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The High Cost-of-Thriving and the Evolving Social Contract for Health Care

Millions of Americans have to work 53 weeks to cover a year’s worth of household expenses. Most Americans haven’t saved much for their retirement. Furthermore, the bullish macroeconomic outlook for the U.S. in early 2020 hasn’t translated into individual American’s optimism for their own family budgets. (Sidebar and caveat: yesterday was the fourth day in a row of the U.S. financial markets losing as much as 10% of market cap, so the global economic outlook is being revised downward by the likes of Goldman Sachs, Vanguard, and Morningstar, among other financial market prognosticators. MarketWatch called this week the worst market

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Why CTA’s Shepherding AI Is Important for Re-Imagining Healthcare

The Consumer Technology Association (CTA), collaborating with industry stakeholders, has ushered in a standard for artificial intelligence in health care.   CTA is the membership organization for companies that innovate, manufacture and market consumer-facing tech like big-screen TVs, slick new autos, video games and voice assistants. So what’s an organization like CTA doing with AI and health care? Let me connect the dots. Check out this graphic taken from my book, HealthConsuming: From Health Consumer to Health Citizen. This shows the ten categories of tech I revisit each year at CES, CTA’s annual mega-conference of new-new things in consumer electronics

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Outpatient is the New Inpatient – The Future of Hospitals in America

Outpatient revenue is crossing the curve of inpatient income. This is the new reality for U.S. hospitals and why I’ve titled this post, “outpatient is the new inpatient,” a future paradigm for U.S. hospitals This realization is informed by data in a new report from Deloitte, Where have the many hospital inpatient gone? The line chart illustrates Deloitte’s top and bottom line: “The shift toward outpatient is happening and will likely have a tremendous impact on operations, business models, staffing, and capital. Health systems should prepare for the future today and start thinking not only about how to manage their

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Tools for Paying Medical Bills Don’t Help Health Consumers Manage Their Financial Health

There’s a gap between the supply of digital health tools that hospitals and health systems offer patients, and what patients-as-consumers need for overall health and wellbeing. This chasm is illustrated in The future of the digital patient experience, the latest report from HIMSS and the Center for Connected Medicine (CCM). The big gap in supply to patients vs. demand by health consumers is highlighted by what the arrow in the chart below points to: managing payments and paying bills. Nowhere in the top 10 most commonly provided digital tools is one for price transparency, cost comparing or cost estimating.  In the

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Will Trade Data for (Cheaper) Health Care – USC’s View of the Future

Patients are now front-line payors in the U.S. health care system. As such, American health consumers are wrestling with sticker shock from surgical procedures, surprise medical bills weeks after leaving the hospital, and the cost of prescription drugs — whether six-figure oncology therapies or essential medicines like insulin and EpiPens. To manage personal health finances, patients-as-payors are increasingly willing to face trade-offs and change personal behaviors to lower health care costs, based on research in The Future of Health Care Study from USC’s Center for the Digital Future. The Center analyzed the perspectives of 1,000 U.S. adults in August 2019 regarding

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Americans’ Top 2 Priorities for President Trump and Congress Are To Lower Health Care and Rx Costs

Health care pocketbook issues rank first and second place for Americans in these months leading up to the 2020 Presidential election, according to research from POLITICO and the Harvard Chan School of Public Health published on 19th February 2020. This poll underscores that whether Democrat or Republican, these are the top two domestic priorities among Americans above all other issues polled including immigration, trade agreements, infrastructure and regulations. The point that Robert Blendon, Harvard’s long-time health care pollster, notes is that, “Even among Democrats, the top issues…(are) not the big system reform debates…They’re worried about their own lives, their own

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Most Workers and their Employers Want to Receive Digital Healthcare On-Demand

Most employers and their workers see the benefits of digital health in helping make health care more accessible and lower-cost, according to survey research published in Health on Demand from Mercer Marsh Benefits. Interestingly, more workers living in developing countries are keener on going digital for health than people working in wealthier nations. Mercer’s study was global, analyzing companies and their employees in both mature and growth economies around the world. In total, Mercer interviewed 16,564 workers and 1,300 senior decision makers in companies. The U.S. sample size was 2,051 employees and 100 decision makers. There’s a treasure trove of insights

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The Ill Health of Rural Hospitals in Four Charts

There are 1,844 rural hospitals operating in the U.S. That number is down by 19 in the 2019 calendar year, the worst year of rural hospital closings seen in the past decade. That hockey-stick growth of closures is shown in the first chart, where 34 rural hospitals shut down in the past 2 years. Rural U.S. hospitals are in poor fiscal health. “The accelerated rate at which rural hospitals are closing continues to unsettle the rural healthcare community and demands a more nuanced investigation into rural hospital performance,” threatening the stability of the rural health safety net, according to the

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The Federal Reserve Chairman Speaks Out on Health Care Costs: “Spending But Getting Nothing”

On February 12, 2020, the Chairman of the Federal Reserve Bank of the U.S. submitted the Semiannual Monetary Policy Report to Congress and testified to the Senate Banking Committee. Chairman Jerome Powell detailed the current state of the economy, discussing the state of the macroeconomy, GDP growth, unemployment, inflation, and projections for 2022 and beyond. The top line data points are shown in the first chart. After his prepared remarks, Chairman Powell responded to questions from members of the Senate Banking Committee. Senator Ben Sasse (R-Neb.) asked him about health care costs’ impact on the national U.S. economy. The Chairman

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What Health Plans, Hospitals and Health Systems Can Learn from CES 2020

At this year’s CES — that’s the annual meta-meet-up of tech-loving folks from around the world who meet in Las Vegas to see the latest in all forms of consumer electronics and technology, from smart refrigerators and sexy sleek cars to videogames and personal emergency systems — there was a lot for the health care industry to soak up. I explain what was not only hot, but impactful, for health care providers and plans in the Medecision Liberation Blog published today. This year’s #CES2020 wasn’t as much about the shiny new things in the Internet of Things as it was

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Health@Retail Update: Kroger and Hy-Vee Morph Grocery into Health, Walmart’s Health Center, CVS/housing and More

With our HealthConsuming “health is everywhere” ethos, this post updates some of the most impactful recent retail health developments shaping consumers’ health/care touchpoints beyond hospitals, physicians, and health plans. For inspiration and context, I’ll kick off with Roz Chast’s latest New Yorker cartoon from the February 3rd 2020 issue — Strangers in the Night, taking place in a Duane Reade pharmacy. Roz really channels the scene in front of the pharmacy counter, from Q-tips to vitamins and tea. And it’s hummable to the tune of, well, Strangers in the Night. Check out the 24-hour pharmacist under the pick-up sign. Now,

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Physicians Lean In to Digital Health, Especially Telehealth and Remote Monitoring

More U.S. doctors are using digital health tools in patient care, with quickening adoption of telehealth and remote monitoring technology, according to a study from the American Medical Association (AMA). This survey, conducted in 2019 among 1,359 U.S. physicians, follows up AMA’s research conducted in 2016 and largely reflects the original questionnaire to be able to understand real changes among doctors’ use of tech in practice. As part of this rigorous study design, AMA used particular definitions for the seven tools the study gauged: remote monitoring for efficiency, remote monitoring and management for improved care, clinical decision support, patient engagement,

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Health Care Costs Concern Americans Approaching Retirement – Especially Women and Sicker People

Even with the prospect of enrolling in Medicare sooner in a year or two or three, Americans approaching retirement are growing concerned about health care costs, according to a study in JAMA Network Open. The paper, Health Insurance Affordability Concerns and health Care Avoidance Among US Adults Approaching Retirement, explored the perspectives of 1,028 US adults between 50 and 64 years of age between November 2018 and March 2019. The patient survey asked one question addressing two aspects of “health care confidence:” “Please rate your confidence with the following:” Being able to afford the cost of your health insurance nad

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USA Today Finds Hidden Common Ground Among Americans For Health Care

“We need to demand our health citizenship. That means our nation must approach medical treatment and data privacy as civil rights that protect everyone.” This is the start of my column, Americans, let’s claim our health care rights, published by USA Today today. USA Today is publishing a 10-part series called “Hidden Common Ground” addressing key issues where Americans can come together. Thus far, the series has covered climate change, and this month health care. Going forward, we’ll see analyses on jobs, gun rights and violence, and immigration through May’s publishing schedule. In their study conducted in December 2020, USA Today

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Come Together – A Health Policy Prescription from the Bipartisan Policy Center

Among all Americans, the most popular approach for improving the health care in the U.S. isn’t repealing or replacing the Affordable Care Act or moving to a Medicare-for-All government-provided plan. It would be to improve the current health care system, according to the Bipartisan Policy Center’s research reported in a Bipartisan Rx for America’s Health Care. The BPC is a truly bipartisan organization, co-founded by Former Democratic Senate Majority Leaders Tom Daschle and George Mitchell, and Former Republican Senate Majority Leaders Howard Baker and Bob Dole. While this political week in America has revealed deep chasms between the Dems and

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What’s Causing Fewer Primary Care Visits in the US?

Americans who have commercial health insurance (say, through an employer or union) are rarely thought to face barriers to receiving health care — in particular, primary care, that front line provider and on-ramp to the health care system. But in a new study published in the Annals of Internal Medicine, commercially-insured adults were found to have visited primary care providers (PCPs) less often, and 1 in 2 had no PCP visits in one year. In Declining Use of Primary Care Among Commercially Insured Adults in the United States, 2008-2016, the researchers analyzed data from a national sample of adult health

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The State of the Union for Prescription Drug Prices

Tonight, President Trump will present his fourth annual State of the Union address. This morning we don’t have a transcript of the speech ahead of the event, but one topic remains high on U.S. voters’ priorities, across political party – prescription drug prices. Few issues unite U.S. voters in 2020 quite like supporting Medicare’s ability to negotiate drug prices with pharmaceutical companies, shown by the October 2019 Kaiser Family Foundation Health Tracking Poll. Whether Democrat, Independent, or Republican, most people living in America favor government intervention in regulating the cost of medicines in some way. In this poll, the top

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Most Americans Are Curious and Hopeful About Genetics Research, But Privacy-Concerned

Most Americans associate more optimistic words with human genetics research than they do darker implications: “curious,” “hopeful,” “amazed.” and indeed “optimistic” ranked the top four impressions in peoples’ minds, based on a survey form the American Society of Human Genetics (ASHG). Below these perceptions are a few concerning concepts such as “cautious,” “concerned,” “hesitant, and “skeptical,” the poll found. Based on the relatively positive views on genetics research, most Americans support increasing Federal funding for that research: 74% said it was somewhat or very important to do so, compared with 15% saying it was not important. People value genetics research

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