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A 2025 Subaru Forester, a Year at U-New Mexico, or a Health Plan for a Family of Four: the 2024 Milliman Medical Index

Health care costs for an “average” person covered by an employer-sponsored PPO in the U.S. rose 6.7% between 2023 and 2024, according to the 2024 Milliman Medical Index. Milliman also calculated that the largest driver of cost increase in health care, accounting for nearly one-half of medical cost increases, was pharmacy, the cost of prescription drugs, which grew 13% in the year.             The big number this year is $32,066, which is the cost of that employer-sponsored PPO for a family of 4 in 2024. I’ve curated the chart of the MMI statistic for many

 

The Thematic Roadmap for AHIP 2024: What the Health Insurance Conference Will Cover

Health insurance plans make mainstream media news every week, whether coverage deals with the cost of a plan, the cost of out-of-network care, prior authorizations, or cybersecurity and ransomware attacks, among other front-page issues. This week, AHIP (the acronym for the industry association of America’s Health Insurance Plans) is convening in Las Vegas for its largest annual 2024 meeting. We expect at least 2,400 attendees registered for the meeting, and they’ll not just be representing the health insurance industry itself; folks will attend #AHIP2024 from other industry segments including pharmaceuticals, technology, hospitals and health systems, and the investment and financial services

 

The ROI on Patient Experience = Loyalty, Trust and Revenue – Listening to Accenture

When health care providers and payers make patients’ lives easier, there’s a multiplying factor for loyalty and revenue growth, according to Accenture’s latest look into the value of experience in The Power of Trust: Unlocking patient loyalty in healthcare.             Accenture conducted two surveys for this research, assessing nearly 16,000 U.S. adult consumers’ views on healthcare providers and health insurance plans. Several factors underpin patients’ selection of a new health care provider, especially: Access (70%), with a convenient location, quickly available appointments, digital/mobile/social interactions, and virtual care availability; and, The provider being a trusted source

 

Prescriptions Are Up, Health Services Utilization Down, and GLP-1s Are a Major Growth Driver: IQVIA’s 2024 Update

In the past year, the growth of prescription drug utilization and spending has much to do with the use of GLP-1 agonists to treat diabetes and obesity, along with immunology therapy, and lipid meds, along with specialty medicines now accounting for over half of spending — up from 49% in 2018. This update comes from The Use of Medicines in the U.S. 2024 from the IQVIA Institute for Human Data Science. The annual report details trends in health services utilization, the use of prescription drugs, patient financing of those costs, the drivers underpinning the medicines spending, and an outlook to 2028.

 

Inflation, Health, and the American Consumer – “The Devil Wears Kirkland”

The Wall Street Journal reported yesterday that surging hospital prices are helping to keep inflation high.                 Hospital costs rose 7.7% last month, the highest increase in 13 years. This chart from WSJ’s reporting illustrates the >2x change in the CPI for hospitals vs the overall rate of price increases. Hospitals are not alone in price cliffs, with health insurance premiums spiking last year at the fastest rate in a decade, the Labor Statistics data showed. “For patients and their employers, the increases have meant higher health-insurance premiums, as well as limiting wage

 

The Cost of Medical Care, Long-Term Care, and Prescription Drugs Top Older Americans’ Health-Related Concerns – With Social Security and Medicare Top of Mind

Among Americans 50 years of age and over, the top health-related concerns are Cost, Cost, and Cost — for medical services, for long-term and home care, and for prescription medications. Quality of care ranks lower as a concern versus the financial aspects of health care in America among people 50 years of age and older, as we learn what’s On Their Minds: Older Adults’ Top Health-Related Concerns from the University of Michigan Institute for Healthcare Policy and Innovation. AARP sponsors this study, which is published nearly every month of the year on the Michigan Medicine portal.           

 

A Tax on Moms’ Financial and Physical Health – The 2024 Women’s Wellness Index

“Motherhood is the exquisite inconvenience of being another person’s everything” is a quote I turn to when I think about my own Mom and the remarkable women in my life raising children. With Mother’s Day soon approaching, the 2024 Women’s Wellness Index reminds us that the act of “being another person’s everything” has its cost. The Index, sponsored by PYMNTS in collaboration with CareCredit, was built on survey responses from 10,045 U.S. consumers fielded in November-December 2023. The study gauged women’s perspectives on finances, family, social life impacts on health and well-being.           My key takeaway from

 

Healthcare 2030: Are We Consumers, CEOs, Health Citizens, or Castaways? 4 Scenarios On the Future of Health Care and Who We Are – Part 2

This post follows up Part 1 of a two-part series I’ve prepared in advance of the AHIP 2024 conference where I’ll be brainstorming these scenarios with a panel of folks who know their stuff in technology, health care and hospital systems, retail health, and pharmacy, among other key issues. Now, let’s dive into the four alternative futures built off of our two driving forces we discussed in Part 1.             The stories: 4 future health care worlds for 2030 My goal for this post and for the AHIP panel is to brainstorm what the person’s

 

Considering Equity and Consumer Impacts of GLP-1 Drugs – A UBS Economist Weighs In

Since the introduction of GLP-1 drugs on the market, their use has split into two categories: for obesity and “recreationally,” according to the Chief Economist with UBS (formerly known as Union Bank of Switzerland). Paul Donovan, said economist, discusses The economics of getting thin in his regularly published comment blog.                   “These different uses have different economic consequences,” Donovan explains: Obese patients who use GLP-1s should become more productive employees, Donovan expects — less subject to prejudice, and less likely to be absent from work. While so-called recreational GLP-1 consumers may experience these

 

Consumers Are So Over Their Paper Chase in Health Care Payments

As we start the month of April 2024 in the U.S., it’s tax season in America with Federal (and other) income taxes due on the 15th of the month. This is also the time my research clock alarm goes off for an important annual report that describes the latest profile of the patient-as-payer in the U.S. ‘Tis the season for J.P. Morgan’s InstaMed team to analyze health care payments data, describing the experiences of consumers, providers and payers in the Trends in Healthcare Payments Fourteenth Annual Report.                   The overall takeaway for

 

The Economic Contours of the Change Healthcare Cyber Attack: Taking Stock So Far

On February 22, 2024, I went to a CVS Pharmacy-Inside-Target in my community to fill a prescription for benzonatate 200 mg capsules. I had caught a bad case of the flu the week before, and subsequently suffered a very long tail of a cough. That’s TMI for me to write about in the Health Populi blog, but this story has a current-events twist: the pharmacist could not electronically link with my insurance company to transact my payment. He tried a few work-flows, and ended up using a discount card which in the moment worked for us, and I paid the

 

A Health Consumer Bill of Rights: Assuring Affordability, Access, Autonomy, and Equity

Let’s put “health” back into the U.S. health care system. That’s the mantra coming out of this week’s annual Capitol Conference convened by the National Association of Benefits and Insurance Professionals (NABIP). (FYI you might know of NABIP by its former acronym, NAHU, the National Association of Health Underwriters).         NABIP, whose members represent professionals in the health insurance benefits industry, drafted and adopted a new American Healthcare Consumer Bill of Rights launched at the meeting. While the digital health stakeholder community is convening this week at VIVE in Los Angeles to share innovations in health tech, NABIP

 

People With Medical Debt Are Much More Likely to Be in Financial Distress in America

How financially vulnerable are people with medical debt in the U.S.? Significantly more, statistically speaking, we learn from the latest survey data revealed by the National Financial Capabilities Study (NFCS) from the FINRA Foundation. The Kaiser Family Foundation and Peterson Center on Healthcare analyzed the NFCS data through a consumer health care financial lens with a focus on medical debt.          Financial distress takes many forms, the first chart inventories. People with medical debt were most likely lack saving for a “rainy day” fund, feel they’re “just getting by” financially, feel their finances control their life, and

 

Why Elevance Health is “Prescribing” Phones for Members

You’ve heard of food-as-medicine and exercise-as-medicine. Now we see the emergence of telecomms-as-medicine — or more specifically, a driver of health, access, and empowerment. Elevance Health, the health plan organization serving 117 million members, launched a program to channel mobile phones and data plans into the hands of some Medicaid plan enrollees, explained in the organization’s press release on the program. To implement this program and get connectivity into consumers’ hands and homes, Elevance Health is collaborating with several telecomms companies including Verizon, AT&T, Samsung, and T-Mobile. Funding is supported by the FCC’s Affordable Connectivity Program.        

 

In 2024 U.S. Consumers Will Mash Financial Resolutions With Those For Physical Health and Mental Health, Fidelity Finds

One-third of U.S. consumers feel in worse financial shape now than in 2022, with inflation a top concern, discovered in the 2024 New Year’s Financial Resolutions Study from Fidelity Investments.          In this 15th annual update of Fidelity’s research into Americans’ New Year’s resolutions for financial health, we learn the mantra that 2024 will be the year of living practically, opening new chapters for saving and paying down debt. Fidelity conducted an online poll among 3,002 U.S. adults 18 and over in October 2023 to gauge peoples’ perspectives on personal finances, and well-being currently and into 2024. This

 

Healthcare Bills, Affordability, and Self-Rationing Care Will Continue to Challenge U.S. Health Consumers in 2024

Two-thirds of U.S. consumers say they can’t afford to pay their medical bills on-time, based on the 2023 Consumer Survey from Access One, a financial services company focused on healthcare payments.               The report’s title page asks the question, “What options do consumers really want for paying healthcare expenses?” The survey report responds to that question, finding out that nearly one-half of patients have taken some kind of action to reduce their medical expenses. Furthermore, one-third of consumers are not confident they could pay a medical bill of $500 or more. Access One fielded

 

Everybody is Stressed in America, and It’s Not Good for Our Health: the 2023 Update from the American Psychological Association

The U.S. is “a nation recovering from collective trauma,” the according to the latest survey on Stress in America 2023 from the American Psychological Association (APA).             The APA has been quantifying Stress in America since 2007; for context, at the end of that year The Great Recession kicked in, and in response President Obama’s team put together assistance to bolster the national economy, jobs, and health technology (codified in the American Recovery and Reinvestment Act). American health citizens are experiencing a deja vu in 2023 akin to their financial stress experienced in the APA 2008 Stress

 

How Healthcare and Patients Can Benefit From a “Simplicity Premium”

“Simplicity is the ultimate sophistication,” Leonardo DaVinci wrote through his lens on innovation. Simplicity can be a transformational cornerstone of health/care innovation, we learn from Siegel+Gale’s report on the World’s Simplest Brands Tenth Edition (WSBX). Siegel+Gale found the most consumers are willing to pay more for simpler brand experiences and are more likely to recommend a brand for those simpler experiences, as well.             Across the 15,000 consumers the firm polled globally (across nine countries), five key factors underpin peoples’ experiences with the enchantingly “simple” companies: they are, Easy to understand Transparent and honest Caring for

 

Slip Slidin’ Away: the Reputations of Pharma and Healthcare in the U.S. Decline in the Latest Gallup Poll

Oh, how quickly people forget…and slow to forgive. U.S. consumers’ positive views for healthcare, pharma and retail have significantly fallen in just one year, the latest annual Gallup poll of industry rankings in America found as of August 2023. This stat for the pharma industry was the lowest Gallup ever recorded for the sector since 2001.                     I can’t help hearing Paul Simon’s lyrics to Slip Slidin’ Away….”you know the nearer your destination, the more you’re slip slidin’ away” when it comes to health citizens’ perceptions of pharma and the healthcare

 

Large Employers Expect More Employees Will Experience Prolonged Health Impacts Due to COVID-19. and a Note About Telehealth Engagement

Due to their delayed return to medical services and diagnostic testing in the COVID-19 pandemic era, U.S. employees are expected to sustain serious health impacts that will drive employers’ health care costs, envisioned in the 2024 Large Employer Health Care Strategy Survey from the Business Group on Health (BGH).               Dealing with mental health issues is the top health and well-being impact workers in large companies are addressing in 2023. Looking forward, large employers foresee their workers will be seeking care for chronic conditions and later-stage cancers that are diagnosed due to delayed screenings.

 

Personalizing Health Means Personalizing Health Insurance for Patient-Members – Learning from HealthEdge

As patients assume more financial skin in their personal healthcare, they take on the role of demanding consumer, or “impatient patients.” HealthEdge’s latest research into health consumers’ perspectives finds peoples’ satisfaction with their health insurance plans lacking, with members seeking easier access their personal health information, high levels of service, and rewards for healthy behaviors.           Health plans would also boost consumers’ satisfaction by channeling patients’ access to the kinds of medical providers that align with consumers’ preferences and personal values, and by personalizing information to steer people toward lower-cost care.          

 

To Avert a GLP-1 Cost Tsunami, Add Lifestyle Interventions: Learning from Virta Health

With consumer and prescriber interest in GLP-1 receptor agonist drugs “soaring,” health plan managers have a new source of financial stress and clinical questions on their to-do list. A team of Virta Health leaders held a webinar on 13th July 2023 to explain the results of a study the company just completed assessing health plan execs’ current views on Ozempic and other GLP-1 medicines with a view on both clinical outcomes and cost implications for this growing category of drugs that address diabetes and obesity.             Indeed, diabetes and obesity are top health concerns among the

 

The Latest KFF Poll on Consumer Experiences with Health Insurance Speaks Volumes About Patients’ Administrative Burden

People love being health-insured, but their negative experiences with health plans create serious burdens on patients-as-consumers. And those burdens impact even more people who are unwell than healthier folks. The 2023 Kaiser Family Foundation Survey of Consumer Experiences with Health Insurance updates our understanding of and empathy for insured peoples’ Patient Administrative Burdens (PAB). For this study, KFF polled 3,605 U.S. adults 18 and over in February and March 2023 who had health insurance across different plan types. Over the past several years, I’ve come to appreciate the concept of PAB by listening to and learning from colleagues Dr, Grace

 

The State of Healthcare in America, State-By-State

If you live in Massachusetts, Hawaii, and New Hampshire, you win a kind of state lottery for public health and well-being, based on this year’s read of the 2023 Scorecard on State Health System Performance from The Commonwealth Fund.           Here’s a picture of the annual study’s top-line findings, a roster of the fifty U.S. states ranked by a mash-up of health system indicators. As Annie Burkey of FierceHealthcare succinctly summed it up, the “Commonwealth Fund gives healthcare in southeastern states failing grades across the board.” I’ll give you more details about the Top and Bottom

 

Consumers and Cancer: 3 Patient-Focused Charts From IQVIA on the State of the Oncology in 2023 – and Introducing CancerX

It’s time for the annual ASCO conference, currently convening the American Society for Clinical Oncology in Chicago. Starting 2nd June, there have been dozens of positive announcements updating research and therapies bringing hope to the 2 million new patients who will be diagnosed with cancer in the U.S. in 2023, and millions of more people worldwide. Just in time for #ASCO2023, the IQVIA Institute published their annual report on Global Oncology Trends 2023 – Outlook to 2027, an update featuring pipelines, therapy approvals, research updates, costs of oncology products, and patients.                  

 

What $31,065 Can Buy You: a Toyota Corolla Cross Hybrid, a Year at Gnomon School, or Healthcare for a Family of 4 in America

“Healthcare costs came roaring back in 2021” after falling in 2020. In 2023, that roaring growth in health care costs continues with expected growth of 5.6%.             For 2023, you could take your $31K+ and buy a Toyota Corolla Cross Hybrid auto, fund a year at the Gnomon School in Hollywood toward a degree in animation or game design, or buy healthcare for your family of 4. Welcome to this year’s annual look at health care costs for a “typical” U.S. family explained in the 2023 Milliman Medical Index (MMI).            

 

The Growing Pet Economy – What It Means for Human Health, Well-Being, and Healthcare Costs

Our pets can be personal and family drivers of health and health care cost savings, according to a new study from  according to a new report from researchers at George Mason University published in their paper, Health Care Cost Savings of Pet Ownership. Reviewing this new paper inspired me to explore the current state of the pet/health market and implications for their human families, my weaving of various stories explored in this Health Populi blog post. Some of the key signposts we’ll cover are: The report on pet ownership driving owners’ health care cost savings A new market analysis of

 

A Public Health Wake-Up Call: Reading Between the Lines in IQVIA’s 2023 Use of Medicines Report

Reviewing the annual 2023 report from the IQVIA Institute for Human Data Science discussing The Use of Medicines in the U.S. is always a detailed, deep, and insightful dive into the state of prescription drugs. It’s a volume speaking volumes on the current picture of prescribed meds, spending and revenues, health care utilization trends, and a forecast looking out to 2027. In my read of this year’s review, I see a flashing light for U.S. health care: “Wake up, public health!” I’ve pulled out a few of the data points that speak to me about population health, prevention and early

 

We Are All Health Consumers Now – Toluna’s Latest Look at Consumers’ Health & Well-Being

The challenging financial climate at the start of 2023 is impacting how people, globally, are perceiving, managing, and spending money on health and well-being, based on the latest (Wave 21) Global Consumer Barometer survey conducted by Toluna, a sister company of Harris Interactive.               Globally, one-third of health citizens the world over are confronting greater stress levels due to the higher cost of living in their daily lives. One in two people say that rising cost of living is negatively impacting their health and well-being. On the positive side, one in three people believe

 

When Household Economics Blur with Health, Technology and Trust – Health Populi’s 2023 TrendCast

By Jane Sarasohn-Kahn on 22 December 2022 in Anxiety, Behavioral health, Big data and health, Big Tech, Broadband, Business and health, Cardiovascular health, Chronic care, Chronic disease, Connected health, Consumer electronics, Consumer experience, Consumer-directed health, Coronavirus, COVID-19, Cybersecurity, Data analytics and health, Demographics and health, Depression, Design and health, Determinants of health, Diet and health, Digital health, Employee benefits, Employers, Financial health, Financial wellness, Fitness, Food and health, Grocery stores, Health apps, Health at home, Health benefits, Health care industry, Health citizenship, Health Consumers, Health costs, Health disparities, Health Economics, Health ecosystem, Health engagement, Health equity, Health insurance, Health Plans, Health policy, Health politics, Health privacy, Healthcare DIY, Heart disease, Heart health, HIPAA, Home care, Home economics, Home health, Hospitals, Infectious disease, Love and health, Medication adherence, Meditation, Mental health, Mindfulness, Moms and health, Money and health, Out of pocket costs, Patient experience, Personal health finance, Pharmaceutical, Pharmacy, Physicians, Popular culture and health, Prescription drugs, Prevention and wellness, Primary care, Public health, Race and health, Remote health monitoring, Retail health, Risk management, SDoH, Self-care, Shopping and health, Social determinants of health, Specialty drugs, Stress, Telehealth, Telemedicine, Transparency, Trust, User experience UX, Vaccines, Value based health, Virtual health, Vitamins, Wearable tech, Wellbeing, Workplace benefits

People are sick of being sick, the New York Times tells us. “Which virus is it?” the title of the article updating the winter 2022-23 sick-season asked. Entering 2023, U.S. health citizens face physical, financial, and mental health challenges of a syndemic, inflation, and stress – all of which will shape peoples’ demand side for health care and digital technology, and a supply side of providers challenged by tech-enabled organizations with design and data chops. Start with pandemic ennui The universal state of well-being among us mere humans is pandemic ennui: call it languishing (as opposed to flourishing), burnout, or

 

Omnichannel, Hybrid Health Care Is Happening – Let’s Bake It with Access and Equity

In just the past few months, we’ve seen the launch of Amazon Care, Instacart adding medical deliveries, and The Villages senior community welcoming virtual care to their homes. Welcome to the growing ecosystem of hybrid health care, anywhere and everywhere. In my latest post on the Medecision portal, I discuss the phenomenon and examples of early models, focusing in on Evernorth, a Cigna company.                 As we add new so-called “digital front doors” to health care delivery, we should be mindful to design in access and equity and avoid further fragmentation of an already-fragmented

 

Men Work in Retirement for Healthy Aging; Women, for the Money – Transamerica Looks at Retirement in 2022

Due to gender pay gaps, time away from the workforce for raising children and caring for loved ones, women in the U.S. face a risky retirement outlook according to Emerging from the COVID-19 Pandemic: Women’s Health, Money, and Retirement Preparations from the Transamerica Center for Retirement Studies (TCRS).               As Transamerica TCRS sums up the top-line, “Societal headwinds are undermining women’s retirement security.” Simply said, by the time a woman is looking to retire, she has saved less than one-half of the money her male counterpart has put away for aging after work-life. The

 

Consumers Rank Healthcare Experiences in the Bottom-Third of All Industries – the ACSI 2021-2022 Index

While consumers’ satisfaction with inpatient care experiences improved a few points over the past year, health insurance and hospitals still fall in the bottom-third of all industries with which people interact, according to the American Customer Satisfaction Index (ACSI) Insurance and Health Care Study 2021-2022.               “With visitor restrictions relaxing and more elective procedures going forward, hospitals are slowly coming out of a COVID-induced satisfaction slump,” the study press released quoted Forrest Morgeson, Assistant Professor of Marketing at Michigan State University. This year’s ACSI Insurance and Health Care Index was developed through 12,840 consumer interviews

 

$22,463 Can Get You a Year of College in Connecticut, a Round of Ref Work in the Stanley Cup Playoffs, or Health Benefits for a Worker’s Family

Employers covering health insurance for workers’ families will face insurance premiums reaching, on average, $22,463. That is roughly what a year at an independent college in Connecticut would cost, or a round of pay for a ref in the Stanley Cup playoffs. With that sticker-shock level of health plan costs, welcome to the 2022 Employer Health Benefits Survey from Kaiser Family Foundation, KFF’s annual study of employer-sponsored health care.                 Each year, KFF assembles data we use all year long for strategic and tactical planning in U.S. health care. This mega-study looks at

 

Consumers’ and the White House’s Growing Focus on Food and Nutrition

Today, the White House is convening a Conference on Hunger, Nutrition and Health. So it’s a propitious time to weave together some of the latest research and insights into food-as-medicine and a key determinant of health and well-being. This is the first White House conference focused on nutrition and food in over 50 years.               The National Strategy was released today, and covers a range of programs that bake health and nutrition into Federal policies going beyond “food” itself: we see various determinants of health embedded into the Strategy, such as supporting physical activity,

 

The Patient As the Payer: Self-Pay, Bad Debt, and the Erosion of Hospital Finances

“The odds are against hospitals collecting patient balances greater than $7,500,” the report analyzing Hospital collection rates for self-pay patient accounts from Crowe concludes.       Crowe benchmarked data from 1,600 hospitals and over 100,00 physicians in the U.S. to reveal trends on health care providers’ ability to collect patient service revenue. And bad debt — write-offs that come out of uncollected patient bill balances after “significant collection efforts” by hospitals and doctors — is challenging their already-thin or negative financial margins.           The first chart quantifies that bad debt attributable to patients’ self-pay payments

 

The More Chronic Conditions, the More Likely a Patient Will Have Medical Debt

There is a direct association between a person’s health status and patient outcomes and their financial health, quantified in original research published this week in JAMA Internal Medicine.                 Researchers from the University of Michigan (my alma mater) Medical School and Institute for Healthcare Policy and Innovation analyzed two years of commercial insurance claims data generated between January 2019 and January 2021, linking to commercial credit data from January 2021 for patients enrolled in a preferred providers organization in Michigan. The first chart illustrates the predicted probability of credit outcomes based on the

 

Gas ‘N Healthcare – How Transportation Links to Health Care Access and Financial Health

Some patients dealing with cancer at Mercy Health’s Lourdes Hospital have been supplied with gas cards. This gesture is enabling families to get to medical appointments around Paducah, Kentucky where, this week, car drivers faced regular gas priced at an average of $4.16 a gallon compared with $2.92 one year ago.           Here’s the Hospital’s Facebook page featuring their gratitude to FiveStar Food Mart, the American Cancer Society, and the Mercy Health Foundation. “By providing cancer patients with gas cards, the cancer care team at Mercy Health Lourdes Hospital in Paducah hopes to mitigate financial challenges

 

Changing Views of Retirement and Health Post-COVID: Transamerica’s Look At Workers’ Disrupted Futures

As more than 1 in 3 U.S. workers were unemployed during the pandemic and another 38% had reductions in hours and pay, Americans’ personal forecasts and expectations for retirement have been disrupted and dislocated.                 In its look at The Road Ahead: Addressing Pandemic-Related Setbacks and Strengthening the U.S. Retirement System from the Tramsamerica Center for Retirement Studies (TCRS), we learn about the changing views of U.S. workers on their future work, income, savings, dreams and fears. Since 1988, TCRS has assessed workers’ perspectives on their futures, this year segmented the 10,003 adults

 

Use of Preventive Health Services Declined Among Commercially Insured People – With Big Differences in Telehealth for Non-White People, Castlight Finds

Declines in preventive care services like cancer screenings and blood glucose testing concern employers, whose continued to cover health insurance for employees during the pandemic.                       “As we enter the third year of the COVID-19 pandemic, employers continue to battle escalating clinical issues, including delayed care for chronic conditions, postponed preventive screenings, and the exponential increase in demand for behavioral health services,” the Chief Medical Officer for Castlight Health notes in an analysis of medical claims titled Millions of People Deferred Crucial Care During the Pandemic, published in June. The

 

A New Chevy Equinox SUV, a Year in Grad School, or Health Care for Four – The 2022 Milliman Medical Index

A new Chevy Equinox SUV, a year in an MS program in kinesiology at Pacific Lutheran U., or health care for a family of four. At $30,260, you could pick one of these three options.             Welcome to this year’s 2022 Milliman Medical Index, which annually calculates the health care costs for a median family of 4 in the U.S. I perennially select two alternative purchases for you to consider aligning with the MMI medical index. I have often picked a new car at list price and a year’s tuition at a U.S. institution of

 

The Patient as Consumer and Payer – A Focus on Financial Stress and Wellbeing

Year 3 into the COVID-19 pandemic, health citizens are dealing with coronavirus variants in convergence with other challenges in daily life: price inflation, civil and social stress, anxiety and depression, global security concerns, and the safety of their families. Add on top of these significant stressors the need to deal with medical bills, which is another source of stress for millions of patients in America. I appreciated the opportunity to share my perspectives on “The Patient As the Payer: How the Pandemic, Inflation, and Anxiety are Reshaping Consumers” in a webinar hosted by CarePayment on 25 May 2022. In this

 

How Business Can Bolster Determinants of Health: The Marmot Review for Industry

“Until now, focus on….the social determinants of health has been for government and civil society. The private sector has not been involved in the discussion or, worse, has been seen as part of the problem. It is time this changed,” asserts the report, The Business of Health Equity: The Marmot Review for Industry, sponsored by Legal & General in collaboration with University College London (UCL) Institute of Health Equity, led by Sir Michael Marmot.               Sir Michael has been researching and writing about social determinants of health and health equity for decades, culminating publications

 

In the New Inflationary Era, Gas and Health Care Costs Top Household Budget Concerns

Inflation and rising prices are the biggest problem facing America, most people told the Kaiser Family Foundation March 2022 Health Tracking Poll. Underpinning that household budget concern are gas and health care costs. Overall, 55% of people in the U.S. pointed to inflation as the top challenge the nation faces (ranging from 46% of Democrats to 70% of Republicans). Second most challenging problem facing the U.S. was Russia’s invasion into Ukraine, noted by 18% of people — from 14% of Republicans up to 23% of Democrats. The COVID-19 pandemic has fallen far down Americans’ concerns list tied third place with

 

McKinsey’s Six Shifts To Add Life to Years — and One More to Consider

People spend one-half of their lives in “less-than-good health,” we learn early in the paper, Adding years to life and life to years from the McKinsey Health Institute. In this data-rich essay, the McKinsey team at MHI sets out an agenda that could help us add 45 billion extra years of higher-quality life equal to an average of six years per person (depending on your country and population demographics). The first graphic from the report illustrates four dimensions of health and the factors underneath each of them that can bolster or diminish our well-being: personal behaviors (such as sleep and diet),

 

Food Insecurity, Energy Prices, and Medical Debt Spike in February 2022

There’s a trifecta cost challenge hitting U.S. household budgets in February 2022, highlighted in a poll from Morning Consult: inflationary spikes for housing, food, and energy, and the COVID-19 Omicron variant forcing health care costs up for some consumers driving medical debt up. This further underscores the reality that medical spending in the U.S. is taking shape as a consumer service or good, competing with — potentially crowding out — other household line items like food and increasingly costly petrol to fill gas tanks. Or taken the other way, gas and food crowding out health care spending, leading to either

 

Doximity Study Finds Telehealth Is Health for Every Day Care

There’s more evidence that doctors and patients, both, want to use telehealth after the COVID-19 pandemic fades. Doximity’s second report on telemedicine explores both physicians’ and patients’ views on virtual care, finding most doctors and health consumers on the same page of virtual care adoption. For the physicians’ profile, Doximity examined 180,000 doctors’ who billed Medicare for telemedicine claims between January 2020 and June 2021. Telemedicine use did not vary much across physician age groups. Doctors in specialties that manage chronic illnesses were more likely to use telehealth: endocrinology (think: diabetes), gastroenterology, rheumatology, urology, nephrology, cardiology, ENT, neurology, allergy, and

 

Mental Health at CES 2022 – The Consumer’s Context for Wellbeing in the New Year

As we enter COVID-19’s “junior year,” one unifying experience shared by most humans are feelings of pandemic fatigue: anxiety, grief, burnout, which together diminish our mental health. There are many signposts pointing to the various flavors of mental and behavioral health challenges, from younger peoples’ greater risk of depression and suicide ideation to increased deaths of despair due to overdose among middle-aged people. And about one-in-three Americans has made a 2022 New Year’s resolution involving some aspect of mental health, the American Psychiatric Association noted approaching the 2021 winter holiday season. Underneath this overall statistic are important differences across various

 

Health Care Planning for 2022 – Start with a Pandemic, Then Pivot to Health and Happiness

One of my favorite Dr. Seuss characters is the narrator featured in the book, I Had Trouble In Getting to Solla-Sollew. I frequently use this book when conducting futures and scenario planning sessions with clients in health/care. “The story opens with our happy-go-lucky narrator taking  a stroll through the Valley of Vung where nothing went wrong,” the Seussblog explains. Then one day, our hero (shown here on the right side of the picture from the book) is not paying attention to where he is walking….thus admitting, “And I learned there are troubles of more than one kind, some come from

 

The 2022 Health Populi TrendCast for Consumers and Health Citizens

I cannot recall a season when so many health consumer studies have been launched into my email inbox. While I have believed consumers’ health engagement has been The New Black for the bulk of my career span, the current Zeitgeist for health care consumerism reflects that futurist mantra: “”We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run,” coined by Roy Amara, past president of Institute for the Future. That well-used and timely observation is known as Amara’s Law. This feels especially apt right “now” as we enter 2022,

 

3 in 4 Insured Americans Worried About Medical Bills — Especially Women

In the U.S., being covered by health insurance is one of the social determinants of health. Without a health plan, an uninsured person in America is far more likely to file for bankruptcy due to medical costs, and lack access to needed health care (and especially primary care). But even with health insurance coverage, most health-insured people are concerned about medical costs in America, found in a MITRE-Harris Poll on U.S. consumers’ health insurance perspectives published today. “Even those fortunate to have insurance struggle with bills that result from misunderstanding or underestimating costs of treatments and procedures,” Juliette Espinosa of

 

The Cost to Cover Health Insurance for a Family in America Is $22,221

Even with growing inflation in the U.S. and post-pandemic job growth in 2021, the cost of health insurance premiums rose faster than either the price of goods or wages. That family health plan premium reached $22,221, an increase of 22% since 2016, we learn in the annual report from Kaiser Family Foundation, 2021 Employer Health Benefits Survey. This report is our go-to encyclopedia of statistics on health insurance year-after-year, surveying companies’ annual health insurance strategies for coverage and tactics for managing spending and workers’ health outcomes. This 2021 update takes into account the impacts and influence of COVID-19 on workers’

 

Still Struggling with Stress in America in 2021

“Americans remain in limbo between lives once lived and whatever the post-pandemic future holds,” the American Psychological Association observes in their latest read into Stress in America 2021, with this phase of the perennial study focused on Stress and Decision-Making During the Pandemic. The top-line: people face a daily web of risk assessment, up-ended routines, and endless news about the coronavirus locally and globally. While most people in the U.S. believe that “everything will work out” after the pandemic ends, the mental, emotional, and logistical daily distance between “now” and “then” brings uncertainty and indeed, prolonged stress. More Millennials, who

 

“Complexity is Profitable” in U.S. Healthcare – How to Save a Quarter-Trillion Dollars

In the U.S., “Health care is complicated because complexity is profitable.” So explain Bob Kocher, MD, and Anuraag Chigurupati, in a viewpoint on Economic Incentives for Administrative Simplification, published this week in JAMA. Dr. Kocher, a physician who is a venture capitalist, and Chigurupati, head of member experience at Devoted Health, explain the misaligned incentives that impede progress in reducing administrative spending. This essay joins two others in the October 20, 2021 issue of JAMA which highlight administrative spending in American health care: Administrative Simplification and the Potential for Saving a Quarter-Trillion Dollars in Health Care by Nikhil Sahni, Brandon

 

Be Mindful About What Makes Health at HLTH

“More than a year and a half into the COVID-19 outbreak, the recent spread of the highly transmissible delta variant in the United States has extended severe financial and health problems in the lives of many households across the country — disproportionately impacting people of color and people with low income,” reports Household Experiences in America During the Delta Variant Outbreak, a new analysis from the Robert Wood Johnson Foundation, NPR, and the Harvard Chan School of Public Health. As the HLTH conference convenes over 6,000 digital health innovators live, in person, in Boston in the wake of the delta

 

Genentech’s Look Into the Mirror of Health Inequities

In 2020, Genentech launched its first study into health inequities. The company spelled out their rationale to undertake this research very clearly: “Through our work pursuing groundbreaking science and developing medicines for people with life-threatening diseases, we consistently witness an underrepresentation of non-white patients in clinical research. We have understood inequities and disproportionate enrollment in clinical trials existed, but nowhere could we find if patients of color had been directly asked: ‘why?’ So, we undertook a landmark study to elevate the perspectives of these medically disenfranchised individuals and reveal how this long-standing inequity impacts their relationships with the healthcare system

 

Chronic Medical Conditions, Mental Health, and Equity On Employers’ Minds for 2022 – Employee Health in the Wake of COVID-19

One in two people in the U.S. receive health insurance through employers. As large employers tend to be on the vanguard of benefit plan design, it’s useful to understand how these companies are thinking ahead on behalf of their employees. With that objective, it’s always instructive to explore the annual study from the Business Group on Health, the 2022 Large Employers’ Health Care Strategy and Plan Design Survey. As a result of the COVID-19 pandemic, large employees have many concerns about worker and dependents’ health. The biggest firms in America providing health insurance for workers are expecting an increase in

 

The Risk of Food and Nutrition Security in America – A Bipartisan Concern and Call-to-Action from the BPC

The COVID-19 pandemic exacerbated food insecurity in the U.S., a situation that was already challenging for millions of American families before the public health crisis emerged. While several Congressional and administrative actions were implemented in 2020 and the first half of 2021, the issue of food insecurity — defined as being unable to acquire enough food due to insufficient money or resources — remains a tragic aspect of daily living for many Americans — and especially for children who live in households where jobs have been lost and incomes reduced. Nutrition security has also been a health risk where people

 

Why Is So Much “Patient Experience” Effort Focused on Financial Experience?

Financial Experience (let’s call it FX) is the next big thing in the world of patient experience and health care. Patients, as health consumers, have taken on more of the financial risk for health care payments. The growth of high-deductible health plans as well as people paying more out-of-pocket exposes patients’ wallets in ways that implore the health care industry to serve up a better retail experience for patients. But that just isn’t happening. One of the challenges has been price transparency, which is the central premise of this weekend’s New York Times research-rich article by reporters Sarah Kliff and

 

Nurses and Aides Are Beloved and Deserve Higher Pay; and a Spotlight on the Filipinx Frontline

A majority of Democrats, Independents, and Republicans agree that nurses are underpaid. Most Americans across political parties also believe that hospital executives are overpaid, according to a poll from The Associated Press-NORC Center for Public Affairs Research. The survey analysis is aptly titled, Most Americans Agree That Nurses and Aides Are Underpaid, While Few Support Using Federal Dollars to Increase Pay for Doctors, . Insurance executives are also overpaid, according to 73% of Americans — an even higher percent of people than the 68% saying hospital execs make too much money. In addition to nurses being underpaid, 6 in 10

 

Pondering Prescription Drugs: Pricing Rx and Going Direct-to-Consumer

There is one health care public policy issue that unites U.S. voters across political party: that is the consumer-facing costs of prescription drugs. With the price of medicines in politicians’ and health citizens’ cross-hairs, the pharmaceutical and biotech industries have responded in many ways to the Rx pricing critiques from consumers (via, for example, Consumer Reports/Consumers Union and AARP), hospitals (through the American Hospital Association), and insurance companies (from AHIP, America’s Health Insurance Plans). The latest poll from the University of Chicago/Harris Public Policy and the Associate Press-NORC Center for Public Affairs Research quantifies the issue cross-party, finding that 74%

 

Doctors’ Offices Morph into Bill Collectors As Patients Face Growing Out-Of-Pocket Costs

In the U.S., patients have assumed the role of health care payors with growing co-payments, coinsurance amounts, and deductibles pushing peoples’ out-of-pocket costs up. This has raised the importance of price transparency, which is based on the hypothesis that if patients had access to personally-relevant price/cost information from doctors and hospitals for medical services, and pharmacies and PBMs for prescription drugs, the patient would behave as a consumer and shop around. That hypothesis has not been well proven-out: even though more health care “sellers” on the supply side have begun to post price information for services, patients still haven’t donned

 

One in Two Americans with Work-Based Insurance Worries That Healthcare Costs Could Lead to Bankruptcy

One in two people in the U.S. with employer-sponsored health insurance worry that a major health event in their household could lead to bankruptcy, according to research gathered by West Health and Gallup in Business Speaks: The Future of Employer-Sponsored Insurance. Gallup and West Health presented their study in a webinar earlier this week; in today’s post, I feature a few key data points that particularly resonate as I celebrate/appreciate yesterday’s U.S. Supreme Court’s ruling on the Affordable Care Act (i.e., California v. Texas) combined with a new study published in JAMA Network Open, discussed below the digital fold in

 

Post-Pandemic, U.S. Healthcare is Entering a “Provide More Care For Less” Era – Pondering PwC’s 2022 Forecast

In the COVID-19 pandemic, health care spending in the U.S. increased by a relatively low 6.0% in 2020. This year, medical cost trend will rise by 7.0%, expected to decline a bit in 2022 according to the annual study from PwC Health Research Institute, Medical Cost Trend: Behind the Numbers 2022. What’s “behind these numbers” are factors that will increase medical spending (the “inflators” in PwC speak) and the “deflators” that lower costs. Looking around the future corner, the inflators are expected to be: A COVID-19 “hangover,” leading to increased health care services utilization Preparations for the next pandemic, and

 

What Do Democrats and Republicans Agree On? Allowing Negotiations to Lower Rx Prices

People living in the U.S. have weathered over fifteen months of life-shifts for work, school, prayer, fitness, and social lives. So you might think that the most important public priority for Congress might have something to do with COVID-19, vaccines, or health insurance coverage. But across all priorities, it turns out that prescription drug costs rank higher in Americans’ minds than any other issue in the Kaiser Family Foundation Health Tracking Poll for May 2021. Two-thirds of U.S. adults said that allowing the federal government and private insurance plans to negotiate for lower prices on Rx drugs was their top

 

Health Care Costs for a Couple in Retirement in the U.S. Reach $300,000

To pay for health care expenses, the average nest-egg required for a couple retiring in the U.S. in 2021 will be $300,000 according to the 20th annual Fidelity Investments Retiree Health Care Cost Estimate. I’ve tracked this survey for over a decade here on Health Populi, and updated the annual chart shown here to reflect a $40,000 increase in retiree costs since 2016. While the rate of increase year-on-year since then has slowed, the $300,000 price-tag for retiree health care costs is a huge number few Americans have saved for. That $300K splits up unequally for an opposite-gender couple (in

 

And the Oscar Goes To….Power to the Patients!

Health care has increased its role in popular culture over the years. In movies in particular, we’ve seen health care costs and hassles play featured in plotlines in As Good as it Gets [theme: health insurance coverage], M*A*S*H [war and its medical impacts are hell], and Philadelphia [HIV/AIDS in the era of The Band Played On], among dozens of others. And this year’s Oscar winner for leading actor, Anthony Hopkins, played The Father, who with his family is dealing with dementia. [The film, by the way, garnered six nominations and won two]. When I say “Oscar” here on the Health

 

How Footwear Became Our Favorite Apparel Item in the Pandemic

Our feet have become an important health focus during the pandemic, as the importance of exercise-as-medicine and mental health helper has looked to walking, running, and biking as good-for-us physical activities. The Mayo Clinic published an informative piece on Feet and the COVID-19 Pandemic, and the Cleveland Clinic posted advice on exercising during the pandemic earlier this month with the strong recommendation of walking. So it makes sense that the apparel category whose brand equity grew most between 2020 and 2021 was footwear, announced in the Brand Finance Apparel 50. Each year, Brand Finance evaluates the value of “brands,” as

 

The Continued Erosion of Trust in the Age of COVID

A year into the COVID-19 pandemic, most Americans are still in “survival mode,” according to an update of the 2021 Edelman Trust Barometer, Trust and the Coronavirus in the U.S. Updating the company’s annual Trust Barometer, Edelman conducted a new round of interviews in the U.S. among 2,500 people in early March. [For context, you can read my take on the 2021 Edelman Trust Barometer published during the World Economic Forum in January 2021 here in Health Populi].  The first chart shows that two in three people in the U.S. are still in a pandemic mindset, worried about safety and

 

“Hope Springs Eternal” With the COVID Vaccine for Both Joe Biden and Most People in the U.S.

More Americans are happier in March 2021 than they’ve been for a year, based on consumer research from Civic Science polling U.S. adults in early March 2021. For the first time, a larger percent of Americans said they were better off financially since the start of the pandemic. This week, Civic Science shared their latest data on what they’re seeing beyond the coronavirus quarantine era to forecast trends that will shape a post-COVID America. Buoying peoples’ growing optimism was the expectation of the passage of the American Cares Act, which President Biden signed into effect yesterday. The HPA-CS Economic Sentiment Index

 

Value-Based Health Care Needs All Stakeholders at the Table – Especially the Patient

2021 is the 20th anniversary of the University of Michigan Center for Value-Based Insurance Design (V-BID). On March 10th, V-BID held its annual Summit, celebrating the Center’s 20 years of innovation and scholarship. The Center is led by Dr. Mark Fendrick, and has an active and innovative advisory board. [Note: I may be biased as a University of Michigan graduate of both the School of Public Health and Rackham School of Graduate Studies in Economics].   Some of the most important areas of the Center’s impact include initiatives addressing low-value care, waste in U.S. health care, patient assistance programs, Medicare

 

The Social Determinants of Prescription Drugs – A View From CoverMyMeds

The COVID-19 pandemic forced consumers to define what were basic or essential needs to them; for most people, those items have been hygiene products, food, and connectivity to the Internet. There’s another good that’s essential to people who are patients: prescription drugs. A new report from CoverMyMeds details the current state of medication access weaving together key health care industry and consumer data. The reality even before the coronavirus crisis emerged in early 2020 was that U.S. patients were already making painful trade-offs, some of which are illustrated in the first chart from the report. These include self-rationing prescription drug

 

Primary Care 2.0 – How Crossover Health is “Re-Bundling” Health Care

In 2020, investments in digital health reached $14.1 bn, much of which went into niche applications like lab testing, medication adherence, and on-demand triage for urgent care. These companies targeting primary care components represent the “unbundling of the family doctor,” as CB Insights recently coined the market trend. Fragmentation is a hallmark of the U.S. health care system, or more aptly “non-system” as my old friend J.D. Kleinke noted in his book titled Oxymorons….published in 2001. Twenty years later, we confront primary care as a dichotomy: as unbundled pieces of (we hope) innovation, and in organizations re-imagining a new continuity

 

The Biden Administration’s Whole-of-Government Approach to Equity – in Health and Beyond

In the U.S., the COVID-19 pandemic has revealed disparities in housing, food, and job security, and the role that one’s ZIP code and social determinants play in health outcomes. Overall, America has done poorly in light of being 4% of the world’s population but having one-fifth of the planet’s deaths due to the coronavirus. But these have disproportionately hit non-white people, who are nearly three times as likely to die from COVID-19 than white Americans. I’ve been head-down reviewing the first two days of President Biden’s signing Executive Orders, reading the National Strategy for COVID-19 Response, and inventorying line items

 

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

 

U.S. Health Consumers’ Growing Financial Pressures, From COVID to Cancer

Before the coronavirus pandemic, patients had been transforming into health care payors, bearing high deductibles, greater out of pocket costs, and financial risk shifting to them for medical spending. In the wake of COVID-19, we see health consumers-as-payors impacted by the pandemic, as well as for existing diagnoses and chronic care management. There is weakening in U.S. consumers’ overall household finances, the latest report from the U.S. Bureau of Economic Analysis (BEA) asserted (published 25 November 2020). In John Leer’s look into the BEA report in Morning Consult, he wrote, “Decreases in income, the expiration of unemployment benefits and increased

 

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

 

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

 

Financial Health Is On Americans’ Minds Just Weeks Before the 2020 Elections

Financial health is part of peoples’ overall health. As Americans approach November 3, 2020, the day of the real-time U.S. Presidential and down-ballot elections, personal home economics are front-of-mind. Twenty-seven days before the 2020 elections, 7 in 10 Americans say their financial health will influence their votes this year, according  to the doxoINSIGHTS survey which shows personal financial health as a key voter consideration in the Presidential election. Doxo, a consumer payments company, conducted a survey among 1,568 U.S. bill-paying households in late September 2020. The study has a 2% margin of error. U.S. voters facing this year’s election are

 

50 Days Before the U.S. Elections, Voters Say Health Care Costs and Access Top Their Health Concerns — More than COVID-19

The coronavirus pandemic has revealed deep cracks and inequities in U.S. health care in terms of exposure to COVID-19 and subsequent outcomes, with access to medical care and mortality rates negatively impacting people of color to a greater extent than White Americans. The pandemic has also led to economic decline that, seven weeks before the 2020 elections in America, is top-of-mind for health citizens with the virus-crisis itself receding to second place, according to the Kaiser Family Foundation September 2020 Health Tracking Poll. KFF polled 1,199 U.S. adults 18 years of age and older between August 28 and September 3,

 

Americans Worry About Medical Bankruptcy, As Prescription Drug Costs Play Into Voters’ Concerns

One in two people in the U.S. are concerned that a major health event in their family would lead to bankruptcy, up 5 percent points over the past eighteen months. In a poll conducted with West Health, Gallup found that more younger people are concerned about medical debt risks, along with more non-white adults, published in their study report, 50% in U.S. Fear Bankruptcy Due to Major Health Event. The survey was fielded in July 2020 among 1,007 U.S. adults 18 and older. One of the basic questions in studies like these is whether a consumer could cover a $500

 

The Burden of Depression in the Pandemic – Greater Among People With Fewer Resources

In the U.S., symptoms of depression were three-times greater in April 2020 in the COVID-19 pandemic than in 2017-2018. And rates for depression were even higher among women versus men, along with people earning lower incomes, losing jobs, and having fewer “social resources” — that is, at greater risk of isolation and loneliness. America’s health system should be prepared to deal with a “probable increase” in mental illness after the pandemic, researchers recommend in Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic in JAMA Network Open. A multidisciplinary team knowledgeable in medicine, epidemiology, public health,

 

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

 

The She-Cession – a Financially Toxic Side-Effect of the Coronavirus Pandemic

Along with the life-threatening impact of the coronavirus on physical health, and the accompanying mental health distress activated by self-distancing comes a third unintended consequence with the pandemic: a hard hit on women’s personal economies. The recession of the pandemic is considered by many economists as a “She-Cession,” a downturn in the economy that’s negatively impacting women more acutely than men. This is markedly different than the Great Recession of 2008, the last major financial crisis: that financial decline was coined a “ManCession,” taking a more significant toll out of more typically men’s jobs like construction and manufacturing where fewer

 

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

 

A Toxic Side Effect of the Coronavirus: Financial Unwellness

One in two people in the U.S. say their financial health has been negatively impacted by the COVID-19 pandemic, through job loss, income disruption, or reduced work hours. The 2020 Financial Wellness Census, from Prudential found that one-half of U.S. adults are anxious about their financial future as of May 2020, an increase from 38% in late 2019. Prudential surveyed 3,000 U.S. adults across three generational cohorts: Millennials, Gen X, and Baby Boomers. The economic hit from the pandemic has disproportionately impacted people of color, younger people, women, small business owners, gig workers, and people working in retailer harder than

 

What Will Healthcare Costs Be After COVID? PwC Looks Behind the 2021 Numbers

Whether healthcare spending in 2021 increases by double-digits or falls by one-third directly depends on how the coronavirus pandemic will play out over the rest of 2020, based on PwC’s annual report on medical cost trends for 2021. The three cost scenarios are based on assumptions shown in the fine print on the first chart: The medium scenario, a sort of “return to normal” where medical trend could stay even at 6.0%, equal to the 2020 trend. This assumes that healthcare spending recovers by October 2020 as patients return to hospitals and doctors’ offices for regular care patterns. In 2021,

 

Americans’ Concerns About the US Healthcare System Loom Larger Than Worries About Their Own Care

The coronavirus pandemic has further opened the kimono of the U.S. healthcare system to Americans: four months into the COVID-19 outbreak, most consumers (62%) of people in the U.S. are more concerned about other people not having access to high quality health care versus themselves. This is a 16 point increase in concern in May 2020 compared with the response to the same question asked in February in a poll conducted by the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research (the AP-NORC Center). The AP-NORC Poll found more of this

 

Financial Insecurity Among U.S. Workers Will Worsen in the Pandemic — Especially for Women

Millions of mainstream, Main Street Americans entered 2020 feeling income inequality and financial insecurity in the U.S. The coronavirus pandemic is exacerbating financial stress in America, hitting women especially hard, based on PwC’s 9th annual Employee Financial Wellness Survey COVID-19 Update. For this report, PwC polled 1,683 full-time employed adults between 18 and 75 years of age in January 2020. While the survey was conducted just as the pandemic began to emerge in the U.S., PwC believes, “the areas of concern back in January will only be more pronounced today,” reflecting, “the realities of the changing employee circumstances we are

 

Health Care In the COVID-19 Era – PwC Finds Self-Rationing of Care and Meds Especially for Chronic Care

Patients in the U.S. are self-rationing care in the era of COVID-19 by cutting spending on health care visits and prescription drugs. The coronavirus pandemic’s impact on health consumers’ spending varies depending on whether the household is generally a healthy family unit, healthy “enthusiasts,” dealing with a simple or more complex chronic conditions, or managing mental health issues. PwC explored how COVID-19 is influencing consumers’ health care behaviors in survey research conducted in early April by the Health Research Institute. The findings were published in a May 2020 report, detailing study findings among 2,533 U.S. adults polled in early April

 

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

 

How COVID-19 is Hurting Americans’ Home Economics in 2020

Beyond the physical and clinical aspects of the COVID-19 pandemic are financial hits that people are taking in the shutdown of large parts of the U.S. economy, impacting jobs, wages, and health insurance rolls. Some 1 in 2 people in the U.S. who have had their income impacted by the coronavirus have either fallen behind in paying off credit card debt or other bills, had problems paying for utilities, have lagged in paying for housing (rent or mortgage), been challenged paying for food, or other out-of-pocket costs. We learn about these fiscal hits from COVID-10 from the latest Health Tracking Poll

 

Health, Wealth & COVID-19 – My Conversation with Jeanne Pinder & Carium, in Charts

The coronavirus pandemic is dramatically impacting and re-shaping our health and wealth, simultaneously. Today, I’ll be brainstorming this convergence in a “collaborative health conversation” hosted by Carium’s Health IRL series.  Here’s a link to the event. Jeanne founded ClearHealthCosts nearly ten years ago, having worked as a journalist with the New York Times and other media. She began to build a network of other journalists, each a node in a network to crowdsource readers’-patients’ medical bills in local markets. Jeanne started in the NYC metro and expanded, one node at a time and through many sources of funding from not-for-profits/foundations,

 

The Coronavirus Impact on American Life, Part 2 – Our Mental Health

As the coronavirus pandemic’s curve of infected Americans ratchets up in the U.S., people are seeking comfort from listening to Dolly Parton’s bedtime stories, crushing on Dr. Anthony Fauci’s science-wrapped-with-empathy, and streaming the Tiger King on Netflix. These and other self-care tactics are taking hold in the U.S. as most people are “social distancing” or sheltering in place, based on numbers from the early April 2020 Kaiser Family Foundation health tracking poll on the impact of the coronavirus on American life. While the collective practice of #StayHome to #FlattenTheCurve is the best-practice advice from the science leaders at CDC, the NIAID

 

In A Nation “At War” with the C19 Virus, Partisan Healthcare Differences Persist

More Democrats would want to get tested for the coronavirus (C19) than would Republicans. And, more women than men believe that a vaccine to address the COVID-19 pandemic believe that treatment would be offered at no-or-low-cost under a Democratic president versus President Trump. These are two key insights gleaned from a look into U.S. adults’ perspectives on the C19 virus in the second week of March 2020. What Are Americans’ Views on the Coronavirus Pandemic? asks and answers an NBC News/Commonwealth Fund Health Care Poll published on 20th March 2020. NBC News and the Commonwealth Fund polled 1,006 people 18

 

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

 

Lockdown Economics for U.S. Health Consumers

The hashtag #StayHome was ushered onto Twitter by 15 U.S. national healthcare leaders in a USA Today editorial yesterday. The op-ed co-authors included Dr. Eric Topol, Dr. Leana Wen, Dr. Zeke Emanuel, Dr. Jordan Shlain, Dr. Vivek Murthy, Andy Slavitt, and other key healthcare opinion leaders. Some states and regions have already mandated that people stay home; at midnight last night, counties in the Bay Area in California instituted this, and there are tightening rules in my area of greater Philadelphia. UBS economist Paul Donovan talked about “Lockdown Economics” in his audio commentary today. Paul’s observations resonated with me as

 

Waking Up a Health Consumer in the COVID-19 Era

With President Trump’s somber speech from the Oval Office last night, we wake up on 12th March 2020 to a ban on most travel from Europe to the U.S., recommendations for hygiene, and call to come together in America. His remarks focused largely on an immigration and travel policy versus science, triaging, testing and treatment of the virus itself. Here is a link to the President’s full remarks from the White House website, presented at about 9 pm on 11 March 2020. Over the past week, I’ve culled several studies and resources to divine a profile of the U.S. consumer

 

Most Americans Concerned About Coronavirus Impact on Economy & Families, and Not a “Hoax”

Seven in 10 Americans are concerned about the coronavirus outbreak’s impact on the economy, and 6 in 10 people worried about someone they love getting sick from COVID-19. But most Americans also get the politicized nature of the coronavirus and say they’re less likely to vote for President Trump in November based on his handling of the public health threat, according to a just-released survey from Protect Our Care fielded by Public Policy Polling. Some of the data points which demonstrate that Americans are taking the emerging coronavirus pandemic quite seriously are that: 53% disagree that President Trump and his

 

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