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Nurses, doctors, pharmacists join with teachers in Gallup’s 2021 honest and ethics poll

Each year, Americans rank nurses as the most honest and ethical professionals along, generally followed by doctors and pharmacists. In the middle of the coronavirus pandemic in the U.S., grade school teachers join the three medical professions in the annual Gallup Poll on the top-ranked professions for honest and ethical behavior in America as we enter 2021 with many U.S. hospitals’ intensive care units at full capacity….and schools largely emptied of students. The three health care professions scored their highest marks ever achieved in this Gallup Poll, which has been assessing honesty and ethics in America since 1999. Nurses are

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The Comforts of Home Drive Demand for Healthcare There

Two in three U.S. consumers skipped or delayed getting in-person medical care in 2020. One in 2 people had a telehealth visit int he last year. Most would use virtual care again. The coronavirus pandemic has mind-shifted how patients envision a health care visit. Today, most consumers prefer the idea of getting health care at home compared with going to a doctor’s office. Most Americans also like the idea of recovering at home instead of at a medical facility after a major medical event, according to the report, Health-at-Home 2020: The New Standard of Care Delivery from CareCentrix. COVID-19 has

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The COVID-19 Era Has Grown Health Consumer Demand for Virtual Care

Over one-half of Americans would likely use virtual care for their healthcare services, and one in four people would actually prefer a virtual relationship with a primary care physician, according to the fifth annual 2020 Consumer Sentiment Survey from UnitedHealthcare. What a difference a pandemic can make in accelerating patients’ adoption of digital health tools. This survey was conducted in mid-September 2020, and so the results demonstrate U.S. health consumers’ growing digital health “muscles” in the form of demand and confidence in using virtual care. One in four people would consider online options as their first-line to evaluating personal health

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In the Past Ten Years, Workers’ Health Insurance Premiums Have Grown Much Faster Than Wages

For a worker in the U.S. who benefits from health insurance at the workplace, the annual family premium will average $21,342 this year, according to the 2020 Employer Health Benefits Survey from the Kaiser Family Foundation. The first chart illustrates the growth of the premium shares split by employer and employee contributions. Over ten years, the premium dollars grew from $13,770 in 2010 to $21K in 2020. The worker’s contribution share was 29% in 2010, and 26% in 2020. Single coverage reached $7,470 in 2020 and was $5,049 in 2010. Roughly the same proportion of companies offered health benefits to

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Only in America: The Loss of Health Insurance as a Toxic Financial Side Effect of the COVID-19 Pandemic

In terms of income, U.S. households entered 2020 in the best financial shape they’d been in years, based on new Census data released earlier this week. However, the U.S. Census Bureau found that the level of health insurance enrollment fell by 1 million people in 2019, with about 30 million Americans not covered by health insurance. In fact, the number of uninsured Americans rose by 2 million people in 2018, and by 1.9 million people in 2017. The coronavirus pandemic has only exacerbated the erosion of the health insured population. What havoc a pandemic can do to minds, bodies, souls, and wallets. By September 2020,

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Health Insurance Affordability in the Time of the Coronavirus Pandemic

The coronavirus pandemic has revealed many flaws in the U.S. healthcare system, first and foremost the nation’s patchwork public health infrastructure and health inequities in mortality rates due to COVID-19. The Commonwealth Fund‘s biennial report, published as the pandemic continues into and beyond the third quarter of 2020, sheds light on another weakness in U.S. healthcare: the cost of health insurance relative to working Americans’ relatively flat incomes. I explored the details of this study in a post titled Health Insurance Affordability: A Call-to-Action for Healthcare Industry Stakeholders in the Pandemic, published on the Medecision Liberation blog site. The survey

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Physicians Practicing in the Age of COVID-19: Lower Incomes, More Telehealth

In the midst of the coronavirus pandemic, two certainties emerge in the lives of physicians: they are generating less revenue, and they have adopted more virtual care in practices. The Physicians Foundation surveyed 3,513 physicians in July 2020 on their perspectives on COVID-19 and how the pandemic has impacted practices and patients. This study is part one of three conducted by the Foundation this year, subtitled the “COVID-19 Impact Edition” of the 2020 Survey of America’s Physicians which the Foundation conducts each year. Merritt Hawkins conducted the study on behalf of the Foundation, shifting the focus to the pandemic. This

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The Median Hospital Charge In the U.S. for COVID-19 Care Ranges From $34-45K

The median charge for hospitalizing a patient with COVID-19 ranged from $34,662 for people 23 to 30, and $45,683 for people between 51 and 60 years of age, according to FAIR Health’s research brief, Key Characteristics of COVID-19 Patients published July 14th, 2020. FAIR Health based these numbers on private insurance claims associated with COVID-19 diagnoses, evaluating patient demographics (age, gender, geography), hospital charges and estimated allowed amounts, and patient comorbidities. They used two ICD-10-CM diagnostic codes for this research: U07.1, 2019-nCoV acute respiratory disease; and, B97.29, other coronavirus as the cause of disease classified elsewhere which was the original code

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As Americans Start to Return-to-Work in the Summer of COVID, Mental Health is a Top Concern Among Employers

Most U.S. employers worry about workers’ mental health and substance use as employees begin returning to work in the summer of 2020. About 4 in 5 U.S. companies are “very concerned” or “concerned” about employees’ chronic illnesses, acute illnesses, and injuries along with behavioral health issue, based on McKinsey’s annual employer survey which coincided this year with the COVID-19 pandemic. Challenges of opioid use in the workforce remain a concern for two-thirds of U.S. companies, as well. Some 9 in 10 U.S. companies say behavioral health has a negative impact on workforce productivity. In response, 7 in 10 employers are

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Saving Money as a Financial Vaccine: BlackRock Finds Consumer Savings Drain and Etsy Sellers Not Saving Much

“Americans are feeling incredible financial pressure as a result of the COVID outbreak,” John Thompson, Chief Program Officer with the Financial Health Network. One in three people in the U.S. has skipped or stopped paying a bill, and over half of Americans have used emergency savings, according to a survey from the BlackRock Emergency Savings Initiative (ESI). BlackRock, the investment firm, allocated $50 million in February 2019 to form the ESI, focused on helping people with lower incomes to bolster savings and financial health. BlackRock partners in the ESI with the Financial Health Network, CommonWealth, the Center for Advanced Hindsight Common

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Stress in America – COVID-19 Takes Toll on Finances, Education, Basic Needs and Parenting

“The COVID-19 pandemic has altered every aspect of American life, from health and work to education and exercise,” the new Stress in America 2020 study from the American Psychological Association begins. The APA summarizes the impact of these mass changes on the nation: “The negative mental health effects of the coronavirus may be as serious as the physical health implications,” with COVID-19 stressors hitting all health citizens in the U.S. in different ways. Beyond the risk of contracting the virus, the Great Lockdown of the U.S. economy has stressed the U.S. worker and the national economy, with 7 in 10

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What $6,553 Buys You in America: A Luxury Watch, a Year at Valdosta State, or a PPO for One – the 2020 Milliman Medical Index

Imagine this: you find yourself with $6,553 in your pocket and you can pick one of the following: A new 2020 Breitling Navitimer watch; A year’s in-state tuition at Valdosta State University; or, A PPO for an average individual. Welcome to the annual Milliman Medical Index (MMI), which gauges the yearly price of an employer-sponsored preferred-provider organization (PPO) health insurance plan for a hypothetical American family and an N of 1 employee. That is a 4.1% increase from the 2019 estimate, about twice the rate of U.S. gross domestic product growth, Milliman points out in its report.   Milliman bases

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COVID-19’s Consumer Health Care Behaviors: Telehealth, Trauma, and Trust, via PwC

In a matter of several weeks, people living in the U.S. have endured massive personal social, emotional, physical and fiscal disruption due to the COVID-19 pandemic. State mandates to shelter at home, the adoption of wearing face masks and covers in public, and re-making dining tables and dens into home-working spaces for kids in school or parents telecommuting, American homes have morphed into petri dishes of people undergoing dramatic changes in a very short time. A new report from PwC looks at peoples’ changes in health behaviors in the first two months of the pandemic, asking whether these changes will

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The Coronavirus Impact on American Life, Part 1 – Life Disrupted, and Money Concerns

Nearly 3 in 4 Americans see their lives disrupted by the coronavirus pandemic, according to the early April Kaiser Family Foundation Health Tracking Poll. This feeling holds true across most demographic factors: among both parents and people without children; men and women alike; white folks as well as people of color (although fewer people identifying as Hispanic, still a majority). There are partisan differences, however, in terms of who perceives a life-disruption due to COVID-19: 76% of Democrats believe this, 72% of Independents, and 70% of Republicans. Interestingly, only 30% of Republicans felt this way in March 2020, more than

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Estimates of COVID-19 Medical Costs in the US: $20K for inpatient stay, $1300 OOP costs

In the midst of growing inpatient admissions and test results for COVID-19, Congress is working as I write this post to finalize a round of legislation to help Americans with the costs-of-living and (hopefully) health care in a national, mandated, clarifying way. Right now in the real world, real patients are already being treated for COVID-19 in American hospitals. Patients are facing health care costs that may result in multi-thousand dollar bills at discharge (or death) that will decimate households’ financial health, particularly among people who don’t have health insurance coverage, covered by skinny or under-benefited plans, and/or lack banked

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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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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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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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Income Inequality is Fostering Mis-Trust, the Edelman 2020 Trust Barometer Observes

Economic development has historically built trust among nations’ citizens. But in developed, wealthier parts of the world, like the U.S., “a record number of countries are experiencing an all-time high ‘mass-class’ trust divide,” according to the 2020 Edelman Trust Barometer. For 20 years, Edelman has released its annual Trust Barometer every year at the World Economic Forum in Davos, recognizing the importance of trust in the global economy and society. Last year, it was the employer who was the most-trusted touch-point in citizens’ lives the world over, I discussed in Health Populi one year ago. This year, even our employers can’t

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In 2020, PwC Expects Consumers to Grow DIY Healthcare Muscles As Medical Prices Increase

The new year will see a “looming tsunami” of high prices in healthcare, regulation trumping health reform, more business deals reshaping the health/care industry landscape, and patients growing do-it-yourself care muscles, according to Top health industry issues of 2020: Will digital start to show an ROI from the PwC Health Research Institute. I’ve looked forward to reviewing this annual report for the past few years, and always learn something new from PwC’s team of researchers who reach out to experts spanning the industry. In this 14th year of the publication, PwC polled executives from payers, providers, and pharma/life science organizations. Internally,

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The Patient As Payor: Workers Covered by Employer Health Insurance Spend 11.5% of Household Incomes on Premiums and Deductibles

Workers covered by health insurance through their companies spend 11.5% of their household income on health insurance premiums and deductibles based on The Commonwealth Fund’s latest report on employee health care costs, Trends in Employer Health Coverage, 2008-2018: Higher Costs for Workers and Their Families. The topline of this study is that average annual growth in employer premiums rose faster between 2016 and 2017, by about 5% for both single and family plans. The bottom line for families is that workers’ premium payments grew faster than median incomes did over the ten years 2008 to 2018. Average deductibles also outpaced

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A Tale of Two Americas as Told by the 2019 OECD Report on Health

It was the best of times, It was the worst of times, It was the age of wisdom, it was the age of foolishness, It was the epoch of belief, it was the epoch of incredulity, … starts Dickens’ Tale of Two Cities.  That’s what came to my mind when reading the latest global health report from the OECD, Health at a Glance 2019, which compares the United States to other nations’ health care outcomes, risk factors, access metrics, and spending. Some trends are consistent across the wealthiest countries of the world, many sobering, such as: Life expectancy rates fell in 19 of the

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Thinking About Health Care One Year From the 2020 Presidential Election

Today is 4th November 2019, exactly one year to the day that Americans can express their political will and cast their vote for President of the United States. Health care will be a key issue driving people to their local polling places, so it’s an opportune moment to take the temperature on U.S. voters’ perspectives on healthcare reform. This post looks at three current polls to gauge how Americans are feeling about health care reform 365 days before the 2020 election, and one day before tomorrow’s 2019 municipal and state elections. Today’s Financial Times features a poll that found two-thirds

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Health Consumer Behaviors in the U.S. Stall, Alegeus Finds in the 2019 Index

In the U.S., the theory of and rationale behind consumer-directed health has been that if you give a patient more financial skin-in-the-game — that is, to compel people to spend more out-of-pocket on health care — you will motivate that patient to don the hat of a consumer — to mindfully research, shop around, and purchase health care in a rational way, benefit from lower-cost and high-quality healthcare services. For years, Alegeus found that patients were indeed growing those consumer health muscles to save and shop for health care. In 2019, it appears that patients have backslid, according to the

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Wasted: $1 of Every $4 Spent on Health Care In America

A study in JAMA published this week analyzed research reports that have measured waste in the U.S. health care system, calculating that 25% of medical spending in America is wasted. If spending is gauged at $3.8 trillion, waste amounts to nearly $1 trillion. If spending is 18% of the American gross domestic product (GDP), then some 4.5% of the U.S. economy is wasted spending by the health care system and its stakeholders. In “Waste in the US Health Care System,” a team from Humana and the Univrsity of Pittsburgh recalibrated the previous finding of 30% of wasted spending to the 25%,

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Health @ Retail – Prelude to GMDC SelfCare Summit with Updates from Hims & Hers, GoodRx, Sam’s Club and Amazon Care

“We knew millions of people weren’t getting the care they needed — they were either too embarrassed to seek help or felt stuck in a system that was confusing and intimidating. Digital health has the potential to radically change the way people approach their wellness and, since launching in 2017, we’ve outpaced even our own expectations, delivering more than 1 million Hims & Hers products to our customers. In collaboration with highly-qualified doctors and healthcare providers, we’ve built a digital health platform that is changing the way people talk about and receive the care they need.” That’s  a verbatim paragraph

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“It’s the Deductible, Stupid” – Health Premiums Reach $20,576 in 2019 for a Family

        Here’s the latest arithmetic on American workers’ financial trade-off of wages for health care insurance coverage: in the ten years since 2009, family premiums have risen 54% and workers’ contribution to health care spending grew 71%. Wages? They rose 26%, and general price inflation by 20%, according to the Kaiser Family Foundation survey on employer-sponsored benefits for 2019 released yesterday. Survey details for this 21st annual encyclopedia on employer-sponsored health care are published in Health Affairs October 2019 issue in a paper titled, Health Benefits in 2019: Premiums Inch Higher, Employers Respond to Federal Policy. Because this

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Worrying About Paying for Health Care Is the Norm in America

Among stresses facing people at least 50 years of age, health care costs rank top of mind compared with other issues like long-term care, health insurance, Social Security, taxes, and being read to retire. Worries about health care costs are particularly stressful among future retirees, 8 of 10 of whom share this top concern along with 7 in 10 recent retirees and 6 in 10 people retired for at least a decade. Health care stress cuts in two ways: most people are worried about paying for health care, as well as experienced an unanticipated decline in their health, according to

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The New Employer Wellness Lens Includes Mental Health, Telehealth and Women’s Health

U.S. employers are tightening their focus on mental and behavioral health, addressing workers’ chronic conditions, emphasizing women’s health, and allocating more resources to digital and telehealth investments, we learn from Optum’s Ten Years of Health and Well-Being at Work: Learning from our past and reimagining the future. Four in five medium, large and jumbo companies expect their spending on health and wellness programs will increase over the next three years. That spending will have a strong focus on behavioral health services: 9 in 10 employers are concerned with the level of access workers have to mental health services. Companies will

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Getting More Personal, Virtual and Excellent – the 2020 NBGH Employer Report

In 2020, large employers will be “doubling down” efforts to control health care costs. Key strategies will include deploying more telehealth and virtual health care services, Centers of Excellence for high-cost conditions, and getting more personal in communicating and engaging through platforms. This is the annual forecast for 2020 brought to us by the National Business Group of Health (NBGH), the Large Employers’ Health Care Strategy and Plan Design Survey. The 42-page report is packed with strategic and tactical data looking at the 2020 tea leaves for large employers, representing over 15 million covered lives. Nearly 150 companies were surveyed

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Talking “HealthConsuming” on the MM&M Podcast

Marc Iskowitz, Executive Editor of MM&M, warmly welcomed me to the Haymarket Media soundproof studio in New York City yesterday. We’d been trying to schedule meeting up to do a live podcast since February, and we finally got our mutual acts together on 6th August 2019. Here’s a link to the 30-minute conversation, where Marc combed through the over 500 endnotes from HealthConsuming‘s appendix to explore the patient as the new health care payor, the Amazon prime-ing of people, and prospects for social determinants of health to bolster medicines “beyond the pill.” https://www.pscp.tv/MMMnews/1eaJbvgovBYJX Thanks for listening — and if you

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Milliman Finds PPO for Family of 4 in 2019 Will Cost $28,386

This year, an employer-sponsored PPO for a family of four in the U.S. will cost $28,386, a 3.6% increase over 2018, according to the 2019 Milliman Medical Index (MMI). Based on my annual read of this year’s Index, the PPO costs roughly the same as a new Dodge Charger or a year attending the engineering school at Alfred University. The Milliman MMI team has updated the methodology for the Index; the chart shown here is my own, recognizing that the calculations and assumptions beneath the 2019 data point differ from previous years. The key points of the report are that:

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Finances Are the Top Cause of Stress, and HSAs Aren’t Helping So Much…Yet

If you heed the mass media headlines and President Trump’s tweets, the U.S. has achieved “the best economy” ever in mid-July 2019. But if you’re working full time in that economy, you tend to feel much less positive about your personal prospects and fiscal fitness. Nearly nine in 10 working Americans believe that medical costs will rise in the next few years as they pondering potential changes to the Affordable Care Act. The bottom line is that one-half of working people are more concerned about how they will save for future health care expenses. That’s the over-arching theme in PwC’s

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Healthcare Costs Inspire Employer Activism and Employee Dissatisfaction – What PwC Found Behind the Numbers

In the U.S. each year between 2006 and 2016, employees’ healthcare cost sharing grew 4.5%. In that decade, Americans’ median wages rose 1.8% a year, PwC notes in their annual report, Medical cost trend: Behind the numbers 2020 from the firm’s Health Research Institute. Medical cost trend is the projected percent growth in healthcare costs over a year based on an equivalent benefit package from one year to the next. As the first chart shows, trend will grow 6% from 2019 to 2020. This is an increase of 0.3 percentage points up from 5.7% for 2019, which was flat from

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How Consumers Look At Social Determinants of Health for Cancer, Diabetes and Mental Health

Enlightened health/care industry and public policy stakeholders have begun to embrace and address social determinants of health. These are the inputs that bolster health beyond health care services: they include economic stability like job security and income level (and equity), education, and access to healthy food, food security, safe neighborhoods, social support, clean environments (water and air), and in my own update on SDoH factors, access to broadband connectivity. As physician leaders in the AMA, technology advocates from AMIA, and numerous health plans focus efforts on strengthening social determinants, what do people – consumers, patients, caregivers — think about these

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The 3 A’s That Millennials Want From Healthcare: Affordability, Accessibility, Availability

With lower expectations of and satisfaction with health care, Millennials in America seek three things: available, accessible, and affordable services, research from the Transamerica Center for Health Studies has found. Far and away the top reason for not obtaining health insurance in 2018 was that it was simply too expensive, cited by 60% of Millennials. Following that, 26% of Millennials noted that paying the tax penalty plus personal medical expenses were, together, less expensive than available health options. While Millennials were least likely to visit a doctor’s office in the past year, they had the most likelihood of making a

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A Dose of Optimism Is a Prescription for Financial Health, Says Frost Bank

People define their personal health and well-being broadly, well beyond physical health. Mental wellness, physical appearance, social connections, and financial wellness all add into our self-health definitions. Mind Over Money is a consumer study conducted by Frost Bank, working with FleischmanHillard, connecting the dots between optimism and financial health. The top-line of the study is that people who are optimists have roughly two-thirds fewer days of financial stress per year than pessimists. Put another way, pessimists stress about finances 62% of the year, shown in the first chart from the study. This translates into 62% of optimists having better financial

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In the Modern Workplace, Workers Favor More Money, New Kinds of Benefits, and Purpose

Today, April 2nd, is National Employee Benefits Day. Who knew? To mark the occasion, I’m mining an important new report from  MetLife, Thriving in the New Work-Life World, the company’s 17th annual U.S. employee benefit trends study with new data for 2019. For the research, MetLife interviewed 2,500 benefits decision makers and influencers of companies with at least two employees. 20% of the firms employed over 10,000 workers; 20%, 50 and fewer staff. Companies polled represented a broad range of industries: 11% in health care and social assistance, 10% in education, 9% manufacturing, 8% each retail and information technology, 7%

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The Evolution of Self-Care for Consumers – Learning and Sharing at CHPA

Self-care in health goes back thousands of years. Reading from Hippocrates’ Corpus about food and clean air’s role in health sounds contemporary today. And even in our most cynical moments, we can all hearken back to our grandmothers’ kitchen table wisdom for dealing with skin issues, the flu, and broken hearts. The annual conference of the Consumer Healthcare Products Association (CHPA) convened this week, and I was grateful to attend and speak on the evolving retail health landscape yesterday. Gary Downing, CEO of Clarion Brands and Chairman of the CHPA Board, kicked off the first day with a nostalgic look

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Loving Wegmans and Amazon, Hating on the US Government: the Axios Harris Poll 100 in 2019

Americans love grocery stores, responsible retailers, technology and Amazon, Axios and Harris Poll found in this year’s top 100 visible company poll. The bottom five of the 100 include a big bank that ripped off consumers, a bankrupt retailer, a Big Tobacco company, and two organizations led by President Trump: The Trump Organization (#98) and the U.S. Government (#100). The summary points to five key findings in the report: The U.S. Government is the worst “company” in America according to “The Citizens of America,” in the words of Axios and Harris Poll. Americans have acquired “prime” tastes and expectations through

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National Health Spending Will Reach Nearly 20% of U.S. GDP By 2027

National health spending in the U.S. is expected to grow by 5.7% every year from 2020 to 2027, the actuaries at the Centers for Medicare and Medicaid Services forecast in their report, National Health Expenditure Projections, 2018-2927: Economic And Demographic Trends Drive Spending And Enrollment Growth, published yesterday by Health Affairs. For context, note that general price inflation in the U.S. was 1.6% for the 12 months ending January 2019 according to the U.S. Bureau of Labor Statistics. This growth rate for health care costs exceeds every period measured since the high of 7.2% recorded in 1990-2007. The bar chart illustrates the

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“Telehealth is a digital distribution channel for health care” – catching up with Roy Schoenberg, President and CEO of American Well

Ten years ago, two brothers, physicians both, started up a telemedicine company called American Well. They launched their service first in Hawaii, where long distances and remote island living challenged the supply and demand sides of health care providers and patients alike. A decade later, I sat down for a “what’s new?” chat with Roy Schoenberg, American Well President and CEO. In full  transparency,  I enjoy and appreciate the opportunity to meet with Roy (or very occasionally Ido, the co-founding brother-other-half) every year at HIMSS and sometimes at CES. In our face-to-face brainstorm this week, we covered a wide range

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Telehealth and Virtual Care Are Melting Into “Just” Health Care at HIMSS19

Just as we experienced “e-business” departments blurring into ecommerce and everyday business processes, so is “telehealth” morphing into, simply, health care delivery as one of many channels and platforms. Telehealth and virtual care are key education topics and exhibitor presences at HIMSS19. Several factors underpin the adoption of telehealth in 2019: Consumers’ demand for accessible, lower-cost health care services as people face greater financial responsibility for paying the medical bill (via high-deductible health plans and greater out-of-pocket costs for co-payments) Some consumers’ lacking or losing health insurance as ACA coverage eroded in the past two years, resulting in these patients

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Trust in 2019 Via Edelman: The Plotline for Women and Healthcare

Fewer than one-half of consumers trust in government and media. Three-quarters trust employers, who in 2019 are the top-trusted institution according to the 2019 Edelman Trust Barometer released last week in Davos at the World Economic Forum. Consumers in the U.S. over-index for trust in employers, with 80% of people saying they have a strong relationship with “my employer,” compared with 73% of Britons, 66% of the French, and 59% of people in Japan. What’s underneath this is employers being trusted to provide certainty: most workers look to their employer to be a trustworthy source of information about social issues and

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In U.S. Health Care, It’s Still the Prices, Stupid – But Transparency and Consumer Behavior Aren’t Working As Planned

I’m glad to be getting back to health economic issues after spending the last couple of weeks firmly focused on consumers, digital health technologies and CES 2019. There’s a lot for me to address concerning health care costs based on news and research published over the past couple of weeks. We’ll start with the centerpiece that will provide the overall context for this post: that’s the ongoing research of Gerard Anderson and colleagues under the title, It’s Still The Prices, Stupid: Why The US Spends So Much On Health Care, And A Tribute To Uwe Reinhardt. It is bittersweet to

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Costs, Consumerism, Cyber and Care, Everywhere – The 2019 Health Populi TrendCast

Today is Boxing Day and St. Stephens Day for people who celebrate Christmas, so I share this post as a holiday gift with well-wishes for you and those you love. The tea leaves have been brewing here at THINK-Health as we prepared our 2019 forecast at the convergence of consumers, health, and technology. Here’s our trend-weaving of 4 C’s for 2019: costs, consumerism, cyber and care, everywhere… Health care costs will continue to be a mainstream pocketbook issue for patients and caregivers, with consequences for payors, suppliers and ultimately, policymakers. Legislators inside the DC Beltway will be challenged by the

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Consumers Want Help With Health: Can Healthcare Providers Supply That Demand?

Among people who have health insurance, managing the costs of their medical care doesn’t rank as a top frustration. Instead, attending to health and wellbeing, staying true to an exercise regime, maintaining good nutrition, and managing stress top U.S. consumers’ frustrations — above managing the costs of care not covered by insurance. And maintaining good mental health and staying on-track with health goals come close to managing uncovered costs, Oliver Wyman’s 2018 consumer survey learned. These and other important health consumer insights are revealed in the firm’s latest report, Waiting for Consumers – The Oliver Wyman 2018 Consumer Survey of US

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Loneliness, Public Policy and AI – Lessons From the UK For the US

There’s a shortage of medical providers in the United Kingdom, a nation where healthcare is guaranteed to all Britons via the most beloved institution in the nation: The National Health Service. The NHS celebrated its 70th anniversary in July this year. The NHS “supply shortage” is a result of financial cuts to both social care and public health. These have negatively impacted older people and care for people at home in Great Britain. This article in the BMJ published earlier this year called for increasing these investments to ensure further erosion of population and public health outcomes, and to prevent

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Koen Kas, the Gardener of Health Tech Delights

The future of healthcare is not about being sick, Prof. Dr. Koen Kas believes. Having spent many years in life sciences in both research and as an entrepreneur, Koen now knows that getting and staying healthy isn’t about just developing medicines and med-tech: optimally, health requires a tincture of delight, Koen advises in his breakthrough, innovative book, Your Guide to Delight. Healthcare must go beyond traditional user-centered design, Koen’s experience has shown, and aspire toward design-to-delight. The concept of “delight” in healthcare, such as we experience in hospitality, grocery stores, and entertainment, is elusive. I’ve observed this, too, in my

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How Digital Health Can Stimulate Economic Development

It’s National Health IT Week in the US, so I’m kicking off the week with this post focused on how digital health can bolster economic development. As the only health economist in the family of the 2018 HIMSS Social Media Ambassadors, this is a voice through which I can uniquely speak. In February 2009, President Barack Obama signed into law the American Recovery and Reinvestment Act (ARRA), less formally known as the Stimulus Bill. This was the legislation best known for addressing and helping to bring the U.S. out of the Great Recession. A lesser-known component of ARRA was Title

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As Workers’ Healthcare Costs Increase, Employers Look to Telehealth and Wearable Tech to Manage Cost & Health Risks

Family premiums for health insurance received at the workplace grew 5% in 2018: to $19,616, according to the 2018 KFF Employer Health Benefits Survey released today by the Kaiser Family Foundation (KFF). These two trends combine for a 212% increase in workers’ deductibles in the past decade. This is about eight times the growth of workers’ wages in the U.S. in the same period. Thus, the main takeaway from the study, KFF President and CEO Drew Altman noted, is that rising health care costs absolutely remain a burden for employers — but a bigger problem for workers in America. Given that

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More U.S. Companies Offering Health Insurance After 8 Years of Decline

After eight years of decline, more U.S. employers offered health insurance to workers in 2017, EBRI reports in its latest Issue Brief. In 2017, 46.9% of U.S. companies offered health insurance to their employees, up by 1.6 percentage points from a low of 45.3% in 2016. For perspective, ten years earlier in 2008, 56.4% of employers offered health insurance, shown in the first bar chart (Figure 1 from the EBRI report). The largest percentage point increase in health plan offer-rates came from the smallest companies, those with less than 10 employees: while 21.7% of those companies offered health insurance in

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Wealth is Health and Health, Wealth, Fidelity Knows – with Weight a Major Risk Factor

The two top stressors in American life are jobs and finances. “My weight” and my family’s health follow just behind these across the generations. Total Well-Being, a research report from Fidelity Investments, looks at the inter-connections between health and wealth – the combined impact of physical, mental, and fiscal factors on our lives. The first chart summarizes the study’s findings, including the facts that: One-third of people have less than three months of income in the bank for emergency Absenteeism is 29% greater for people who don’t have sufficient emergency funds saved People who are highly stressed tend not to

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Employers Take on Health Activism, Embracing Behavioral Health, Virtual Care, AI, and Transparency

More U.S. employers are growing activist roles as stakeholders in the healthcare system, according to the 2019 Large Employers Health Care Strategy and Plan Design Survey from the National Business Group on Health (NBGH). Consider the Amazon-Berkshire Hathaway-JPMorgan Chase link up between Jeff Bezos, Warren Buffet, and Jamie Dimon, as the symbol of such employer-health activism. The NBGH report is based on survey results collected from 170 large employers representing 13 million workers and 19 million covered lives (families/dependents). This annual survey is one of the most influential such reports released each year, providing a current snapshot of large employers’ views

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How Taking Care of Your Health Boosts Savings Accounts

It will cost about $275,000 for a couple retiring in the U.S. this year to cover their healthcare costs for the rest of their life in retirement, Fidelity estimated. But Americans are notoriously pretty undisciplined about saving money, compared with peers living in other developed countries. How to address this challenge? Show people what improving their personal health can do to boost their 401(k) plans. This tactic is discussed in Health & Retirement Savings: Leveraging Healthcare Costs to Drive 401(k) Contributions & Improve Health, from HealthyCapital, a joint venture of Mercy health systems and HealthView Services.   The chart illustrates three

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Design, Empathy and Ethics Come to Healthcare: HXD

Design-thinking has come to health/care, finally, and Amy Cueva has been beating this drum for a very long time. I’m delighted to be in her collegial circle, speaking at the conference about the evolving healthcare consumer who’s financially strapped, stressed-out, and Amazon Primed for customer service. I’m blogging live while attending HXD 2018 in Cambridge, MA, the health/care design conference convened by Mad*Pow, 26th and 27th June 2018. Today was Day 1 and I want to recap my learnings and share with you. Amy, Founder and Chief Experience Office of Mad*Pow, kicked off the conference with context-setting and inspiration. Design

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Food as Medicine Update: Danone Goes B-Corp, Once Upon a Farm Garners Garner, and Livongo Buys Retrofit

As the nation battles an obesity epidemic that adds $$ costs to U.S. national health spending, there are many opportunities to address this impactful social determinant of health to reduce health spending per person and to drive public and individual health. In this post, I examine a few very current events in the food-as-medicine marketspace. Big Food as an industry gets a bad rap, as Big Tobacco and Big Oil have had. In the case of Big Food, the public health critique points to processed foods, those of high sugar content (especially when cleverly marketed to children), and sustainability. But

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Healthcare Access and Cost Top Americans’ Concerns in Latest Gallup Poll

Healthcare — availability and affordability — is a more intense worry for Americans in March 2018 than crime and violence, Federal spending, guns, drug use, and hunger and homelessness. The Gallup Poll, fielded in the first week of March 2018, found that peoples’ overall economic and employment concerns are on the decline since 2010, at the height of the Great Recession which began in 2008. While 70% of Americans were worried about economic matters in 2010, only 34% of people in the U.S. were worried about the economy, and 23% about unemployment, in March 2018. Gallup has asked this “worry”

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Add Behavioral Data to Social Determinants For Better Patient Understanding

“Health agencies will have to become at least as sophisticated as other consumer/retail industries in analyzing a variety of data that helps uncover root causes of human behavior,” Gartner recommended in 2017. That’s because “health” is not all pre-determined by our parent-given genetics. Health is determined by many factors in our own hands, and in forces around us: physical environment, built environment, and public policy. These are the social determinants of health, but knowing them even for the N of 1 patient isn’t quite enough to help the healthcare industry move the needle on outcomes and costs. We need to

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Warren Buffett’s Healthcare Cost Tapeworm & His Alliance with Amazon and JPMorgan

The fact that the average U.S. employer committed to spend nearly $27,000 a year for a PPO to cover a family of 4 in America in 2017 is the most important rationale underlying the announcement that Amazon, Berkshire-Hathaway, and JP Morgan made on 30th January 2017. That news immediately shook Wall Street trading, sending downward shocks down the proverbial spines of healthcare insurance plans and suppliers to the industry — legacy healthcare companies that scale patient-members and healthcare supplies, like pills and surgical implants. The “new competition” chart published in the Wall Street Journal in the morning illustrates those shock

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The 2018 Edelman Trust Barometer – What It Means for Health/Care in America

Trust in the United States has declined to its lowest level since the Edelman Trust Barometer has conducted its annual survey among U.S. adults. Welcome to America in Crisis, as Edelman brands Brand USA in 2018. In the 2018 Edelman Trust Barometer, across the 28 nations polled, trust among the “informed public” in the U.S. “plunged,” as Edelman describes it, by 23 points to 45. The Trust Index in America is now #28 of 28 countries surveyed (that is, rock bottom), dropping below Russia and South Africa. “The public’s confidence in the traditional structures of American leadership is now fully

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Hug Your Physician: S/He Needs It – Listening to the 2018 Medscape National Physician Burnout & Depression Report

Two in five U.S. physicians feels burned out, according to the Medscape National Physician Burnout & Depression Report for 2018. This year, Medscape explicitly adds the condition of “depression” to its important study, and its title. In 2017, the Medscape report was about bias and burnout. Physicians involved in primary care specialties and critical care are especially at-risk for burnout, the study found. One in five OBGYNs experience both burnout and depression. Furthermore, there’s a big gender disparity when it comes to feeling burned out: nearly one-half of female physicians feel burnout compared with 38% of male doctors. Being employed by

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The Patient as Payor – Consumers and the Government Bear the Largest Share of Healthcare Spending in America

The biggest healthcare spenders in the United States are households and the Federal government, each responsible for paying 28% of the $3.3 trillion spent in 2016. Private business — that is, employers covering healthcare insurance — paid for 20% of healthcare costs in 2016, based on calculations from the CMS Office of the Actuary’s report on 2016 National Health Expenditures. The positive spin on this report is that overall national health spending grew at a slower rate in 2016, at 4.3% after 5.8% growth in 2015. This was due to a decline in the growth rates for the use of

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The State of Financial Wellness and Health in America – Suffering Across the Ages

Nearly one-half of Americans are challenged by low financial well-being. Compared to emotional/mental, job/career, social, physical, and financial, it’s this last lens on personal health that gets the lowest ratings for the largest number of Americans. The second most worrying factor diminishing well-being is a tie between physical health and social health. Welcome to The uncomfortable reality of financial wellbeing, a report on the 2017 Financial Mindset Study Highlights from Alight Solutions, an HR services company. The first chart arrays the well-being rankings across the five factors, showing that just over one-half of Americans have more positive views on their emotional

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Movin’ Out(patient) – The Future of the Hospital is Virtual at UPMC

In 2016, most consultations between patients and Kaiser-Permanente Health Plan were virtual — that is, between consumers and clinicians who were not in the same room when the exam or conversation took place. Virtual healthcare may be the new black for healthcare providers. Mercy Health System in St. Louis launched a virtual hospital in 2016, covered here in the Health Populi post, “Love, Mercy, and Virtual Healthcare.” Intermountain Healthcare announced plans to build a virtual hospital in 2018. And, earlier this month, UPMC’s CEO, Jeffrey Romoff, made healthcare headlines saying, “UPMC desires to be the Amazon of healthcare.” UPMC, aka University of Pittsburgh

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Employees Continue To Pick Up More Health Insurance Costs, Even As Their Growth Slows

The average cost of an employer=sponsored health plan for a family reached $18,764 in 2017. While this premium grew overall by a historically relative low of 3.4%, employees covered under that plan faced an increase of 8.3% over what their plan share cost them in 2016, according to the 2017 Employer Health Benefit Survey published today by the Kaiser Family Foundation. [Here’s a link to the 2016 KFF report, which provided the baseline for this 8.3% calculation]. Average family premiums at the workplace rose 19% since 2012, a slowdown from the two previous five-year periods — 30% between 2007 and 2012, and

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Cost and Personalization Are Key For Health Consumers Who Shop for Health Plans

        Between 2012 and 2017, the number of US consumers who shopped online for health insurance grew by three times, from 14% to 42%, according to a survey from Connecture. Cost first, then “keeping my doctor,” are the two top considerations when shopping for health insurance. 71% of consumers would consider switching their doctor(s) to save on plan costs. Beyond clinician cost, health plans shoppers are also concerned with prescription drug costs in supporting their decisions. 80% of consumers would be willing to talk with their doctors about prescription drug alternatives, looking for a balance between convenience

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Employer Health Benefits Stable In the Midst of Uncertain Health Politics

As we look for signs of stability in U.S. health care, there’s one stakeholder that’s holding firm: employers providing healthcare benefits. Two studies out this week demonstrate companies’ commitment to sponsoring health insurance benefits….with continued tweaks to benefit design that nudges workers toward healthier behaviors, lower cost-settings, and greater cost-sharing. As Julie Stone, senior benefits consultant with Willis Towers Watson (WLTW), noted, “The extent of uncertainty in Washington has made people reluctant to make changes to their benefit programs without knowing what’s happening. They’re taking a wait-and-see attitude.” First, the Willis Towers Watson 22nd annual Best Practices in Health Care Employer

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Pharmacy and Outpatient Costs Will Take A Larger Portion of Health Spending in 2018

Health care costs will trend upward by 6.5% in 2018 according to the forecast, Medical Cost Trends: Behind the Numbers 2018, from PwC’s Health Research Institute. The expected increase of 6.5% is a half-percentage point up from the 2017 rate of 6.0%, which is 8% higher than last year’s rate matching that of 2014. PwC’s Health Research Institute has tracked medical cost trends since 2007, as the line chart illustrates, when trend was nearly double at nearly 12%. The research consider medical prices, health care services and goods utilization, and a PwC employer benefit cost index for the U.S. The key

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As High Deductible Health Plans Grow, So Does Health Consumers’ Cost-Consciousness

A person enrolled in a high-deductible health insurance plan is more likely to be cost-conscious than someone with traditional health insurance. Cost-consciousness behaviors including checking whether a plan covers care, asking for generic drugs versus a brand name pharmaceutical, and using online cost-tracking tools provided by health plans, according to the report, Consumer Engagement in Health Care: Findings from the 2016 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey from EBRI, the Employee Benefit Research Institute. A high deductible is correlated with more engaged health plan members, EBRI believes based on the data. One example: more than one-half of people enrolled

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Healthcare Costs for a Family of Four Will Reach $27,000 in 2017

If you had $27,000 in your wallet, would you spend it on a 2017 Kia Optima sedan, 28 shares of Amazon stock, or healthcare? $26,944 is this year’s estimate of what healthcare will cost a family of four in the U.S., based on the 2017 Milliman Medical Index (MMI). This is based on the projected total costs of healthcare for a family covered by an employer-sponsored PPO plan. Milliman, the actuarial consulting firm, has conducted the MMI going back to 2001. I’ve watched the rise and rise of this index for years, explained annually in the Health Populi blog since its inception

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Shopping Food for Health is Mainstream, But Nutrition Confusion is Super-Sized

Americans are overwhelmingly keen to use food for their health, and overwhelmed by the amount of nutrition information they face to make good shopping and eating decisions. Welcome to “food confusion,” a phenomenon gleaned from the 12th Annual Food and Health Survey conducted by the International Food Information Council Foundation (IFIC). This 12th annual survey from IFIC finds that most Americans take many steps to be healthy. In the past year, the most popular health-steps include drinking more for hydration, making small changes to achieve a healthier diet, consuming smaller portions, eating more fruits and vegetables, and eating more whole grains.

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Building Digital Trust Is Now Part of Serving Up Healthcare

The most trusted stewards for protecting consumers’ health data are “my providers:” “my” physician (88%), “my” pharmacy (85%), and “my” hospital” (84%). according to the Accenture 2017 Consumer Survey on Healthcare Cybersecurity and Digital Trust. Who’s least-trusted? Government (56%) and tech companies (57%). Note, though, that most Americans (over 50%) trust these health data holders — it’s just that fewer people trust them than healthcare providers, who are top health information protectors in health consumers’ trust rosters. Accenture commissioned Nielsen to conduct this survey in November 2016 in seven countries. The results discussed here in Health Populi focus on the

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Health Care Worries Top Terrorism, By Far, In Americans’ Minds

Health care is the top concern of American families, according to a Monmouth University Poll conducted in the week prior to Donald Trump’s Presidential inauguration. Among U.S. consumers’ top ten worries, eight in ten directly point to financial concerns — with health care costs at the top of the worry-list for 25% of people. Health care financial worries led the second place concern, job security and unemployment, by a large margin (11 percentage points) In third place was “everyday bills,” the top concern for 12% of U.S. adults. Immigration was the top worry for only 3% of U.S. adults; terrorism and

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The Growth of Digital Health @Retail

This post was written to support the upcoming meeting of the PCHA, the Personal Connected Health Alliance, to be held 11-14 December 2016 at the Gaylord Hotel in greater Washington, DC. You can follow the events and social content via Twitter using the hashtag #Connect2Health. Have you visited your local Big Box, discount or consumer electronics store lately? You’ll find expanding shelf space for digital health technologies aimed squarely at consumers. 2017 promises even more of them, aimed at helping people accomplish health tasks once  performed in hospitals and by healthcare providers, or tasks not yet delivered in today’s healthcare

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Americans Have Begun to Raid Retirement Savings for Current Healthcare Costs

While American workers appreciate the benefits they receive at work, people are concerned about health care costs. And consumers’ collective response to rising health care costs is changing the way they use health care services and products, like prescription drugs. Furthermore, 6 in 10 U.S. health citizens rank healthcare as poor (27%) or fair (33%). This sober profile on healthcare consumers emerges out of survey research conducted by EBRI (the Employee Benefit Research Institute), analyzed in the report Workers Like Their Benefits, Are Confident of Future Availability, But Dissatisfied With the Health Care System and Pessimistic About Future Access and

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Looking for Amazon in Healthcare

  Consumers have grown accustomed to Amazon, and increasingly to the just-in-time convenience of Amazon Prime. Today, workers who sign onto employee benefit portals are looking for Amazon-style convenience, access, and streamlined experiences, found in the Aflac Workforces Report 2016. Aflac polled 1,900 U.S. adults employed full or part time in June and July 2016 to gauge consumers’ views on benefit selections through the workplace. Consumers have an overall angst and ennui about health benefits sign-ups: 72% of employees say reading about benefits is long, complicated, or stressful 48% of people would rather do something unpleasant like talking to their ex or

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Employer Health Insurance Costs $18,142 in 2016, in KFF Study

Consumers face increasing health insurance deductibles in 2016, faster-growing than earnings and well above general price inflation, featured in the Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2016. This report, updated annually, is the go-to source on the availability of, cost for, and trends in U.S. employer-based health plans. The average annual health insurance premium in 2016 reached $18,142, the survey found, about $600 more than in 2015. Over the past ten years since 2006, workers’ contributions to health insurance premiums increased 78%; employers’ contributions grew 58% over the decade.   To help stem costs, employers are adopting new services to

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The State of Mobile Apps in 2016 and Healthcare Implications

Some of the fastest-growing mobile phone apps help people manage life-tasks every day, like getting real-time directions when driving, finding dates, getting rides, and tracking health, according to The 2016 U.S. Mobile App Report from comScore. The chart from the comScore Mobile Metrix survey illustrates some popular apps well-used by people on smartphones, with one of the fastest growth rates found for the Fitbit app — 1,524% growth over two years, from June 2014 to June 2016. In comparison, the Uber app visits increased 828% in the period, half as fast, and the Tinder app, 220%. Some key topline results of

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Employers Changing Health Care Delivery – Health Reform At Work

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

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PhRMA vs. Employers: Healthcare Costs In the Eye of the Beholder

In the past week, the Pharmaceutical Research and Manufacturers of America (PhRMA), the advocacy organization for the branded prescription drug industry, published Medicines: Costs in Context,” the group’s lens on the value of prescription drugs in the larger healthcare economy. Their view: that prescription drug costs comprise a relatively low share of health care spending in America, and a high-value one at that. PhRMA contends that 10% of the health care dollar was allocated to prescription drugs in 2015, the same proportion as in 1960. “Even with new treatments for hepatitis C, high cholesterol and cancer, spending on retail prescription

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More Patients Morph Into Financially Burdened Health Consumers

Health care payment responsibility continues to shift from employers to employee-patients, More of those patients are morphing into financially burdened health consumers, according to TransUnion, the credit agency and financial risk information company, in the TransUnion Healthcare Report published in June 2016. Patients saw a 13% increase in their health insurance deductible and out-of-pocket (OOP) maximum costs between 2014 and 2015. At the same time, the average base salary in the U.S. grew 3% in 2015, SHRM estimated. Thus, deductibles and OOP costs grew for consumers more than 4 times faster than the average base salary from 2014 to 2015.  In

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Workplace Wellness Goes Holistic, Virgin Pulse Finds

“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

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The State of Health Benefits in 2016: Reallocating the Components

Virtually all employers who offer health coverage to workers extend health benefits to all full-time employees. 94% offer health care coverage to opposite-sex spouses, and 83% to same-sex spouses. One-half off health benefits to both opposite-sex and same-sex domestic partners (unmarried). Dental insurance, prescription drug coverage, vision insurance, mail order prescription programs, and mental health coverage are also offered by a vast majority (85% and over) of employers. Welcome to the detailed profile of workplace benefits for the year, published in 2016 Employee Benefits, Looking Back at 20 Years of Employee Benefits Offerings in the U.S., from the Society for Human

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

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

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

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

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Financial Wellness Declines In US, Even As Economy Improves

American workers are feeling financial stress and uncertainty, struggling with health care costs, and seeking support for managing finances. 75% of employees feel financially insecure, with 60% feeling stressed about their financial situation, according to the 2016 Workplace Benefits Report, based on consumer research conducted by Bank of America Merrill Lynch. The overall feeling of financial wellness fell between 2013 and 2015. 75% of U.S. workers don’t feel secure (34% “not very secure” and 41% “not at all secure”), with the proportion of workers identifying as “not at all secure” growing from 31% to 41%. Financial wellness was defined for this

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Cost Comes Before “My Doctor” In Picking Health Insurance

Consumers are extremely price-sensitive when it comes to shopping for health insurance. The cost of health insurance premiums, deductibles and copays, prescription drug coverage and out-of-pocket expenses rank higher in the minds of health insurance shoppers than the list of doctors and hospitals included in a health plan for health consumers in 2015. The Employee Benefit Research Institute (EBRI) surveyed 1,500 workers in the U.S. ages 21-64 for their views on workers’ satisfaction with health care in America. The results of this study are compiled in EBRI’s March 2016 issue of Notes, Views on Employment-based Health Benefits: Findings from the 2015 Health

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People Want Healthcare Sherpas

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

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Sleep And Health/Tech – It’s National Sleep Awareness Week

One in three people suffer from some form of insomnia in the U.S. With sleep a major contributor to health and wellness, we recognize it’s National Sleep Awareness Week. As a health economist, I’m well aware of sleep’s role in employee productivity, absenteeism and presenteeism. U.S. companies lose 11.3 days of lost work performance per person who suffers from insomnia, according to research from a Harvard-based team published in the journal Sleep. The cost of this to U.S. business is about $63 billion annually. Science writers at the BBC developed a long list of modern-life issues that deter us from

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Prescription Drug Costs Will Be In Health Benefits Bullseye in 2016

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

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51% of Americans Say It’s Government’s Responsibility To Provide Health Insurance

For the first time since 2008, a majority of Americans say government is responsible for ensuring that people have health insurance. The first chart shows the crossing lines between those who see government-assured health insurance in the rising dark green line in 2015, and people who see it as a private sector responsibility. The demographics and sentiments underneath the 51% are important to parse out: people who approve of the Affordable Care Act are over 3x more likely to believe in government sponsoring health insurance versus those who disapprove, 80% compared with 26%. The demographic differences are also striking, detailed

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What Retail Telemedicine Means For Healthcare Providers

Direct-to-consumer retail health options are fast-growing in the U.S. health ecosystem. CVS Health brought three telemedicine vendors to its pharmacy brick-and-mortar stores. CVS also acquired Target’s pharmacies, expanding its retail health footprint. Rite Aid has added HealthSpot kiosks to its pharmacies, while Walgreens expanded its relationship with MDLive. And, Cox Cable acquired Trapollo to bring remote health monitoring into subscribers’ homes, along with the cable company’s venture with Cleveland Clinic, Vivre Health. Coupled with the growing supply side of telemedicine vendors, the latest National Business Group on Health survey found that most large employers plan to expand the telemedicine services they

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Health consumers’ cost increases far outpace wage growth

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

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Fitbit Means Business When It Comes To Privacy

Fitbit, the company that makes and markets the most popular activity tracker, is getting serious about its users’ personal data. The company  announced that it will enter into HIPAA business associate agreements with employers, health plans, and companies that offer workers the devices and the apps that organize and analyze consumers’ personal data. The Health Insurance Portability and Accountability Act (HIPAA) protects patients’ personal health information generated in a doctor’s office, a hospital, lab, and other healthcare entities covered under the law (as such, “covered entities”). However, data generated through activity tracking devices such as Fitbit’s many wearable technologies have

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A Company’s Healthy Bottom Line Requires Healthy Employees

“What is the meaning of health to our businesses?” asked Dr. Thomas Parry of the Integrated Benefits Institute (IBI) at a dinner last night, convened by the Pittsburgh Business Group on Health on the eve of the organization’s annual meeting being held today in Steel City. I was fortunate to attend the dinner and hear Dr. Parry speak; I will be addressing the meeting today on the topic, “Building a Better Health Consumer.” The IBI is researching the direct link between the top line of a healthy employee base and healthy workers’ impacts on the bottom line. A report will be

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Employers pushing consumerism for health benefits in 2016

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

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Sports and the Internet of Things: the Scoop & Score podcast

From elite soccer and football fields to youth athletes in public school gyms, wearable technology has come to sports bringing two big benefits of gathering data at the point of exercise: to gauge performance and coach back to the athlete in real time, and to prevent injury. I discussed the advent of the Internet of Things in sports on the Scoop and Score podcast with Andrew Kahn, sports journalist and writer, and Stephen Kahn, sports enthusiast and business analyst. [In full disclosure these two Kahn’s are also my brilliant nephews.] We recorded the podcast on July 14, 2015, the day

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Congratulations, Fitbit – what $4.1 bn looks like

When I clipped you to my underwear for the first time in 2011, I’d no idea that you were about to change my life, health and mindfulness. You were my first digital activity tracker and since then, I’ve purchased three versions of you…as well as others. Fitbit, you really did change my life and help me become more mindful of my activity, my calorie burn, ultimately supporting me in losing weight and keeping it off. Since its launch in 2009, the brand name “Fitbit” has become synonymous with digital activity tracking, the most popular digital pedometer on the market —

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