Categories

Health spending in America – self-rationing slows cost increases

The Big Headline under the banner of Health Economics this week is the statistic that growth in U.S. national health spending slowed to an anemic 3.9%  in 2010 — the slowest rate of growth in the 51-year history of keeping the National Health Expenditure Accounts.   Before American policymakers, providers, plans and suppliers pat themselves on their collective back on a job well-done, the heavy-lifting behind this story was largely undertaken by health consumers themselves in the form of facing greater co-pays, premiums and prices for health services — and as a result, self-rationing off health care services and utilization, which

 

US doctors less sanguine about the benefits of health IT

To doctors working in eight countries around the globe, the biggest benefit of health IT is better access to quality data for clinical access, followed by reducing medical errors, improving coordination of care across care settings, and improving cross-organizational workflow. However, except for the issue of health IT’s potential to improve cross-organizational working processes, American doctors have lower expectations about these benefits than their peers who work in the 7 other nations polled in a global study from Accenture‘s Eight-Country Survey of Doctors Shows Agreement on Top Healthcare Information Technology Benefits, But a Generational Divide Exists. Accenture polled over 3,700 doctors working in

 

The social determinants of health – U.S. doctors feel unable to close the gap and deliver quality care

Most U.S. primary care physicians realize the health of their patients is largely out of their hands — with their social needs ranking as important as addressing their medical conditions, according to the 2011 Physicians’ Daily Life Report, conducted on behalf of the Robert Wood Johnson Foundation by Harris Interactive in September-October 2011, results published in November 2011. In fact, unmet social needs are directly leading to worse health for Americans, say 9 in 10 doctors. With that recognition, most physicians feel they’re unable to address patients’ health concerns caused by unmet social needs. This has led to most doctors confessing

 

The Proustian joy of a well-honed walking playlist: how music propels and sustains joyful exercise

By Jane Sarasohn-Kahn on 6 January 2012 in Uncategorized

In rounding out what’s turned into Wellness Week on Health Populi, I’d like to share one last (for now) learning from 2011 – My Year of Health: what I’ll call the “Proustian joy” of a personalized iTunes playlist for daily walks. In waking very early — in the dark this winter season — for my daily walk, music plays a key role in propelling my energy and waking up my body. After a few months of this regime, it’s become routine, but not a bore: instead, by refreshing my playlist, and learning about how to best organize it for optimal

 

What Inspires and Tires Women When It Comes to Weight – The Fat Trap and the role of exercise

‘Tis the season of weight loss plans, particularly among women, as this NPR story discusses. For the weight loss industry, this first quarter of the new year is akin to Black Friday for retailers the day-after-Thanksgiving. Special K called January 2, 2012, as National Weigh-In Day. To commemorate the event, Kelloggs commissioned a survey among women to find out what “inspires and tires” them when it comes to losing weight. Two-thirds of women in the U.S. started or re-started a weight management plan on January 1st, 2012. Other times of the year when women initiate weight-loss plans are to prep

 

Connected Health and obesity – will mObesity be able to mitigate the epidemic?

It’s January and the #1 most popular post-New Year’s resolution is to lose weight, get fit, and live well. The signs of this are manifested in ads featuring Janet Jackson promoting Nutrisystem, Jennifer Hudson dueting with her then-and-now selves pitching Weight Watchers, as well as the new Weight Watchers for Men promotion starring Charles Barkley. But there are new signs that losing weight and getting fit are going beyond “diets” and food plans: research shows that moving around and getting exercise can help people sustain hard-earned weight loss more than just changing food intake and “dieting.” So the Apple store

 

Paying medical bills is a chronic problem for 1 in 3 uninsured, and 1 in 5 insured people under 65

Over 20% of U.S. families had problems paying medical bills in 2010 — about the same proportion as in 2007. The Center for Studying Health System Change found this datapoint “surprising,” given the Great Recession of 2008 that lingers into 2012. However, HSC points out that the leveling of medical bill problems may be a “byproduct” of reduced medical care utilization; in Health Populi-speak, self-rationing of health care. In the Tracking Report, Medical Bill Problems Steady for U.S. Families, 2007-2010, HSC analyzed data from the 2010 Health Tracking Household Survey and discovered that since 2003, the proportion of families facing problems with medical debt

 

Make 2012 the year of living health-fully

When I would meet up with clients and friends during the latter half of 2011, people whom I hadn’t seen for months would do a double-take when they saw me. “What have you done?” they have asked. In this first post of 2012, I will share with Health Populi readers my story of 2011 — a year of living health-fully for me. One of the blessings of my work-life is that I have access to some of the great minds in health and health care. But not until I began to personally harness their wisdom, intentionally incorporating what they’ve learned into my own life-flow and

 

Health IT in 2012: a dynamic sector in the context of a fiscally-challenged health system

2012 will be a dynamic year for health information technology (health IT) in the U.S., which I outline in my annual health IT forecast in iHealthBeat, the online publication on technology and health care published by the California HealthCare Foundation. The full forecast can be found here. The key headlines for you Reader’s Digest abridged fans are that: The Health IT sector will continue to grow jobs in the ongoing Great Depression, particularly in key competencies in data security, analytics, integration, and EHR implementation. There will be more data breaches, and consumers will be justifiably concerned about data security. Government will more consistently

 

Consumers are at the center of the business of health and wellness

The market for health and wellness has traditionally included over-the-counter medicines, gym memberships, and vitamins/minerals/supplements. In 2012, the boundaries of health/wellness are blurring beyond these line items toward preventive medical services and consumer electronics. This morphing market is discussed by Cambridge Consultants in their report on the disruptions driving The Business of Health & Wellness: Engaging consumers and making money. Cambridge correctly introduces this analysis by saying that economics, the growing prevalence of chronic diseases, an aging population, and demand consumers are shaping health/wellness, “recharacterizing” the market as one driven by “life events.” Cambridge sees that health consumers are changing their spending

 

Consumer engagement in health: greater cost-consciousness and demand for cost/quality information

People enrolled in consumer-directed health plans (CDHPs) are more likely than enrollees in traditional health insurance products to be cost-conscious. In particular, CDHP members check prices before they receive health care services, ask for generic drugs versus branded Rx’s, talk to doctors about treatment options and their costs, and use online cost-tracking tools. Furthermore, CDHP members are also more likely to use wellness programs offered by their employers, and are offered “carrots” to participate in them in the forms of financial rewards and other incentives, as well as reduced health care insurance premiums. The 7th annual Employee Benefits Research Institute

 

UK finds telehealth reduces mortality by 45%; telehealth’s tipping point in 2012

As we approach 2012, we health prognosticators like to forecast what we’ll likely see in 2012. One of the for-certain trends will be the uptake of telehealth programs, which will be publicly, privately, and jointly-funded. The business case is clear for telehealth, both in the U.S. and globally. Jon Linkous, CEO of the American Telemedicine Association, told the mHealth Summit last week that, the “shift in the way healthcare is paid will put providers in driver’s seat when it comes to choosing the best way  to deliver healthcare and whether or not to use telemedicine.” The forces are converging for telehealth

 

Peoples’ decline in health information seeking related to the fall of print and educational attainment

The percentage of U.S. adults seeking health information declined from 2007 to 2010, according to the Health Tracking Household Study conducted by the Center for Studying Health System Change (HSC), published in November 2011. In 2007, 57% of consumers sought health information, falling to 50% in 2010, HSC found. The chart illustrates where the big drop in health information seeking occurred: in print media including books, magazines and newspapers, falling by one-half from 33% of consumers to 18%. The Internet (with 33% of consumers searching health information online) and friends and family (attracting 29% of consumers) remained relatively flat as information sources. TV/radio dropped 5.6 percentage

 

Value and values will drive the adoption of mobile health

This week’s mHealth Summit in Washington, DC, features scores of presentations, posters, and corporate announcements demonstrating the typical chaos of emerging technology markets: the Big Question at this stage on S-curves for new tech is always, “what’s the timing of the pace of change,” or for you mathematically-inclined readers, “what’s the slope of the mHealth adoption curve?” Before we address that question, let’s be transparent about the fact that there are several definitions of just what ‘mHealth’ is: purists may conceive it as covering only those health tools and applications that ‘go’ mobile–that is, that are deployed via mobile phones and

 

Employees predict reduced benefits in 2012; one-half expect layoffs

By Jane Sarasohn-Kahn on 6 December 2011 in Employers, Health Economics, Health insurance, Health Plans

On the face of the raw data, tbe good news from the U.S. Bureau of Labor Statistics on the nation’s employment picture was an additional 120,000 jobs in November. This drove the unemployment rate down to 8.6%. Underneath that number, though, remains what is still a shaky economy for both workers and those seeking full employment to match what they might have lost as a result of their layoffs. First and foremost, most people who are fortunate to still have their jobs see 2012 as a year where the benefits they receive through their employers will fall, according to the Randstad Employee Attachment Index,

 

The New American Dream: personal sustainability, not wealth

The Great American Recession of 2008 will reawaken in 2012, Goldman Sachs expects. In the current economic climate of a jobless recovery and dropping home values, the definition of The American Dream has changed. It’s more about personal fulfillment than financial gain, according to the 2011 MetLife Study of The American Dream: The Do-It-Yourself Dream. This is the rise of the “do-it-yourself” American Dream, MetLife found in its survey of 2,420 online adults conducted in September-October 2011. Across the generations — from Silent (born between 1920 and 1945) to Gen Y (born between 1978 and 1993), this redefining concept is relatively consistent.

 

What’s baked into the Affordable Care Act? Half of Americans still don’t realize there’s no-cost preventive care

The U.S. public’s views on health reform — the Affordable Care Act (ACT) – remain fairly negative, although the percent of people feeling favorably toward it increased from 34% to 37% between October and November. Still, that represents a low from the 50% who favored the law back in July 2010. It’s quite possible that American health citizens’ views on health reform are largely reflective of their more general feelings about the direction of the country and what’s going on in Washington right now, versus what’s specifically embodied in the health care law, according to the November 2011 Kaiser Health

 

Designing health technology for people at home

The Internet, broadband, mobile health platforms, and consumers’ demand for more convenient health care services are fueling the development and adoption of health technologies in peoples’ homes. However, designing products that people will delight in using is based on incorporating human factors in design. Human factors are part of engineering science and account for the people using the device, the equipment being used, and the tasks the people are undertaking. The model illustrates these three interactive factors, along with the outer rings of environments: health policy, community, social, and physical. Getting these aspects right in the design of health technologies meant for

 

Retail health is hot, especially for the young, affluent and not particularly sick

Walmart issued a Request for Information to expand its retail health footprint in the communities in which the world’s largest company operates. That was a strong sign that retail health has surpassed a tipping point. Now, there are hard data to support this observation from a RAND Corporation research team. Trends in Retail Clinic Use Among the Commercially Insured, published in the November 25, 2011, issue of The American Journal of Managed Care, quantifies retail clinic utilization among a group of Aetna health plan enrollees between 2007 and 2009. In those two years, use of retail clinics grew 10-fold. RAND looked

 

Food choice and overweight Americans: it’s not just about self-control

Per capita calorie intake has grown by 9 to 30 calories a day since the 1980s. Portion sizes have grown; as a result, so has the level of overweight and obesity in America. By 2020, 83% of men will be overweight or obese in the U.S.; so will 72% of U.S. women, according to Mark Huffman in a paper presented to the American Heart Association meeting in November 2011. “An individual’s decision to eat is not a result of personal weakness, but rather is determined, to a great extent, by the many environmental cues that have emerged since the early

 

Employers aren’t engaging with patient/health engagement

The vast majority of employers who sponsor health benefits look at those benefits as part of a larger organization culture of health. While one-third are adopting value-based health plan strategies — doubling from 16% in 2010 to 37% in 2011 — only 3% of employers are taking an integrated view of value-based benefits and corporate wellness. This is the second year for the International Foundation of Employee Benefit Plans (IFEBP) and Pfizer to examine employers’ approaches to value-based health care (VBHC). As explained by Michael Porter, the guru on health value chains, value in health care focuses on the patient at

 

Sustainable health care: patients, doctors and hospital execs see different futures

There is broad consensus among doctors, patients and health administrators that the current U.S. health system is broken and unsustainable; preventive services is under-utilized and -valued, quality is highly variable from region to region and patient to patient, and costs continue to spiral upward without demonstrating value. While these 3 segments – physicians, people-patient-consumers, and hospital execs, agree on this topline assessment, what they see about the future of health delivery in America varies, according to a new survey from the new Optum Institute for Sustainable Health, Sustainable health communities: A manifesto for improvement. This is the kick-off of the Optum Institute, a member of the

 

Workplace wellness: the cost of unhealthy behaviors in the American workforce is $623 per worker

The health status of the American workforce is declining. Every year, unhealthy behaviors of the U.S. workforce cost employers $623 per employee annually, according to the Thomson Reuters Workforce Wellness Index. People point to smoking, obesity and stress as the 3 most important factors impacting health costs. Thomson Reuters and NPR polled over 3,000 Americans on their health behaviors, utilization and costs of health care, publishing their results in a summary, Paying for Unhealthy Behaviors in October 2011. 4 in 5 overall — and 9 in 10 of those with over $50,000 annual income — believe that people with healthy behaviors should receive a

 

Why a Foundation and the Federal Reserve are working together to improve health in the U.S.

Health philanthropies are about more than making grants. The Robert Wood Johnson Association, among the largest health philanthropic organizations in the world, is partnering with the Federal Reserve Bank (the Fed) on how community development impacts health — and vice versa. You cannot have a healthy community without focusing on housing, schools, and other neighborhood stakeholders, Dr. Risa Lavizzo-Mourey told the conference on Healthy Communities: Building Systems to Integrate Community Development and Health. In this context, Dr. Lavizzo-Mourey quoted Robert Kennedy who said, “The gross national product does not allow for the health of our children, the quality of their education, or

 

Primary care, everywhere: how the shortage of PCPs is driving innovation – especially for patient participation in their own care

The signs of the primary care crisis in America are visible: A growing number of visits to the emergency room for treating commonplace ailments Waiting lists for signing up with and queuing lines to see primary care doctors Fewer med students entering primary care disciplines Maldistribution of primary care practitioners (PCPs) in underserved areas, rural, exurban and urban. The implementation of the Affordable Care Act will (try to) enroll at least 30 million newly-insured health citizens into the U.S. health system. That’s the objective: whether being insured will actually provide people access to needed primary care is a big question given the current supply of

 

Prescription drug spend in 2012: moving from “educating” patients to empowering them

The growth in prescription drug costs covered by employers and Rx plan sponsors are driving them to adopt a long list of utilization management and price-tiering strategies looking to 2012, according to the 2011-2012 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda Pharmaceuticals. The average drug trend for 2011 — that is, the average annual percentage increase in drug cost spending — was 5.5%, 1.5 percentage points greater than general price inflation of about 4%. The generic fill rate was 73% of prescription drugs purchased at retail. While drug price inflation is expected to increase in 2012, plan

 

Get into the sunshine, church is out – the GAO report on health care price transparency

This morning during my still-dark-at-5:15 am walk, my iPod was motivating me to “get up offa that thing,” as James Brown was motivating me to “release the pressure.” Two minutes into the song, he urges, “Get into the sunshine, church is out.” This brought to mind a publication I’ve taken time to review from the General Accounting Office (GAO) report to the U.S. Congress, Health Care Price Transparency – Meaningful Price Information Is Difficult for Consumers to Obtain Prior to Receiving Care, published in September 2011. While employers and health plans want consumers to become more engaged in their health, a key barrier facing

 

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

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

 

Consumer electronics comes to health care — but don’t overestimate consumer demand just yet

More people with higher levels of concern about their health feel they are in good health, see their doctors regularly for check-ups, take prescription meds “exactly” as instructed, feel they eat right, and prefer lifestyle changes over using medicines. And 40% of these highly-health-concerned people have also used a health technology in the past year. At the other end of the spectrum are people with low levels of health concern: few see the doctor regularly for check-ups, less than one-half take their meds as prescribed by their doctors, only 31% feel they eat right, and only 36% feel they’re in

 

Every picture tells a story, and nowhere more important than in health

A picture’s not only worth the proverbial thousand words, but can save a life. So can a t-shirt…er, TeachShirt. At the Unniched meeting held on 25 October 2011 in NYC, I spent a few minutes talking with two members of Zemoga‘s brain trust: Sven Larsen, Chief Marketing Office, and the firm’s Principal Design guru, Dan Licht. We discussed how design is so critical a factor in health, and in life — particularly, in DIY health, where we are all taking on more responsibility for our own health care — clinical, financial, mental, social. Among Zemoga’s colorful and uber-creative portfolio is its concept, the

 

Walmart’s rollback of health insurance for employees: just another employer facing higher health care costs?

Walmart is increasing premium sharing costs for employees subscribing to health insurance, and cutting the benefit for part-timers. Quoted in the New York Times, a company rep said, “over the last few years, we’ve all seen our health care rates increase and it’s probably not a surprise that this year will be no different. We made the difficult decision to raise rates that will affect our associates’ medical costs.” In so doing, Walmart told the Times that they will, “strike a balance between managing costs and providing quality care and coverage.” MarketWatch wrote that Walmart will increase health care premium costs

 

Tech fast forward families are ripe for health care self-care

Kids lead their parents in the adoption of  digital technologies; that’s why the youngers are called Digital Natives. An intriguing survey of adults’ use of technologies finds that those who do so like “childlike play,” and at the same time, for kids, make them feel more grown up. The trend, Ogilvy says, is blurring generational lines: market to adults as kids, and kids as adults. This convergence is leading families to become more “units” — parents and kids increasingly on the same page in purchase decisions. In Tech Fast Forward: Plug in to see the brighter side of life, from

 

Unretirement: the number of Americans planning to retire at 67 is plummeting

Two publications this week reinforce the new reality of health and financial insecurity: The Vanishing Middle America issue of Advertising Age (October 17, 2011 issue) and the Sun Life Financial U.S. Unretirement Index – Fall 2011 with the subtitle, “Americans’ trust in retirement reaches a tipping point.” The chart shows the retirement coin’s two sides: since 2008, the proportion of people in the U.S. who expect to retire by 67 dropped from 52% down to 35%; and, those who believe they will be working full-time (I emphasize “full,” not “part,” time) grew from 19% to 29%. 61% of working Americans plan to

 

The economy’s impact on personal health: shopping and social

The recessionary, sluggish U.S. economy has had an impact on Americans’ mental and physical health. The least healthy citizens have experienced a disproportionately hard hit on their health and health care. But necessity being the mother of invention, some people are re-inventing their personal workflows in health care — and many of these tactics may well benefit their health in the long run. The Economy and Health: 10 Observations is the analysis from Euro RSCG‘s survey of U.S. adults’ views on their personal health in light of the continued economic downturn. The first chart shows the economy’s impact on the overall mood of

 

More U.S. health citizens embrace digital personal health information: the topline of Manhattan Research’s Cybercitizen Health survey

“56 million U.S. Consumers Access Medical Information from Electronic Health Records,” asserted Manhattan Research’s press release of October 12, 2011. This statistic, fresh out of the firm’s 2011 Cybercitizen Health survey, is among several stunning numbers that demonstrate a growing trend: U.S. health citizens’ embrace of their personal health information in digital formats, via electronic channels. To kick the tires on the survey a bit, I spent time on the phone with the “3 M’s” of Manhattan Research — Meredith Ressi, President; Monique Levy, VP of Research; and, Maureen Malloy, Senior Healthcare Analyst who can recite the survey data backwards and forwards. Together,

 

Americans’ new normal in health: paying attention and responding to costs

The passage of health reform in the U.S. has not enhanced peoples’ confidence in the American health system. In fact, U.S. health consumers’ high confidence level in the future of employer-sponsored health benefits has eroded over the past ten years, according to the Employee Benefit Research Institute‘s (EBRI) 2011 Health Confidence Survey: Most Americans Unfamiliar with Key Aspect of Health Reform. Most people are dissatisfied with the U.S. health system overall, with 27% of U.S. adults rating the system as “poor” and 29% giving a rating of “fair.” High costs may be at the root of peoples’ dissatisfaction with the U.S. health

 

Health is a team sport: the 2011 Edelman Health Barometer

Lifestyle, nutrition, the environment and the health system are four key factors that people globally say have the most impact on their health. Underlying these influences, its friends and family who most shape our health, followed by government and business. Welcome to the 2011 Edelman Health Barometer, the third year the communications firm has polled health citizens around the world on their views on health, behavior change, and the use of information and digital tools. Edelman conducted 15,165 interviews 12 countries in North America, Asia and Europe to gather health citizens’ perspectives. The top-line, globally, is that there is a knowledge-action

 

The tough nut of health behavior change: it’s about today, not next week

While women may equally ‘value’ healthy aging in the long-run, it’s their daily quality of life that may motivate them to stick with exercise routines. Simply put, immediate payoffs are more motivating to sustaining behavior change than the long-term promise of “health.” In Rebranding exercise: closing the gap between values and behavior, Michelle Segar and colleagues from the University of Michigan (disclosure: my beloved alma mater) describe the state of women and chronic illness, and the difficulty in sustaining physical activity especially in middle age. “While a number of interventions can help individuals successfully initiate an exercise program, most interventions have failed

 

Physicians won’t be celebrating Independence Day, at least when it comes to their practices

Doctors won’t be celebrating Independence Day on July 4th — at least when it comes to their professional practices. The days of the cottage industry physician are dwindling as more doctors are losing their independence, instead opting for employment. There are several reasons for physicians’ exodus from private practice: these include increasing administrative burdens, economies of scale for adopting information and communications technology, security in uncertain futures around reimbursement, and that all-important work-life balance. Accenture points out these trends in a summary report, Clinical Transformation: Dramatic Changes as Physician Employment Grows.  Accenture sees benefits accruing to health systems acquiring physician

 

Prospecting for gold: the role of data in the health economy

3 in 4 of the Fortune 50 companies are part of the U.S. health economy in some way. Only 1 in 3 of these is in traditional health industries like pharmaceutical and life science companies, insurance, and businesses in the Old School Health Care value chain. 2 in 3 of the Fortune 50 companies involved in health are in new-new segments. In their report, The New Gold Rush, PricewaterhouseCoopers (PwC) identifies four roles for “prospectors” in the new health economy which will represent 20% of the GDP by 2019: Fixers Connectors Retailers, and Implementers. These are the disruptive roles that will

 

Employers’ health plans look to behavior change, while accelerating the premium cost shift to employees

The new mantra for employers who sponsor health benefits is: “a healthy workplace leads to a healthy workforce.” Employers that sponsor health plans are now in the behavior change business, according to Aon’s 2011 Health Care Survey. Health plans are tightly focusing on wellness, motivating and sustaining positive personal health changes, with carefully designed incentives (carrots and sticks) informed by behavioral economics. The paradigm is value-based insurance design (VBID) that removes barriers to essential, high-value health services to bolster treatment adherence, improve productivity, and reduce overall medical costs. The top five priority tactics for employers in health are: To offer incentives

 

Telemedicine is an enabler of health reform

Globally, in developed economies, the challenges of increasing health care costs, access to quality health care, aging citizens and the supply of clinicians are universal. CSC says telemedicine can address these challenges as part of reforming health care delivery and financing throughout the world. In Telemedicine: An Essential Technology for Reformed Healthcare, CSC sees telemedicine as an enabler for health reforms’ goals the world over. In the U.S., telemedicine is explicitly mentioned in the Affordable Care Act. In April 2011, the Federal Register included language about health financing reform that said, “The ACO shall define processes to promote evidence-based medicine and patient engagement, report

 

Doctors using tablet-based EMRs like portability, productivity and patient communication

The past year has seen a huge jump in the number of hours that physicians spend online; at the margin, the increase is due to physicians’ use of online via mobile platforms. Meredith Abreu-Ressi, President of Manhattan Research, shared her insights into the firm’s study, Taking the Pulse (v. 11), with me today. The top-line finding of the annual survey is that health professionals have quickly adopted mobile platforms in health — with special attention paid to Apple products, the iPhone and the iPad. Manhattan Research has tracked physicians’ use of online health resources for over a decade. They’ve found

 

Employers continue to worry about health costs in 2011, and expect to expand defined benefit plans

With health reform uncertainties, growing health regulations, and ever-increasing costs, employers who sponsor health plans for their workforce will continue to cover active employees. That is, at least until 2017, according to the crystal ball used by Mercer, explained in the Health & Benefits Perspective called Emerging challenges…and opportunities…in the new health care world, published in May 2011. Note that it’s “active” employees who Mercer expects will retain access to health benefits. For retirees, however, it’s another story. They need to be ready to take on more responsibility, financially and perhaps going-to-market to select coverage, while employers may continue some level

 

A long-term care crisis is brewing around the world: who will provide and pay for LTC?

By 2050, the demand for long-term care (LTC) workers will more than double in the developed world, from Norway and New Zealand to Japan and the U.S. Aging populations with growing incidence of disabilities, looser family ties, and more women in the labor force are driving this reality. This is a multi-dimensional problem which requires looking beyond the issue of the simple aging demographic. Help Wanted? is an apt title for the report from The Organization of Economic Cooperation and Development (OECD), subtitled, “providing and paying for long-term care.” The report details the complex forces exacerbating the LTC carer shortage, focusing

 

Most Americans like the idea “Big Government” when it comes to food safety

Two-thirds of Americans favor increasing funding to the Food & Drug Administration (FDA) to ensure food safety in the U.S. Furthermore, 9 in 10 Americans also believe that the Federal government should be responsible for ensuring that food is safe to eat. And, 3 in 4 Americans say if it costs 1 to 3% more money to buy safer foods. they’d be willing to pay for those foods kept safer by the new food safety measures. A poll from the Pew Charitable Trusts, conducted by Hart Research Associates in April and May 2011, finds that when it comes to what Americans eat,

 

Patients feel out of the Rx drug development process: why participatory health in pharma is important

“Value” in prescription drugs is first and foremost about outcomes, in the eyes of physicians and biopharma. For managed care, “value” is first about safety, then patient outcomes. However, although one-third of patients managing a chronic condition cannot define “value” in health care, 9 in 10 say that prescription drugs are “valuable” to their health and wellbeing. In fact, 80% say that the money they spend on prescription medications is “worth it.” Yet patients feel largely out of the prescription drug development process. These findings come from Quintiles research report, The 2011 New Health Report, subtitled: exploring perceptions of value and collaborative relationships among

 

Health care where we live, play, work and pray: how Ford & Toyota’s mhealth pilots fit into Whole Health

In an interview in March 2011 with the Los Angeles Times, Dr. Regina Benjamin, the U.S. Surgeon General, said, “We can’t look at health in isolation. It’s not just in the doctor’s office. It’s got to be where we live, we work, we play, we pray. If you have a healthy community, you have a healthy individual.” Ford’s announcement last week that the automaker would team up with WellDoc to incorporate mobile health sensors into the company’s SYNC connectivity system  follows Toyota’s mhealth concept, the RiN, launched in 2007. Among various applications envisioned at this preliminary stage: Glucose monitors, from Medtronic, will

 

Don’t assume generics will stop drug cost trends in 2012 and beyond: specialty drugs will drive growing Rx spending

In the 2011 Medco Drug Trend Report, there’s good news and bad news depending on the lens you wear as a health care stakeholder in the U.S. On the positive side of the ledger, for consumers, payers and health plan sponsors, drug trend in 2010 stayed fairly flat at 3.7% growth. That’s due in major part to the increasing roster of generic drugs taking the place of aging branded prescriptions products. More than $100 billion (with a ‘b’) worth of branded drugs will go off-patent between 2010 and 2020, and the generic dispensing rate could reach 85% by 2020, Medco

 

Working past 70 is the new retirement

By Jane Sarasohn-Kahn on 18 May 2011 in Baby Boomers and Health, Employers, Medicare

American workers are worried about outliving their savings and not being able to meet the financial needs of their families, according to The 12th Annual Retirement Survey from the Transamerica Center for Retirement Studies. The study paints a picture of 4,080 U.S. workers who forecast insecure financial futures. Their personal portraits find them working into older ages than they had previously expected to — before the recession. 54% of workers plan to work in retirement. 39% of workers will retire after age 70, or not at all. It’s not only Baby Boomers who expect to work past 65. Two-thirds of workers in their

 

Patient perspectives should be part of evidence-based medicine, Dr. Weil et al say

Randomized controlled trials (RCTs) have been the rational cornerstone of medical decision making for decades. RCTs demonstrate a drug or therapeutic course’s efficacy – that is, the extent to which a specific intervention, procedure, or regimen produces a beneficial result under ideal conditions. Of course, how a particular therapy works in an individual is highly personalized based not only on a body’s biochemistry, but personal preferences, perceptions, and personality. That’s why Dr. Andrew Weil and his colleagues, Dr. Scott Shannon and Dr. Bonnie Kaplan, say that medical decision making should take into account the patient perspective. In Medical Decision Making in

 

Botox over preventive health: health consumers have spoken, delaying diagnoses

Americans are opting for Botox and cosmetic procedures more than colonoscopies and cancer tests, according to a story in Reuters. This trend makes companies like Allergan, makers of Botox and the Lap-Band for gastric surgery, very happy indeed. Plastics and gastric bypass surgeries are back up to pre-recession levels as of 2Q11. However, for companies and providers in other segments of the health care and surgery value-chain, prospects for bounceback in 2011 aren’t as promising. Various indices on consumers’ health care sentiment — such as the Thomson-Reuters Consumer Healthcare Sentiment Index and the EBRI Health Confidence Survey, show U.S. consumers’ perceptions of their ability to

 

Health information gumbo: peoples’ health searches are mashed-up and increasingly mobile

Health professionals are go-to sources for medical diagnoses, information about prescription drugs and alternative treatments, and recommendations for doctors and hospitals. On the other hand, health information seekers turn to fellow patients, friends and family for emotional support in dealing with health issues, and quick remedies for everyday issues. And increasingly, those health information searches are going mobile, with 17% of U.S. adults having ever used their cell phone to look up health or medical information. This proportion nearly doubles for 18-29 year olds, and is also higher for wealthier people, Latino’s, college graduates, and urbanites. 1 in 10 people with a

 

The average annual health costs for a U.S. family of four approach $20,000, with employees bearing 40%

Health care costs have doubled in less than nine years for the typical American family of four covered by a preferred provider health plan (PPO). In 2011, that health cost is nearly $20,000; in 2002, it was $9,235, as measured by the 2011 Milliman Medical Index (MMI). To put this in context, The 2011 poverty level for a family of 4 in the 48 contiguous U.S. states is $22,350 The car buyer could purchase a Mini-Cooper with $20,000 The investor could invest $20K to yield $265,353 at a 9% return-on-investment. The MMI increased 7.3% between 2010 and 2011, about the same

 

Brand “Health:” where is it in the Top 100 most valuable brands?

Apple has supplanted Google as the world’s #1 most valuable brand, worth more brand-wise than Microsoft and Coca-Cola combined (#5 and #6). the other most valuable global brands are IBM, McDonalds, AT&T, Marlboro, China Mobile, and GE. Technology brands have significantly grown in value with consumers allocating more personal disposable income to products like tablet computers and smartphones, even in the face of recessionary economics the world over. Technology companies are now 1/3 of the top 100 brands. Millward Brown, the brand consultancy that is part of WPP, the global communications firm, has conducted the BrandZ top 100 most valuable

 

ePrescribing continues to challenge physicians – but can be a link for patient engagement

  About 1.3 million people in the U.S. experience a medication error each year, which are preventable events that may cause or lead to inappropriate medication use or harm a patient, any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Two very common causes of medication errors are illegible handwriting by prescribers and misplaced decimal points on prescription forms. Twenty percent of adverse drug events lead to life-threatening circumstances, according to The Leapfrog Group.  The costs of medication errors has been

 

The new health reform is online and mobile; talking at J. Boye 2011 in Philadelphia

With non-communicable diseases (NCDs) killing two-third’s of the Earth’s residents — not malaria, HIV or other infectious diseases — the World Health Organization calls lifestyle-borne chronic conditions a “slow-motion catastrophe.” The solution for addressing this global challenge isn’t just about deploying more doctors and medical technology in hospitals and bricks-and-mortar institutions. The real health reform is about infrastructure-independent care and feeding that bolsters peoples’ health where they live, work, play and pray, as characterized by the U.S. Surgeon General Dr. Regina Benjamin in the Los Angeles Times on March 13, 2011. Today I’ll be participating on the eHealth track at the J.

 

Verizon expanding into remote and mobile health for senior living – what it means for healthy aging and medical costs

The announcement that Verizon, the telecommunications giant, will partner with Healthsense, a home health monitoring company, indicates that the adoption of telehealth services beyond project pilots and government-funds required to bolster the market is real. Verizon is upgrading the FiOS network, which it will extend to senior housing and assisted living communities that would use Healthsense’s suite of remote health monitoring, personal emergency response systems, wireless nurse call, and wellness monitoring products. The broadband FiOS network is upgradeable to 100 megabits per second, which would enable the bandwidth required by home health technologies that require high performance and reliable network connectivity. These

 

The patent cliff coupled with value-based health purchasing makes for declining branded pharma market in the U.S.

Two mega-trends are driving down branded pharmaceutical sales in the U.S.: switches from branded to generic prescription drug products for major chronic conditions; and, the lack of new-new branded Rx products that (could) command higher prices. A down-market picture emerges from The Use of Medicines in the United States: Review of 2010, based on market data analyzed by the IMS Institute for Healthcare Informatics (IMS). While U.S. market growth for pharma overall ranges from 3% to 5%, IMS says, protected Rx brands were negatively impacted through the switch to cheaper generic substitutes. Generics now comprise 78% of pharma market share. The key sentence

 

Patients’ health activation leads to better outcomes, but providers aren’t as engaging as they should be

Patient engagement improves health outcomes. But deploying patient empowerment and engagement tools involve many challenges, among them: privacy, security, integrity of medical records, liability, and payment. These have prevented health providers – doctors and hospitals – from adopting strategies to more closely engage patients. From the patient’s perspective, though, many patients have project-managed their own approaches to engagement with online and mobile health tools, such as participating in peer-to-peer health social networks, downloading and using mobile health apps, and monitoring calories, weight and sleep through devices like FitBit, Zeo, and the Withings scale. The Institute for Health Technology Transformation (iHT2) published the

 

Are health innovation and cost-reduction mutually exclusive? Insights from West Wireless’s Health Care Innovation Day DC

Representatives from eight U.S. Federal government agencies, including the FDA and Veterans Administration, among others; health financiers (VCs, angels); health tech start-ups; providers, life science companies, and analysts, attended the Health Care Innovation Day DC sponsored by West Wireless Health Institute on April 28, 2011. The meeting had the tagline, A Discussion with the FDA, setting the stage for a day-long consideration of the role of regulation vis-a-vis health innovation. The $2.5+ trillion question (annual spending on health care in the U.S.) is: can innovation drive making health care “cheaper?” This was the underlying theme of the panel on which I sat

 

Bye-bye, Ward & June Cleaver; Hello, multi-cultural, digital-happy family

“Ward and June Cleaver have left the building,” observe analysts at Nielsen. “The white, two-parent, ‘Leave it to Beaver’ family unit of the 1950s has evolved into a multi-layered, multi-cultural construct dominated by older, childless households,” starts a report from The Nielsen Company, The New Digital American Family. Whatever ethnic flavor this Digital Family may represent, there’s one equalizer across all of them: the smartphone, which is owned by households across cultures and income levels. First, the socio-demographics paint a picture of increasingly multi-cultural households. Recent immigrants to the U.S. accounted for 90% of population growth from 2000-2010, over-indexing for Hispanic and

 

Consumer engagement with health IT isn’t about technology

Today’s kickoff of the National eHealth Collaborative‘s Consumer Consortium on eHealth convened the most diverse workgroup of over 70 stakeholders with various lenses on consumers and health, rarely seen at similar meetings, as Lygeia Ricciardi (@lygeia) of the Office of the National Coordiantor for Health IT (ONC) in the Department of Health and Human Services, observed. However, although representing every conceivable segment of health consumer stakeholders, from seniors (AARP)  and physicians (MGMA) to people with disabilities (AAPD), women (National Partnership for Women and Families) and people who fall through the health safety net (the National Health IT Collaborative for the Underserved), there was concurrence

 

American health consumers still health rationing in 2011

The top 4 personal consumer worries are incomes not keeping up with rising prices; having to pay more for health care and health insurance; not having enough money for retirement; and. not being able to afford health care services we think we need. The April 2011 Kaiser Public Opinion poll from the Kaiser Family Foundation paints a picture of an American populus that’s putting health economic worries at the top of their list of personal concerns. The survey was fielded in March 2011. 1 in 2 U.S. adults has skipped some aspect of health care due to cost in the

 

Retail health options expand with American Well and Activ Doctors going direct

The traditional venues for retail health are found in pharmacies, grocery chains, and on the ground floor storefronts in hospitals. Joining these bricks-based models are digital, online health ventures that are expanding the definition and space of retail health. This week, two announcements illustrate this phenomenon, from American Well and Active Doctors. American Well, which launched in 2008, is an online physician consultation service in the U.S. that has successfully worked with health plans to channel consults to patients in Hawaii, Minnesota, and New York, among other local programs. Last year, American Well went live with the Rite Aid pharmacy chain in Pennsylvania. This week, American

 

Physicians in the U.S. are becoming health economists

Doctors practicing in the U.S. are becoming increasingly conscious of the increasing costs of health care. Most consider themselves cost-conscious, and are considering the impact of their practice patterns — in terms of prescribing medicines, tests, and procedures — on the nation’s health bill. In fact, most physicians feel they have a responsibility to bring down health costs. This perspective on physicians comes from the survey report, The new cost-conscious doctor: Changing America’s healthcare landscape, from Bain & Company, published in March 2011. Bain spoke with over 300 U.S. physicians to assess their perspectives on managing costs, drug and device usage, and

 

While BlackBerry will hold largest share of health market, iPhone and Android adoption will grow in next 2 years

Nearly 1 in two mobile phone platforms in hospitals had a BlackBerry brand in the fourth quarter of 2010. However, within 2 years, more mobile phones will be labeled iPhone or Android, eroding the Blackberry share of the market as health workers abandon their cell phones for smartphones and switch away from their BlackBerry devices. Still, 1 in 3 hospital workers will be using a BlackBerry in 2013, as the chart illustrates. Amcom Software conducted a survey of 300 hospitals and health systems in October 2010 to assess their views on smartphones and the emergence of tablets in hospital settings. While paging (job-related alerts)

 

The most engaged patients want “Social Media Liberación!”

Anyone attending a Health 2.0 or health IT meeting in the past 18 months has (hopefully) been exposed to the force known as  Todd Park, Chief Technology Officer of the Department of Health and Human Services, and his mantra of “Data Liberación.” Data Liberación is the act of freeing data — in this instance, health data — locked within data silos, to be ‘liberated” allowing it to move about so that analysts can learn from it and develop strategies to better manage health for individuals and populations. Now there’s a force advocating for “Social Media Liberación” in Health: health activists, the most engaged patients

 

The intent-behavior gap is what stands between the doctor and optimal health outcomes

The environmental landscape for pharmaceutical manufacturers and retail pharmacies is marked with landmines, yield signs, and cautionary wild cards: health reform, supply chain dynamics, specialty drug pricing, pharmacogenomics, and the high burden of chronic disease among them. But the crux of the challenge for achieving optimal outcomes has less to do with these factors than it does with consumer behavior: specifically, the chasm between what people/health consumers say they want versus what people actually do. Express Scripts calls this “The Intent-Behavior Gap,” and it’s the theme of the company’s 2010 Drug Trend Report, Complex Challenges, New Solutions. The cost of sub-optimal pharmacy behaviors are huge: in 2010, pharmacy-related waste

 

The online digital health divide persists for African Americans and Hispanics; implications for health reform

Differences in race, ethnicity and income drive online health disparities, according to a poll from The Washington Post/Kaiser Family Foundation (KFF)/Harvard University Race and Recession Survey, based on data from early 2011. The underlying issue here is the online digital divide, which still persists for African Americans and Hispanics of lower socioeconomic status. Overall, 84% of U.S. adults use the Internet or email at least occasionally. However, only 69% of African Americans and 64% of Hispanics with less than $40,000 annual income use the Internet or email. However, income flattens Internet/email use: for people who earn over $40K a year, 95% of whites, 94% of African

 

Visiting branded drug websites can increase medication adherence, comScore finds

Unique visits to online health sites continue to grow as a proportion of total unique visitors to the Internet, based on comScore’s research of web activity from January 2010 to January 2011. comScore published its Fifth Annual Online Marketing Effectiveness Benchmarks for the Pharmaceutical Industry in March 2011 based on a one million person U.S. panel coupled with 77 studies into specific pharmaceutical cases. The growth in people using online health resources is an opportunity for health marketers — in this case, pharmaceutical drug marketers — to reach potential patients and develop more effective education campaigns that are unbranded (to provide information

 

Even the most wealthy, healthy U.S. citizens worry about future health access and finance

It is no surprise that sicker, poorer people in the U.S. have concerns about how they’ll access and pay for health care in the future. What stands out in the latest Commonwealth Fund Survey of Public Views of the U.S. Health System, published in an April 11, 2011, Issue Brief, is that most U.S. health citizens in the healthiest, wealthiest demographic groups worry about accessing and paying for health care in the future. The chart highlights these findings: overall, 7 in 10 people worry about not getting high-quality care when they will need it, or that they won’t be able to pay

 

Independent drugstores — facing tough health and retail economics — are still beloved by consumers

In the pharmacy market battle between Davids and the Goliath, David wins in the latest Consumer Reports survey on best drugstores according to consumers: independent pharmacies come out on top, and Walmart ranks last on the roster. The most highly-rated chains, highly indexed at 90 or more points, Health-Mart, The Medicine Shoppe, Bi-Mart, Publix, Hy-Vee, and Wegmans. Target, which was just ranked the #1 retailer in brand equity by the Harris Poll (where Target also beats Walmart in general retailing brand equity), ranked lower with an 88: much higher than Walmart with a 78 index, but below Walmart’s Sam’s Club and several grocery

 

What telehealth can do for the Health of Nations

Health care cost increases are unsustainable the world over; in developed nations, the forecast is even more dire given exploding demand for health services as citizens age. Cisco polled senior leaders in health systems globally to gauge their views on the challenging state of health care in their respective nations, and prospects for health system improvement. The triple-mantra for senior health leaders is access, efficiency, and quality. Access takes the form in this survey in maldistribution and insufficient number of health professionals. Efficiency looks like patients referred for unnecessary care coupled with long lines (queues) for needed services. Quality measurement continues to

 

There’s hard ROI for physician groups that fully implement electronic health records

About one-half of physician practices used an electronic health record (EHR) as of late 2010, with 36% of groups still storing health records in paper charts. While 1 in 2 physician groups in the U.S. have implemented electronic health records, they confess that they haven’t yet optimized their use. Only 16% of medical groups have implemented EHRs and believe their practices have optimized their EHRs. But optimization has its rewards: over 1 in 3 groups that have had sufficient time to fully implement their EHRs report decreased practice operating costs. Furthermore, 41% of these fully-operational EHR environments have seen physician productivity increase. With the subtitle, “snapshot of

 

The Withings scale – building block for the self-powered home-health hub

In the “House & Home” section of last weekend’s Financial Times, an article titled ‘Domestic Science’ talked about internet-operated vacuum cleaners that feed pets, refrigerators that track emptying cartons of milk, and the $10 Savant TruControl iPad app that helps control home systems’ remotely (tied to a $6,000 home-based system). The article also touched on the Withings WiFi body scale. The Withings scale communicates wirelessly to a computer or mobile phone, transferring and automatically recording the user’s weight, BMI, body fat percentage and other parameters to a secure, password-protected online system. The user can choose to tweet their weight via Twitter if they choose

 

Women, Chief Household Officers, Like to Manage Health Via Smartphones

“The tipping point for smartphones is now,” claims BabyCenter, the mom-focused internet portal. Mothers are 18% more likely to have a smartphone than the average person, according to the 2011 Mobile Mom Report, a survey from BabyCenter. Why do moms like smartphones? According to BabyCenter, the smartphone is a mom’s “helping hand.” Nearly 1 in 2 say the smartphone helps them decrease stress, and 1 in 4 say it gives them a sense of calm. So is the smartphone in itself a health-promoting device? For readers of Health Populi, the answer is “yes” based on this poll. In the past

 

Increasing smartphone uptake will drive higher use of mHealth apps globally

Adoption of mobile health (mHealth) apps will increase by 23% as a compound annual growth rate. according to a forecast from Arthur D. Little (ADL), featured in their report published in April 2011, Capturing Value in the mHealth Oasis. What is this mHealth Oasis? ADL notes that mobile network operators (MNOs — mobile phone companies) see gold in them thar’ health hills given unsustainable health economies the world over. However, ADL rightly points out that mobile health is just about as easy to conquer as any other aspect of health technology, full of minefields. ADL lays out the success factors for MNOs who want to engage

 

Drugs & Deli retail pharmacy in the Caribbean – a harbinger of things-to-come in U.S. health care?

The Family Sarasohn-Kahn is sailing on the Caribbean this week for a long-overdue winter break. Imagine my surprise and ironic delight when at our port this morning we happened onto a storefront called, “Drugs & Deli.” Inside, there’s the usual combination of barcodes that are the hallmark of convenience stores: Pringles, Gatorade, candy, gum, and since we’re on the sea, sunscreen. But there’s another product group sold here in a very retail way: prescription drugs. The décor tells the story:  while the name of the store tells the headline, the interior of the shop screams the storyline. Above our heads

 

Mayo finds heart patients skip meds due to costs; self-rationing in health continues

If you are a person with heart disease and you have received treatment at the Mayo Clinic, you’re certainly a fortunate health citizen. The hospital was just ranked #2 best hospital in the U.S. by US News & World Report. However, if that’s you and the costs of post-op treatment — namely prescription drugs — are out of your financial reach, then you might skip them; thus, undoing your top-notch acute care. This scenario is discussed in the April 2011 issue of Mayo Clinic Proceedings, which describes a study by Mayo researchers among 209 patients with heart failure who were prescribed

 

One-half of U.S.health consumers want electronic access to doctors – including online medical records

Most U.S. health consumers would be keen to take advantage of alternative communications for their health care encounters. Of these 6 in 10 people, 72% would like nurse helplines, 60% email, and 1 in 3 would use a private online forum for their health. However, only 1 in 10 would use some form of social media for interacting with their providers, such as Facebook or Twitter, were it available to them in February 2011. Capstrat surveyed U.S. adults to learn about their perceptions and interactions with the health system. At least one-half of health consumers would use electronically-accessible applications offered by

 

Wellness is the new health benefit (a double entendre)

Wellness and disease prevention were the meta-themes at Health 2.0’s Spring Fling held earlier this week in San Diego. where the discussions, technology demonstrations, and keynote speakers were all-health (as opposed to health care), all-the-time. Dr. Dean Ornish told the attendees in the standing-room-only ballroom space that the joy of living is a greater motivator than the fear of death. And the 1.0 version of managing health risks has been more the latter than the former. As a result, Ornish’s two decades of research have shown that health is more a function of lifestyle choices than it is drugs and surgery. In fact, people have

 

Health consumers spend more out-of-pocket than the Federal government counts

Consumers have  been shell-shocked with health care costs — an increasing proportion of household spending in the U.S. This is true for the increasing costs consumers bear in the traditional health system. However, consumers are continuing to spend discretionary income on non-traditional health services such as complementary and alternative medicine (CAM) providers and products, along with vitamins/minerals/supplements and weight loss regimes. With increasing health cost burdens on households, those householders have less money to allocate to other aspects of life. In particular, growing medical costs have translated into greater credit problems for American consumers, according to The hidden costs of

 

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

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

 

Health consumers like integrated health plans – and medical homes, based on J.D. Power’s latest survey

J.D. Power and Associates, known for its insights into consumers’ opinions on cars, insurance and telecomms, published its latest poll on consumers’ favorite health plans. The verdict: health citizens like integrated health insurance plans where providers and insurance are part of the same organization like Kaiser Foundation Health Plans (rated in the top 3 in virtually every market where they operate polled by J.D. Power), Health Alliance Plan of Michigan, Geisinger in Pennsylvania, Dean Health Plan of Minnesota, and Group Health Cooperative of the northwest. Each of these integrated plans grew up based on local medical, economic and political cultures.

 

Telemonitoring for health must be patient-centered and participatory

In December 2010, an article describing a telehealth remote monitoring program for heart failure patients concluded that telemonitoring did not improve patient outcomes. The paper, Telemonitoring in Patients with Heart Failure, written by Sarwat I. Chaudhry, M.D, and nine other authors, analyzed 1,653 CHF patients, 826 of whom participated in a remote health intervention: a telephone-based interactive voice-response system that patients dialed into on a daily basis to report symptoms and weight; this was designed to occur every day over six months.  These data were then reviewed by patients’ clinicians who could contact patients when data pointed to the clinical need to adjust patients’ medications and other parameters.

 

Branded prescription drug prices increased between 2006-2010 while generic prices fell

By Jane Sarasohn-Kahn on 15 March 2011 in Bio/life sciences, Health Economics, Prescription drugs

The Federal government covers about $1 in every $3 of spending on prescription drugs in the U.S. That equates to $78 bn of the total $250 bn spent on Rx in 2009. Between 2006 and 2010, the indexed cost of the usual and customary price for commonly used branded prescription drugs grew by 8.3%; in that period the price of commonly used generic drugs fell by 2.6%. The General Accounting Office (GAO), those nonpartisan bean-counters in Washington DC, analyzed pricing trends of prescription drugs over the most recent five years, based on changes from first quarter to first quarter in each subsequent year. The GAO also

 

What the US health system can learn from mHealth expertise in emerging countries

There’s cameraphone hacking that morphs the phone into a blood test device. Embrace Labs in India builds an incubator for $25. Micro- mobile payments are financing health care on the ground in emerging economies.   At SXSW in Austin, TX, on March 12, 2011, a globally experienced quartet of panelists shared their observations of working with highly constrained budgets in developing countries during the session, Mobile Health in Africa: What Can We Learn? The answer is: plenty. Doug Naegele of Infield Health moderated the panel, which included Patricia Mechael of the Center for Global Health and Economic Development at the Earth Institute, part of Columbia University; Josh

 

Health: is there really an app for that? A preview of our SXSW Health Panel

As we are in the midst of the Hype Cycle for mHealth, the answer to the question, Health – is there really an app for that? has a loaded answer. This will be evident during the panel on which I’m participating on Sunday 3/13/11, the first full day of health hosted as part of the legendary South by Southwest conference. I am absolutely gob-smacked thrilled to be sharing the stage with John DeSouza, President and CEO of MedHelp; BJ Fogg of the Stanford Persuasive Technology Lab; and, Margie Morris, clinical psychologist and senior researcher at Intel Labs. We’ll be shepherded by Gigi Peterkin of Edelman, who

 

How an EHR can help manage population health

There’s a lot of chatter about Meaningful Use in the context of electronic health records adoption; if you Googled the term today you’d find millions of references to the concept. The Centers for Medicare and Medicaid Services (CMS)’s website offers three main components of Meaningful Use as specified in The American Recovery and Reinvestment Act of 2009: – The use of a certified EHR in a meaningful manner, such as e-prescribing – The use of certified EHR technology for electronic exchange of health information to improve quality of health care – The use of certified EHR technology to submit clinical quality and other

 

Self-service health: consumers want the same kinds of online services available to them in other aspects of their lives

Health consumers are at least as keen to access their medical history online as they are to manage other aspects of their personal lives. Intuit, the people who brought Quicken to the market to help consumers manage their personal financial lives, are keen to do the same for health care. And they’ve got the survey data in The Intuit Health Second Annual Health Care Check Up to make their case for the online personal health information management market. It is no surprise that the survey found that 70% of U.S. adults are concerned (very or somewhat) about managing their health

 

The Post-Health Plan Health Plan: Humana

“If nothing else, the health reform bill has signaled the beginning of the end of the health plan as we know and love it,” David Brailer, once health IT czar under President GW Bush and now venture capitalist, is quoted in Reuters on Hot Healthcare Investing Trends for 2011. One health plan Brailer called out that could be relevant in the post-reform, post-recessionary US health world is Humana. I had the opportunity to spend time with Paul Kusserow, Chief Strategy Officer for Humana, during the HIMSS11 meeting. Our conversation began with me asking why the chief strategist for Humana would

 

Patients like health IT and digital data, balancing privacy concerns

Patients like the idea of advanced health IT, while continuing to be concerned about the safety and security of their personal health data. Dell polled patients and hospital executives on their opinions of health reform, technology, and other health care topics, reported out in The Dell Executive & Patient Survey. Overwhelming majorities of consumers are inerested in: Electronic access to information about a hospital to help determine which hospital to visit (81%) Electronic prescription processing (76%) Making it possible for EHRs to be shared between physicians, hospitals, and ancillary providers (74%) Providing more information electronically such as follow-up care post-discharge (73%)

 

Welcome Migraine.com to the health care community

  About 1 in 10 people in the U.S. suffer from migraine headaches. The direct cost to business for medical care and wage replacement is over $1 bn, but this underestimates the total economic impact of lost productivity to the economy and personal lives (for more on  whole-health costs, read yesterday’s Health Populi, Lost Costs: Lost Productivity Represents One-Half of Health Costs for U.S. Employers). There are actually 14 kinds of headaches, as classified by the International Headache Society (IHS). Among these, there are four primary headache types: migraine, tension-type headaches, cluster headaches and trigeminal autonomic cephalagias, and a fourth

 

Lost costs: lost productivity represents one-half of health costs for U.S. employers

By Jane Sarasohn-Kahn on 3 March 2011 in Employers, Health Economics

51% of total health costs are attributed to lost productivity at work in terms of on-the-job performance and absence. The other 49% is made up of direct medical costs (27%) and wage replacements (22%). Thus, most health care ‘costs’ to employers aren’t in the medical care or insurance line item at all — they’re in productivity.  “The ultimate ‘good’ to be purchased from our health care ‘system’ is the overall health of Americans,” asserts a new report, Synergies at Work: Realizing the Full Value of Health Investments, from researchers at the Center for Value-Based Insurance Design at the University of Michigan (my

 

Will providers be ready for patient-centricity in health IT?

In October 2012, Stage 2 of the HITECH Act’s meaningful use begins. That means that providers, both hospitals and physicians, who adopt electronic medical records systems and are looking to receive a financial incentive from the ARRA stimulus funds, must meet criteria defined as “meaningful use” (MU). Stage 2 will feature standards for providers to communicate health information to patients, based on the draft set of criteria issued by the U.S. Department of Health and Human Services. Will providers be ready to put patients in the center of the EMR? PricewaterhouseCoopers assesses the complex answer to this question in their report,

 

Reader’s Digest + Organized Wisdom = Wiser Patients

“Life well shared” is the tagline for Reader’s Digest. The publication began in 1922 and was, until 2009, the #1 best-selling magazine in the U.S. (losing its position to Better Homes and Gardens). How does a magazine that’s over eight decades old stay relevant? More digital offerings appeared in 2010. And, in 2011, Reader’s Digest is collaborating with one of the most well-used and -respected online health social networks, OrganizedWisdom (OW). How did this collaboration come to be? I spent some quality time in February 2011 with Unity Stoakes, co-founder of OW with Steven Krein, in New York City, the geographic HQ of OW.

 

Patients can handle the truth, and are looking for it: peer-to-peer health care

Most health consumers in the U.S. use the internet to seek health information, socialization and empowerment. Dig deeper, and you’ll find a growing cadre of people who go online to find people with the same conditions they have; 1 in 4 people (23%) among those living with chronic conditions have gone online to ID others like them, including people with high blood pressure, diabetes, heart disease, lung conditions, cancer, and other chronic health issues. The percentage of people looking for “people like me” drops to 15% of internet users with no chronic conditions seeking health-peers online. However, peers-in-health aren’t always seen as the ideal source

 

The health IT talent shortage could slow HIT adoption in U.S. health care

For hospital CIOs, 2011 and 2012 are all about achieving meaningful use, focusing on clinical systems, safe-keeping health information, and staying financially healthy as an organization.  These insights are brought to you by the 22nd Annual HIMSS Leadership Survey, sponsored by Citrix. This survey has become the most important snapshot of health CIOs’ priorities looking ahead. This year’s survey results, unveiled week at HIMSS 2011 in Orlando, held some important findings. While achieving meaningful use is the top IT priority for the next two years (with 81% of organizations believing they’ll quality for MU in 2011 or 2012), clinical systems implementation and

 

The Connected Patient: some forces converging in the market, but barriers remain

Remote health monitoring, which enables people to track health and daily living metrics when they are in one place and communicate those measures to another node via some communications platform, is not a new concept. Telehealth, telemedicine, consumer-facing health electronics like USB-ported blood pressure monitors, and some mobile apps can all fall under the broad umbrella of remote health monitoring. There are strong market forces converging to enable health citizens to connect to their providers, institutions, payors, health coaches, caregivers, and each other. Still, a balanced look under the remote health monitoring hood reminds us that old saw taught to me by colleagues