and desired by 32% of employees.

Wearable tech is “primed for growth,” Virgin Pulse asserts in the report. While 54% of companies aren’t yet using wearable tech nor plan to do so, 22% currently use wearable tech and 24% are interested in implementing wearable devices in wellness programs.

Health Populi’s Hot Points:  As competition for workplace talent gets more acute, companies will compete on the basis of benefits in addition to wages. It’s clear that workers are keen on wellness programs, but may be on different pages from their employers on certain wellness programs received in the workplace versus those accessed outside of work.

As much as consumers desire health food choices in their daily life (frequently discussed in Health Populi, such as in this recent post on food-as-medicine), workers may be more comfortable dealing with weight issues, nutrition and physical exercise “elsewhere” in the health/care ecosystem. This suggests the importance of employers in collaborating with other health/care stakeholders, like grocery stores, retailers, gyms, YMCA organizations, and other places where employees live out their lives outside of the workplace.

The importance of financial wellness was mentioned at the start of the report, but no deeper dive was made into employees’ interest in receiving such support through workplace wellness programs in this study. However, other surveys have found workers’ keen interest in receiving financial wellness support, and there is a growing list of programs addressing this issue for emerging areas such as student loan support, wedding expenses, and Tesla leases covered here in the Washington Post.

The post Workplace Wellness Goes Holistic, Virgin Pulse Finds appeared first on HealthPopuli.com.

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