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2017 Rx Cost Trend Over 5 Times U.S. Inflation, Segal Projects

Driven by price increases, costs for the prescription drug benefit carve-out will increase 11.6% this year, based on Segal Consulting’s survey report, High Rx Cost Trends Projected to Be Lower for 2018, published today. The report is accessible on the Segal Co. website. While the Segal team expects prescription drug (Rx) benefit plan cost trends to be “less severe” in 2018, Rx cost increases is a top priority for many sponsors of health plans as their rate of increase far exceeds those for inpatient hospital claims or physician expense. Drug costs continue to be the fastest-growing line item in health

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Prescription Drug Coverage at Work: Common, Complex, and Costly

Getting health insurance at work means also having prescription drug coverage; 99% of covered workers’ companies cover drugs, based on the 2017 Employer Health Benefits Survey released by the Kaiser Family Foundation (KFF). I covered the top-line of this important annual report in yesterday’s Health Populi post, which found that the health insurance premium for a family of four covered in the workplace has reached $18,764 — approaching the price of a new 2017 small car according to the Kelley Blue Book. The complexities of prescription drug plans have proliferated, since KFF began monitoring the drug portion of health benefits

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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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Patients Are Looking to Finance Healthcare Over Time

Most U.S. patients want healthcare providers to offer cost information before a procedure, and whether doctors offer financial options to help them extend payments over time. This is an automotive or home appliance procedure we’re talking about. It’s healthcare services, and American patients are now the third largest payors to providers in the nation. Thus, the title of a new report summarizing a consumer survey from HealthFirst notes, “It’s Never Too Soon to Communicate Pricing and Payment Options. The study found that two-thirds of U.S. consumers would like healthcare providers to discuss financing options; however, only 18 percent of providers have

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Healthcare Overtreatment in the U.S. – Risky and Costly

Overtreatment is a major contributor to waste and patient risk in America. Most U.S. physicians say it’s a common fact of life in American healthcare, gleaned through physician survey detailed in Overtreatment in the United States, published in PLOS One on September 6, 2017. The overwhelming majority (8 in 10 physicians) identified malpractice as the reason for overtreatment, followed by patient pressure/request (59%). Other reasons cited for overtreatment included: Difficulty accessing prior medical records Borderline indications Inadequate time to spend with patients, and Lack of adequate information or previous medical history. Overall, physicians judged 20% of healthcare to fall into

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Americans and Prescription Drugs: Cost, Misuse, and Self-Rationing

In 2017, Americans’ relationship with prescription drugs can be characterized in three ways: cost-rationing, misuse, and abuse. Three new studies about medicines in America paint this picture, brought to light by the AARP, Truven Analytics, and Quest Diagnostics. First, let’s look at the cost issue covered by AARP. AARP tracks the cost of prescription drugs among its constituents, namely people 50 years of age and over. The data were published in AARP’s Rx Price Watch Report, Trends in Retail Prices of Specialty Prescription Drugs Widely Used by Older Americans, 2006-2015. The average annual cost for one specialty medication used for

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Decline in Pharmacy Reputations Related to Prescription Drug Prices, J.D. Power Finds

Cost is the number one driver among consumers declining satisfaction with pharmacies, J.D. Power found in its 2017 U.S. Pharmacy Study. Historically in J.D. Power’s studies into consumer perceptions of pharmacy, the retail segment has performed very well, However, in 2017, peoples’ concerns about drug prices negatively impact their views of the pharmacy — the front-line at the point-of-purchase for prescription drugs. In the past year, dissatisfaction with brick-and-mortar pharmacies related to the cost of drugs and the in-store experience. For mail-order drugs, consumer dissatisfaction was driven by cost and the prescription ordering process. Among all pharmacy channels, supermarket drugstores

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Celebrating 10 Years of Health Populi, 10 Healthcare Milestones and Learnings

Happy anniversary to me…well, to the Health Populi blog! It’s ten years this week since I launched this site, to share my (then) 20 years of experience advising health care stakeholders in the U.S. and Europe at the convergence of health, economics, technology, and people. To celebrate the decade’s worth of 1,791 posts here on Health Populi (all written by me in my independent voice), I’ll offer ten health/care milestones that represent key themes covered from early September 2007 through to today… 1. Healthcare is one-fifth of the national U.S. economy, and the top worrisome line item in the American

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Transparency in Drug Prices, from OTC to Oncology

While on vacation in Bermuda, I found a box of private label ibuprofen for $2.45 for 20 – 200mg tablets, and one for Advil PM for $10.50 for the same number of pills, same strength. I’ve just returned from a lovely week’s holiday. When I travel, whether for work or vacation, it’s always a sort of Busman’s Holiday for me as I love to seek out health destinations wherever I go. So it was natural for me to spot the Dockyard Pharmacy at the port in Hamilton and wander in. I made my way back to the well-stocked pharmacy counter,

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A Couple Retiring Today Will Need $275,000 For Health Care Expenses

A 65-year-old couple in America, retiring in 2017, will need to have saved $275,000 to cover their health and medical costs in retirement. This represents a $15,000 (5.8%) increase from last year’s number of $260,000, according to the annual retirement healthcare cost study from Fidelity Investments. This number does not include long-term care costs — only medical and health care spending. Here’s a link to my take on last year’s Fidelity healthcare retirement cost study: Health Care Costs in Retirement Will Run $260K If You’re Retiring This Year. Note that the 2016 cost was also $15,000 greater than the retirement healthcare costs calculated

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Healthcare Quality and Access Disparities Persist in the U.S.

  In 2015, poor and low-income people in America had worse health care than high-income households; care for nearly half of the middle-class was also worse than for wealthier families.   Welcome to the 2016 National Healthcare Quality and Disparities Report from the Agency for Healthcare Research and Quality (AHRQ). The report assesses many measures quantifying peoples’ access to health care, such as uninsurance rates (which improved between 2010 and 2016), and quality of health care — including person-centered care, patient safety, healthy living, effective treatment, care coordination, and care affordability. While some disparities lessened between 2000 and 2015, disparities

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Price-Shopping for Healthcare Still A Heavy Lift for Consumers

Most U.S. consumers support the idea of price-shopping for healthcare, but don’t practice it. While patients “should” shop for health care and perceive differences in costs across providers, few seek information about their personal out-of-pocket costs before getting treatment. Few Americans shop around for health care, even when insured under a high-deductible health plan, conclude Ateev Mehrotra and colleagues in their research paper, Americans Support Price Shopping For Health Care, But Few Actually Seek Out Price Information. The article is published in Health Affairs‘ August 2017 issue. The bar chart shows some of the survey results, with the top-line finding

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Patients Want Doctors To Know How Much Their Drugs Cost

  Patients want their doctors to know what their personal costs for medicines are; 42% of patients also believe their doctor is aware of how much they spend on prescription drugs. However, 61% of these people have not talked with doctors about drug prices. Nor do most doctors have access to this kind of information at the individual patient level. One important tactic to addressing overall healthcare costs, and managing the prescription drug line item in those costs, is discussed in Doctors and Pharmacists: An Underused Resource to Manage Drug Costs for Older Adults, a report on a survey sponsored

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Learning From Adam Niskar – Living Beyond The Wheelchair

After diving into Walnut Lake in suburban Detroit, Adam Niskar sustained a spinal injury that would paralyze much of his body for the rest of his life. The trauma didn’t paralyze his life and living, though. But today, my family will celebrate that life at Adam’s memorial service. Adam was my cousin. He was one of the best-loved people on the planet, and that was part of a therapeutic recipe that sustained him from the traumatic accident in 1999 until Monday, July 31st, 2017, when Adam passed away from complications due to an infection that, this time around, his body

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Health Equity Lessons from July 23, 1967, Detroit

On July 23, 1967, I was a little girl wearing a pretty dress, attending my cousin’s wedding at a swanky hotel in mid-town Detroit. Driving home with my parents and sisters after the wedding, the radio news channel warned us of the blazing fires that were burning in a part of the city not far from where we were on a highway leading out to the suburbs. Fifty years and five days later, I am addressing the subject of health equity at a speech over breakfast at the American Hospital Association 25th Annual Health Leadership Summit today. In my talk,

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Note to Mooch: The ER is Not Universal Health Care

I quote directly from the Twitter feed of Anthony Scaramucci, @scaramucci: “@dhank2525 agree. We already have Univ Health Care, we made decision long ago to treat everyone that enters an emergency room.” Mr. Scaramucci is President Trump’s Communications Chief, replacing Sean Spicer. Mr. Scaramucci is neither veteran journalist nor healthcare policy wonk. He’s a successful businessman, which I respect for his savvy and ability to build a fund, attract investors, and create a media persona which he has telegenically broadcast on CNBC and elsewhere over the past decade. He’s got a engaging public personality, and goes by the moniker, “Mooch.” But

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Is There Political Will for Healthcare Access in the US?

The Netherlands, France and Germany are the best places to be a patient, based on the Global Access to Healthcare Index, developed by the Economist Intelligence Unit (EIU). Throughout the world, nations wrestle with how to provide healthcare to health citizens, in the context of stretched government budgets and demand for innovative and accessible services. The Global Access to Healthcare Index gauges countries’ healthcare systems in light of peoples’ ability to access services, detailed in Global Access to Healthcare: Building Sustainable Health Systems. The United States comes up 10th in line (tied with Spain) in this analysis. Countries that score the

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The Pursuit of Health Equity and the State of U.S. Health Care

Between 2014 and 2015, death rates increased for eight of the ten leading causes; only death rates caused by cancer fell, and mortality rates for influenza and pneumonia stayed flat. The first chart paints this sobering portrait of Americans’ health outcomes, presented in the CDC’s data-rich 488-page primer, Health, United States, 2016. Think of this publication as America’s annual report on health. Every year, it is prepared and submitted to the President and Congress by the Secretary of the Department of Health and Human Services. This year’s report was delivered by DHHS Secretary Tom Price to President Trump and the

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Costs of Healthcare Top Americans’ Financial Concerns: It’s Financial Health Matters Day

Americans are most worried about healthcare costs among all financial concerns; most people in the U.S. also believe the Federal government should ensure that all people have health coverage. Two polls published in the past week point to the fact that most U.S. health citizens are concerned about health care for themselves and their families, driving a growing proportion of people to favor a single-payer health system. The first line chart illustrates a dramatic trajectory up of the number of American identifying healthcare costs as their #1 financial problem, rising from 10% of people in 2013 to 17% in 2017.

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Shopping Food for Health: the 2017 U.S. Grocery Shopper Trends

Wellness is at the grocery store, the vast majority of U.S. health citizens say. 8 in 10 U.S. shoppers are concerned about the nutritional content in the food they eat. As grocery shoppers look for more fresh and less processed foods, grocery stores are seen as trusted allies for meeting wellness needs. Grocers are coupling the growth of more healthy packaged foods in the middle of the store with more fresh and prepared food options that consumers see as healthier than restaurant meals, according to U.S. Grocery Shopper Trends 2017 from FMI (the Food Marketing Institute) and Hartman Group. While

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Global Drug Sales Forecasts Fall For Next Five Years

Total prescription drug sales have been trimmed, based on calculations of EvaluatePharma which forecasts a $390 bn drop in revenues between 2017 and 2022. “Political and public scrutiny over pricing of both new and old drugs is not going to go away,” EvaluatePharma called out in its report. The intense scrutiny on pharma industry pricing was fostered by Martin Shkreli in his pricing of Daraprim (taking a $13.50 product raising the price to $750), Harvoni and Sovaldi pricing for Hepatitis C therapies, and last year’s EpiPen pricing uproar. A May 2017 analysis of prescription drug costs by AARP judges that, “Nothing

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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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Healthcare Cost Concerns Trump All Others Across the Generations

Patients, evolving into health consumers, seek a better healthcare experience. While most people are pretty satisfied with their medical care, cost and confusion reign. This is the topline finding of a study from Oliver Wyman appropriately titled, Complexity and Opportunity, a survey of U.S. health consumers’ worries and wants. Oliver Wyman collaborated on the research with the FORTUNE Knowledge Group. Consumers’ biggest healthcare concerns deal with costs: rising insurance premiums; greater out-of-pocket costs for care not covered by insurance; and, the growing costs of prescription drugs together rank as the top 3 healthcare concerns in this study. After costs, consumers cite government

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12% of Americans Have At Least 5 Chronic Conditions and Spend 41% of Healthcare Dollars

Forget about the 80/20 Rule. Welcome to the 41/12 Metric: 12% of U.S. adults account for 41% of healthcare spending in America, calculated by RAND Corporation in their new report, Multiple Chronic Conditions in the United States. RAND’s report quantifies the growing chronic care landscape in America that will be a burdensome legacy for younger Americans in terms of financial and social costs. First, a definition: RAND defines a chronic condition as a physical or mental health issue that lasts more than one year and causes functional restrictions or requires ongoing monitoring or treatment. Older adults are more likely to

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How To Pay For A Serious Medical Illness Tops Americans’ Fiscal Fears

While Americans’ financial worries are softening in 2017, one issue tops the list of fiscal fears: not having enough money to pay the costs involved in a serious illness or accident, Gallup found in a consumer poll fielded in early April 2017. 54% of Americans fear an inability to cover healthcare costs in the event of an accident or serious illness. This percentage was 60% in 2016, and 55% in 2015. This year’s data point ties with Americans financial worry about not having enough money for retirement, but healthcare cost concerns rank higher in terms of being “very worried” versus

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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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Americans Say Healthcare is the Nation’s #1 Problem – Tied with Dissatisfaction with Government

Healthcare tops the list of Americans’ concerns, tied with a dissatisfaction for government, this month (May 2017). According to a Gallup poll published 12 May, poor government leadership and healthcare are together the most important problem currently facing the U.S. Immigration, the economy, jobs, and race relations are distance 3rd places in this survey, which was conducted during the first week of May 2017 among 1,011 U.S. adults 18 years and older. The highest percent of Americans citing healthcare as America’s most important problem was 26%, found in August/September 2008 when town hall meetings round the country were protesting healthcare

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So Far, Food and Nutrition Aren’t Baked Into President Trump’s Health Policies

The FDA is delaying the public posting of calorie counts, a policy that President Obama’s administration had pioneered for public health and wellness. Menu labeling has applied to grocery stores, gas stations, convenience stores, movie theaters and sports stadiums that sell prepared food. “Health and Human Services Secretary Tom Price said the menu labeling requirements would be ‘unwise and unhelpful’ as currently written, and added that the FDA is looking for ways to make the rules ‘more flexible and less burdensome.'” Former FLOTUS Michelle Obama took on the issue of healthy food and fitness for America’s children. Except for keeping her White

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Home Is the New and Future Medical Home for Dialysis

The economics of kidney disease in America is a hefty burden: about 26 million people in the U.S. have some aspect of chronic kidney disease and are at-risk of kidney failure. The number of people diagnosed with kidney disease doubled during each of the last two decades, according to the American Society of Nephrology. The annual cost of treating end-stage renal disease (ESRD) is over $32 billion, consuming 28% of Medicare expenditures…and increasing. Now consider the personal costs of dialysis in America: about $500 for a single hemodialysis treatment in a center, roughly $72,000 a year for one patient. There

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Medicines in America: The Half-Trillion Dollar Line Item

Prescription drug spending in the U.S. grew nearly 6% in 2016, reaching $450 billion, according to the QuintilesIMS Institute report, Medicines Use and Spending in the U.S., published today. U.S. drug spending is forecasted to grow by 30% over the next 5 years to 2021, amounting to $610 billion. In 2016, per capita (per person) spending on medicines for U.S. health citizens averaged $895. Specialty drugs made up $384 of that total, equal to 43% of personal drug spending, shown in the first chart. Spending on specialty drugs continues to increase as a proportion of total drug spending: traditional medicines’ share

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Healthier Eating Is the Peoples’ Health Reform: the Gallup-Sharecare Well-Being Index

The top healthiest eating communities tend to circle the perimeter of the map of the lower 48 U.S. states. In these towns, more than 72% of health citizens report healthy eating. These areas are located in California, Florida, and Massachusetts, among others. Areas with the lowest rates of healthy eating are concentrated generally south of the Mason-Dixon Line, in places like Arkansas, Kentucky, and Mississippi, and other states. In these places, fewer than 57% of people eat healthy. Eating healthy foods in moderation is a mighty contributor to personal and public health, discussed in the report, State of American Well-Being

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The Power of Joy in Health and Medicine – Learning From Dr. Regina Benjamin

Former Surgeon General Dr. Regina Benjamin was the first person who quoted to me, “Health isn’t in the doctor’s office. It’s where people live, work, play and pray,” imparting that transformational mantra to me in her 2011 interview with the Los Angeles Times. I wrote about that lightbulb moment here in Health Populi. Dr. Benjamin was the 18th Surgeon General, appointed by President Obama in 2009. As “America’s Doctor,” she served a four-year term, her mission focused on health disparities, prevention, rual health, and children’s health. Today, Dr. Benjamin wears many hats: she’s the Times Picayune/NOLA.com professor of medicine at

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Financial Stress As A Health Risk Factor Impacts More Americans

A family in Orange County, California, paid a brother’s 1982 hospital bill by selling 50 pieces of their newly-deceased mother’s jewelry. “It’s what she wanted,” the surviving son told a reporter from The Orange County Register. The cache of jewelry fetched enough to pay the $10,000 bill. Patients in the U.S. cobble together various strategies to pay for healthcare, as the first chart drawn from a Kaiser Family Foundation report on medical debt attests. As health care consumers, people cut back on household spending like vacations and household goods. Two-thirds of insured patients use up all or most of their savings

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Health Care Costs Are A Top Worry for Americans Across Political Parties

Health care costs are out-of-reach for more Americans, among both people who have insurance through the workplace or via health insurance exchanges. The first chart illustrates the growing healthcare affordability challenge for American health consumers, discussed in a data note to the Kaiser Family Foundation Health Tracking Poll in March 2017. In 2017, 43% of consumers found it difficult to meet the health care deductible before insurance would kick in 37% of consumers found it difficult to pay for the cost of health insurance each month 31% said it was difficult to pay for copayments for doctor visits and prescription drugs.

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Most Americans Favor Some Flavor Of National Health Care Plan

Most US adults favor some kind of national health care plan, based on an Economist/YouGov poll conducted in April 2017. Six in ten people are for expanding so-called “Medicare for All,” where the health plan that currently serves older Americans would extend to all U.S. health citizens. Six in ten people would also favor a Federally-funded health insurance system that would cover all Americans — that is, universal health care. The table details this poll question by political party identification and family income. At least 3 in 4 Democrats would be more likely to favor either of the two healthcare

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Slow Food As Medicine: Eating In Italian

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Health Inequity in the United States – A View From Across the Pond

The statistics on the health of people living in America illustrate a divide between have’s and have-not’s. Average life expectancy is lower in the US compared with other wealthy nations: the wealthiest Americans live 10 to 15 years longer than the poorest, according to a landmark article in JAMA from 2016 studying the relationship between income inequality and mortality. See the first chart: this illustrates that people living in the US whose income reaches the top 95th percentile far outlive folks in the bottom 5th percentile of income. I find myself in London, England, this week, across the Pond (that is,

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Medical Bill Toxicity: 53% of Americans Say A Big Bill Is As Bad As A Serious Diagnosis

3 in 4 Americans’ health care costs have risen in the past few years. Two-thirds of Americans want to lower their costs, but don’t know how to do that. A survey from Amino released this week, conducted by Ipsos, has found that one in five people could not afford to pay an unexpected medical bill without taking on debt, and another 18% of Americans could only afford up to $100 if presented with an unexpected medical bill. This medical debt side effect more likely impacts women versus men, the less affluent, the unmarried, and those with no college degree. While

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Americans Are Not Sold On the American Health Care Act

Most Americans do not believe that TrumpCare, the GOP plan to replace the Affordable Care Act (the ACA, aka  ObamaCare), will make things better for U.S. health citizens when it comes to peoples’ health insurance coverage, the premium costs charged for those health plans, and protections for people with pre-existing medical conditions. The March 2017 Kaiser Family Foundation Health Tracking Poll examined U.S. adults’ initial perceptions of AHCA, the American Health Care Act, which is the GOP’s replacement plan for the ACA. There are deep partisan differences in perceptions about TrumpCare, with more Republicans favorable to the plan — although not

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The Healthcare Reform Issue Americans Agree On: Lowering Rx Costs

Yesterday, the Tweeter-in-Chief President Donald Trump tweeted, “I am working on a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down!” Those 140 characters sent pharma stocks tumbling, as illustrated by the chart for Mylan shares dated 7 March 2017. This is one issue that Americans across the political spectrum agree on with the POTUS. The latest Zogby poll into this issue, conducted for Prescription Justice, found 3 in 4 Americans agree that pharmaceutical companies are “getting away with murder,” as President Trump said in a TIME magazine interview

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Your Zip Code Is Your Wellness Address

Geography is destiny, Napoleon is thought to have first said. More recently, the brilliant physician Dr. Abraham Verghese has spoken about “geography as destiny” in his speeches, such as “Two Souls Intertwined,” The Tanner Lecture he delivered at the University of Utah in 2012. Geography is destiny for all of us when it comes to our health and well-being, once again proven by Gallup-Healthways in The State of American Well-Being 2016 Community Well-Being Rankings. The darkest blue circles in the U.S. map indicate the metro areas in the highest-quintile of well-being. The index of well-being is based on five metrics, of consumer self-ranking

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Will Republican Healthcare Policy “Make America Sick Again?” Two New Polls Show Growing Support for ACA

Results of two polls published in the past week, from the Kaiser Family Foundation and Pew Research Center, demonstrate growing support for the Affordable Care Act, aka Obamacare. The Kaiser Health Tracking Poll: Future Directions for the ACA and Medicaid was published 24 February 2017. The first line chart illustrates the results, with the blue line for consumers’ “favorable view” on the ACA crossing several points above the “unfavorable” orange line for the first time since the law was signed in 2010. The margins in February 2017 were 48% favorable, 42% unfavorable. While the majority of Republicans continue to be solidly

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From EHRecords to EHDelivery: Talking With Dr. Roy Schoenberg of American Well

Telehealth has come of age at HIMSS in 2017. No longer is the concept relegated to footnote or edge-booth status on the conference floor. Instead, telehealth, broadly defined, is now a mainstream concept embraced by healthcare providers, payors and, increasingly, consumers. I spent time brainstorming telehealth with one of the pioneers of modern telehealth in the U.S., Dr. Roy Schoenberg, who co-founded American Well with his brother Ido Schoenberg, in 2007. As such, the company is among the most mature telehealth entities operating in America, delivering live video health visits to millions of health consumers through the American Well telehealth

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20% of the US Economy Will Be Healthcare Spending in 2025

Price increases and growing use of healthcare services will drive national health spending (NHE) in the U.S. to 20% of the nation’s economy by 2025, according to projections calculated by a team from the Centers for Medicare and Medicaid Services (CMS). Health spending will reach $3.6 trillion dollars this year. These were published in a Web-First article in Health Affairs on 15 February 2017 The caveat on these numbers is that the CMS team used economic models based on “current-law framework:” these make no assumptions about legislative changes that may occur in healthcare reform between 2017 and 2025. While that’s a

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Marketing Medicines: Going Boldly and Accessibly for Rx

Over the past two weeks, we see two marketing campaigns emerge to market medicines: first, from the branded pharmaceutical association PhRMA, the #GoBoldly initiative with a theme of innovation and personalized medicine. Second, there’s a campaign from the Generic Pharmaceutical Association (GPhA), rebranding the organization as the Association for Accessible Medicines with the tagline, “keep medicines in reach.” What’s this all about? To put these marketing initiatives in context, let’s start with the publication of Express Scripts 2016 Drug Trend Report. “Drug trend” is short-hand for growth in prescription drug spending, year on year. The first graph illustrates the price index

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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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Patients Anxiously Prep to Be Healthcare Consumers, Alegeus Finds

Healthcare consumers are in a “state of denial,” according to research conducted for Alegeus, the consumer health benefits company. Overall, 3 in 4 consumers feel fear when it comes to their healthcare finances: most people worry about being hit with unexpected healthcare costs they can’t afford, and nearly half fear they won’t be able to afford their family’s healthcare needs. The wordle illustrates consumers’ mixed feelings about healthcare: while people feel frustrated, overwhelmed, powerless, confused and skeptical about healthcare in America, there are some emerging adjectives hinting at growing consumer health muscle-building: optimistic, hopeful, supported, engaged, accountable. Still, denial and

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Americans Far More Likely to Self-Ration Prescription Drugs Due To Cost

Americans are more than five times more likely to skip medication doses or not fill prescriptions due to cost than peers in the United Kingdom or Switzerland. U.S. patients are twice as likely as Canadians to avoid medicines due to cost. And, compared with health citizens in France, U.S. consumers are ten-times more likely to be non-adherent to prescription medications due to cost. It’s very clear that more consumers tend to avoid filling and taking prescription drugs, due to cost barriers, when faced with higher direct charges for medicines. This evidence is presented in the research article, Cost-related non-adherence to prescribed

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Medical Debt Is A Risk Factor For Consumers’ Financial Wellness

The top reason US consumers hear from a debt collector is due to medical bills, for 6 in 10 people in Americans contacted regarding a collection. This month, the Consumer Financial Protection Bureau (CFPB) published its report on Consumer Experiences with Debt Collection. Medical bill collections are the most common debt for which consumers are contacted by collectors, followed by phone bills, utility bills, and tax bills. The prevalence of past-due medical debt is unique compared with these other types because healthcare cost problems impact consumers at low, middle, and high incomes alike. Specifically: 62% of consumers earning $20,000 to

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Most Consumers Willing to See Doctor Over Video in 2017

  Two in three U.S. consumers are willing to see a doctor online. American health consumers welcome the opportunity to engage in virtual healthcare services via telehealth. American Well’s 2017 Telehealth Index surveyed 2,100 U.S. adults 18 and over in August and September 2016 to gauge consumers’ views on healthcare services, access, and receptivity to virtual care modes of delivery. Underneath the 66% of consumers open to telehealth are demographic differences: people with children are more likely to value virtual care, as well as people between 45 and 54, the survey found. Note, though, that a majority of older Americans over

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Health Care For All — Only Better, US Consumers Tell Consumer Reports

Availability of quality healthcare, followed by affordable care, are the top two issues concerning U.S. consumers surveyed just prior to Donald Trump’s inauguration as the 45th U.S. President. Welcome to Consumer Reports profile of Consumer Voices, As Trump Takes Office, What’s Top of Consumers’ Minds? “Healthcare for All, Only Better,” Consumer Reports summarizes as the top-line finding of the research. 64% of people are confident of having access to good healthcare, but 55% aren’t sure they can afford healthcare insurance to be able to access those services. Costs are too high, and choices in local markets can be spotty or non-existent.

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The Health Disparity of Information Access

Among many health disparities which mar healthcare quality in the United States, there’s another one to add to the list: health and healthcare information access. Access to health care is underpinned in large part on a health consumer’s access to information about available health care services, their location, price, and if the patient is very fortunate to glean, quality. As people take on more responsibility for managing their health care utilization and financing in America, their access to information that is easy-to-find, clear, comprehensive and current is critical to personal and public health outcomes. But consumers are dissatisfied with the

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Pharma’s Branding Problem – Profits Over Patients

Nine in 10 U.S. consumers think pharma and biotech put profits above patient interests, according to the latest Harris Poll studying reputation equity across organizations serving health care. Notice the relatively low position of the green bars in the first chart (with the exception of the impression for “strong financial performance); these are the pharma/biotech consumer impressions. The health industry stakeholders consumers believe would more likely place them above making money are health care providers, like doctors and nurses, hospitals, and pharmacists. Health insurance companies fare somewhat better than pharma and biotech in this Poll, although rank low on social

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More Consumers Use Retail Health Clinics for Healthcare Management, Harris Finds

1 in 5 U.S. adults used a retail clinic in 2016. Increasingly, health consumers seek care from retail clinics for more complex healthcare services beyond flu shots and pre-school exams, according to the Harris Poll’s survey, One in Five Adults Turn to Retail Health Clinics for Treatment, Prevention, and More, published January 5, 2017. Additional points the poll revealed are worth attention for public health policy purposes: Twice as many people who identify as LGBT turn to retail clinics than others (35% vs. 18%) Older people frequent retail clinics for flu vaccines more than younger people do More younger men

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Health Care Costs, Not the ACA, Rank #1 in Americans’ Minds As President Trump Assumes the Presidency

More Americans are worried about their out-of-pocket health care costs than they are about repealing the Affordable Care Act (ACA), according to the Kaiser Family Foundation (KFF) Health Tracking Poll published 6th January 2017, the first KFF poll for the new year. Cost worries fall into two buckets of concerns: the cost of health care, and the cost of prescription drugs. Managing the opioid epidemic falls in third place after health care costs. Repealing the Affordable Care Act? It’s #4 on Americans’ health care priorities as of mid-December 2016, followed by shrinking the Federal’s government’s role in and spending on

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Looking Beyond Tech for Health at CES 2017 – the Social Determinants

I’m at CES 2017 in Las Vegas all this week looking for signs of health in new technology announcements. While it’s no surprise there are hundreds of new and new-and-improved digital health innovations on the exhibition floor, you can look beyond those aisles to other companies who are new entrants in health. Arguably, these companies can bolster peoples’ health at least as much as activity tracking and calorie counting. Here are five examples I wrote about in my Huffington Post column yesterday, The Social Determinants of Health Live At CES 2017: Safety – Liberty Mutual Nutrition – Terraillon Healthy Sex

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How Consumers’ Health Economics Will Drive Personal Health-Tech Spending – My Lens on Digital Health at CES 2017

Consumers spend one in five dollars of their household budgets on healthcare in America. This fiscal reality is motivating more U.S. health citizens to seek information and control for their and loved ones’ health care. Personal health technologies will play a growing part in peoples’ self-care outside of the healthcare system and, increasingly, as part of their care prescribed by clinicians and (to some extent, for the short-term) paid-for by payors – namely, employers and government sponsors of health plans. This week is the Disneyland event for the personal tech aficionados known as CES (once called the Consumer Electronics Show).

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One-Half of Privately-Insured Americans Are Dissatisfied With Healthcare Costs

A plurality of Americans, 4 in 10, are dissatisfied with the healthcare costs they face. The level of dissatisfaction varies by a consumer’s type of health insurance, while overall, 42% of people are dissatisfied with costs… 48% of privately insured people are dissatisfied with thei healthcare costs 29% of people on Medicare or Medicaid are dissatisfied 62% of uninsured people are dissatisfied. Gallup has polled Americans on this question since 2014 every November. Dissatisfaction with healthcare costs is up from 38% from the period 2011-2013. As the line chart illustrates, the current levels of cost-dissatisfaction are similar to those felt

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A Growing Medicines Bill for Global Health Consumers to 2021

The global market for spending on medicines will high $1.5 trillion by 2021, according to the latest forecast from QuintilesIMS. Drug spending grew about 9% in the past two years, and is expected to moderate to 4 to 7 percent annually over the next five years. That dramatic 9% growth was heavily driven by new (expensive) specialty drugs to treat Hepatitis C (e.g., Harvoni and Sovaldi) and cancer therapies that hit the market in the past couple of years. There will be a “healthy level” of new innovative meds coming out of the drug pipeline in the next several years

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U.S. Healthcare Spending Hit Nearly $10,000 A Person In 2015

Spending on health care in the U.S. hit $3.2 trillion in 2015, increasing 5.8% from 2014. This works out to $9,990 per person in the U.S., and nearly 18% of the nation’s gross domestic product (GDP). Factors that drove such significant spending growth included increases in private health insurance coverage owing to the Affordable Care Act (ACA) coverage (7.2%), and spending on physician services (7.2%) and hospital care (5.6%). Prescription drug spending grew by 9% between 2014 and 2015 (a topic which I’ll cover in tomorrow’s Health Populi discussing IMS Institute’s latest report into global medicines spending). The topic of

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Both Healthcare Prices and Use of Services Driving Up Spending

Health care spending grew 4.6% in 2015, higher than the rise in either 2013 or 2014, according to the 2015 Health Care Cost and Utilization Report published by HCCI, the Health Care Cost Institute. The key contributors to health care spending by percentage were, first and foremost, prescription drugs which rose 9% in the year — notably, specialty medicines like anti-infective drugs (such as those for Hepatitis C and HIV) costing on average $83 per “filled day.” This cost doubled from $53 per person in 2012 to $101 per person in 2015. Hospital costs saw the second greatest percentage price increase

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1 in 3 Americans Still Self-Rations Healthcare

People in the U.S. are much more likely to go without health care they need compared with health citizens in 10 other wealthy countries, according to the Commonwealth Fund’s 2016 international survey. One-third of Americans did not seek care due to costs, including going without recommended care, failing to fill a prescription drug, and/or not seeing a doctor when sick. While this self-rationing proportion of Americans dropped from 37% in 2013, the U.S. still ranks #1 in foregoing necessary healthcare due to cost. “In comparison to adults in the other 10 countries, adult sin the U.S. are sicker and more

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The Patient Is The Best Sensor – Consumers At the Center of Health

“The patient is the best sensor,” asserted Jamie Heywood, founder of Patients Like Me, during the perennial meeting sponsored by PwC, the 180° Health Forum. This event featured several panels of PwC’s curated group of so-called “provocateurs” in healthcare, and I was grateful to be one of nine selected for the event. Heywood joined Dr. Leanna Wen, Baltimore City Health Commissioner, and me in a panel called, “Strange Bedfellows or Soul Mates? The New Dating Game in Health.” The theme of our collective brainstorm was how collaborations across the ecosystem could help make health and healthcare better. The drawing is

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Hospitals Need to Cross the Health Consumer Chasm

Most U.S. hospitals have not put consumerism into action, a new report from KaufmanHall and Caden’s Consulting asserts from the second paragraph. Patient experience is the highest priority, but has the biggest capability gap for hospitals, the report calls out. KaufmanHall surveyed 1,000 hospital and health system executives in 100 organizations to gauge their perspectives on health consumers and the hospital’s business. KaufmanHall points out several barriers for hospitals working to be consumer-centered: Internal/institutional resistance to change Lack of urgency Competing priorities Skepticism Lack of clarity (vis-a-vis strategic plan) Lack of data and analytics. The key areas identified for consumer centricity

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Most Americans Are Trying To Lose Weight: Obesity on the Minds of Americans

60% of Americans are currently trying to lose weight. So it shouldn’t be a surprise that when asked, “what’s the most serious health problem in the United States?” Americans say it’s obesity, tied with cancer, and ahead of heart disease and diabetes. Overweight and obesity are top-of-mind for most Americans, according to research conducted by the American Society for Metabolic and Bariatric Surgery (ASMBS) and NORC at the University of Chicago. This research has created two reports which can be accessed at the link. The survey, conducted among 1,509 consumers in August and September 2016, found that Americans’ understanding of

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Growing Sentiment for a Single Payer Healthcare System in the U.S.

There is growing support for a single payer healthcare system in America, found in the latest Gallup Poll and a survey the organization conducted earlier this year in May 2016. A slight majority of Americans favor a single payer system, shown in the first chart. By political party, that splits into 3 in 4 Democrats pro-single payer, and 4 in 10 Republicans (41%). Note that the 41% of Republicans who favor single payer is a much higher number than the 16% who favor keeping the Affordable Care Act in place. Gallup writes, “The general idea of a single payer system seems to

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In #Election2016, Americans Care More About the Cost of Prescription Drugs Than the ACA

“When thinking about health care priorities for the next president and Congress to address, dealing with the high price of prescription drugs tops the public’s list while issues specific to the Affordable Care Act (ACA), such as repealing provisions of the law or repealing the law entirely, are viewed as top priorities by fewer Americans,” according to the Kaiser Health Tracking Poll for October 2016 – the last such survey to be taken before the 2016 Presidential election. The poster child snapshot image representing the high cost of prescription drugs is the increase in cost for an EpiPen, which among

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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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43% of Americans Worry About How They’ll Pay for Health Care

4 in 10 Americans are worried about how they’ll pay for health care, according to Americans’ Views on Current Trade and Health Policies, a poll conducted jointly between the Harvard T.H. Chan School of Public Health and Politico. There are no significant party differences between Democrats and Republicans regarding peoples’ worrying about their ability to pay medical costs in the next year. But there are differences in geography, with 53% of people in the South significantly more worried about health care costs compared with other regions of the U.S. Who’s to blame for the high costs of health care that

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Costs of Care and the ACA Top Voters’ Healthcare Issues

Two in three US voters put the future of the Affordable Care Act as the #1 healthcare issue in the 2016 President election. The ACA is closely followed by healthcare costs — for insurance premiums, deductibles, and prescription drugs, according to the September 2016 Kaiser Health Tracking Poll. The opioid addiction and mortality epidemic is a top healthcare issue for 43% of US voters, and the Zika virus, among 26% of voters. Note that more supporters of Hillary Clinton are healthcare-oriented voters than people who favor Donald Trump. Uninsurance and costs, in addition to the future of the ACA, rank

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Let’s Go Healthcare Shopping!

Healthcare is going direct-to-consumer for a lot more than over-the-counter medicines and retail clinic visits to deal with little Johnny’s sore throat on a Sunday afternoon. Entrepreneurs recognize the growing opportunity to support patients, now consumers, in going shopping for health care products and services. Those health consumers are in search of specific offerings, in accessible locations and channels, and — perhaps top-of-mind — at value-based prices as defined by the consumer herself. (Remember: value-based healthcare means valuing what matters to patients, as a recent JAMA article attested). At this week’s tenth annual Health 2.0 Conference, I’m in the zeitgeist

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The Reshaping Medical Tourism Market: More US Patients Seek Lower-Priced Care Overseas

More U.S. patients are faced with spending more out-of-pocket for health care services, to meet high-deductible health plans and rationally spend their health savings account investments. As rational economic men and women, some are seeking care outside of the United States where many find transparently priced, high-value, lower-cost healthcare. Check out the table from the Medical Tourism Association, and you can empathize with cash-paying patients looking for, say, gastric bypass surgery or a heart valve replacement. My latest column in the Huffington Post discussed this trend, which points first to the Cleveland Clinic — a top-tier American healthcare brand that’s

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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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What EpiPen Pricing and Parents Teach Us About Social Media In Health

Mylan, the marketer of the EpiPen, dropped the price by 50% this week. This response was due in large part to pressure that outraged parents’ call-outs on social media put on the company. Tara Parker-Pope in the NY Times Well blog pointed this out in her column, How Parents Harnessed the Power of Social Media to Challenge EpiPen Prices. Online petitions, patient and parent social networks, and patient activists’ ability to leverage social media are the new tools of health and patient engagement. EpiPen is a must-have medicine for people who deal with serious allergy and asthma conditions, many of

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Aging America Is Driving Growth in Federal Healthcare Spending

Federal healthcare program costs are the largest component of mandatory spending in the U.S. budget, according to An Update to the Budget and Economic Outlook: 2016 to 2026 from the U.S. Congressional Budget Office (CBO). Federal spending for healthcare will increase $77 billion in 2016, about 8% over 2015, for a total of $1.1 trillion. The CBO believes that number overstates the growth in Medicare and Medicaid because of a one-time payment shift of $22 bn to Medicare (from 2017 back into 2016); adjusting for this, CBO sees Federal healthcare spending growing 6% (about $55 bn) this year. The driver

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Knowing And Acting On How Patients Think Will Improve Health and Healthcare

“In the developed world, patient disengagement has become the new killer disease — not the lack of diagnostic devices, trained physicians or efficacious treatment options,” argues Andrea LaFountain, PhD, in her book, How Patients Think. Disbanding prescription drugs in advance of doctors’ instructions, postponing lab and diagnostic tests, and avoiding daily blood glucose testing when managing diabetes are just some examples of “how patients think” about health care and the many tasks involved in caring for oneself and the health of loved ones. But better understanding how patients think — technically speaking, the cognitive neuropsychology underneath the thinking — can

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Health Care Costs in Retirement Will Run $260K If You’re Retiring This Year

If you’re retiring in 2016, you’ll need $260,000 to cover your health care costs during your retirement years. In 2015, that number was $245,000, so retiree health care costs increased 6% in one year according to Fidelity’s Retirement Health Care Cost Estimator. The 6% annual cost increase is exactly what the National Business Group on Health found in their recently published 2017 Health Plan Design Survey polling large employers covering health care, discussed here in Health Populi. The 6% health care cost increases are driven primary by people using more health services and the higher costs for many medicines — specifically, specialty

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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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Most US Doctors Say They Ration Patients’ Healthcare

Rationing has long been seen as a common practice in national, single-payer health systems like the UK’s National Health Service and Canada’s national health insurance program (known as “Medicare”).  However, over half of U.S. physicians say they ration care to patients. In a peer-reviewed column in the Journal of General Internal Medicine published in July 2016, Dr. Robert Sheeler and colleagues at the Mayo Clinic, University of Iowa, and University of Michigan, found that 53% of physicians surveyed personally “refrained” in the past six months from using specific clinical services that would have provided the “best patient care” due to cost.

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US Health Care Prices Would Be Sticker-Shocking For Europeans

The average hospital cost per day in the U.S. is $5,220. In Switzerland it’s $4,781, and in Spain that inpatient day looks like a bargain at $424. An MRI in the U.S. runs, on average, $1,119. In the UK, that MRI is $788, and in Australia, $215, illustrated in the first chart. Drug prices are strikingly greater in the U.S. versus other developed nations, as shown in the first chart for Xarelto. If you live in the U.S. and have a television tuned in during the six o’clock news, chances are you’ve seen an ad for this drug featuring Arnold

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The Average Monthly Health Plan Premium in the U.S. Hit $885 in 2016

  Three years after the launch of the Affordable Care Act (ACA), the big picture of employer-sponsored health benefits in the U.S. show stability, with modest changes in costs being kept in check by a growing younger workforce, according to the 2016 ADP Annual Health Benefits Report. Roughly 9 in 10 employees in large companies are eligible to participate in health insurance plans at the workplace, with two-thirds of people participating, shown in the chart. Younger people, under 26 years of age, have much lower participation rates than those over 26, with many staying on their parents’ plans (taking advantage of

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Broadband – A Social Determinant of Health

The promise of digital, connected health to engage all health citizens cannot be fully realized until people have access to the new social determinant of health: broadband connectivity. The World Health Organization considers social determinants of health inputs like education, safe drinking water, nutritious food, safe neighborhoods for walking, employment and transportation access. Together, these factors bolster personal/individual and public health. See the map of the U.S., and note whee the concentrations of aqua blue are. These are areas that lack broadband access. Telehealth and other digital health tools can get health care to under-served people in under-served geographic areas….where broadband

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Health in America: Improving, But Disparities Need Policy Prescriptions

The bad news: mortality rates haven’t improved much and obesity rates rose in one-third of communities. The good news: public health gains can be made in resource-poor communities with the right health policies, based on research from The Commonwealth Fund, Rising to the Challenge, the Fund’s Scorecard on local health system performance for 2016. The top-line of this benchmark report is that health care in the U.S. has, overall, improved more than it’s declined. Among the big levers driving health care improvement in the past year have been the further expansion of health citizens covered with insurance through the Affordable

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U.S. Health Spending Will Comprise 20% of GDP in 2025

Spending on health care in America will comprise $1 in every $5 of gross domestic product in 2025, according to National Health Expenditure Projections, 2015-25: Economy, Prices, And Aging Expected to Shape Spending and Enrollment, featured in the Health Affairs July 2016 issue. Details on national health spending are shown by line item in the table, excerpted from the article. Health spending will grow by 5.8% per year, on average, between 2015 and 2025, based on the calculations by the actuarial team from the Centers for Medicare and Medicaid Services (CMS), authors of the study. The team noted that the Affordable Care

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In Healthcare, Pharmacists and Doctors Most Trusted. Insurance Execs and Congress? Not.

When consumers consider the many stakeholder organizations in healthcare, a majority trust pharmacists first, then doctors and dentists. Hospital and health insurance execs, and members of Congress? Hardly, according to a survey from Meyocks, a marketing consultancy. Meyocks conducted the survey via email among 1,170 US adults, 18 years of age and older. This survey correspondends well with the most recent Gallup Poll on most ethical professions, conducted in December 2015. In that study, pharmacists, nurses and doctors come out on top, with advertisers (“Mad Men”), car salespeople, and members of Congress at the bottom, as shown in the second

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Health Care Reform: President Obama Pens Progress in JAMA

“Take Governor John Kasich’s explanation for expanding Medicaid: ‘For those that live in the shadows of life, those who are the least among us, I will not accept the fact that the most vulnerable in our state should be ignored. We can help them.’” So quotes President Barack Obama in the Journal of the American Medical Association, JAMA, in today’s online issue. #POTUS penned, United States Health Care Reform: Progress to Date and Next Steps. The author is named as “Barack Obama, JD,” a nod to the President’s legal credentials. Governor Kasich, a Republican, was one of 31 Governors who

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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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Healthcare Consumerism? Not So Fast, Alegeus Finds

Millions of U.S. patients have more financial skin in the American health care game. But are they behaving like the “consumers” they are assumed to be as members in consumer-directed health plans? Not so much, yet, explained John Park, Chief Strategy Officer at Alegeus, during a discussion of his company’s 2016 Healthcare Consumerism Index. This research is based on an online survey of over 1,000 U.S. healthcare consumers in April 2016. Alegeus looks at healthcare consumerism across two main dimensions: healthcare spending and healthcare saving. As the chart summarizes, consumers show greater engagement and focus on buying a TV or car, choosing

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What Financial Health Means to Me: It’s Baked Into Wellness

Today is Financial Wellness Day. Do you know how financially well you are? Let me take a crack at that answer, even though I haven’t seen your bank account (which you may not even have as over 20% of people in the US are, as financial services companies would call you “un-banked” or “under-banked”.) You have some level of fiscal stress, ranging from a little to a lot. You aren’t taking all of your summer vacation your employer extends to you. You’re spending around $1 in every $5 of your household budget on health care. And your sleep isn’t as

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Will the Big Box Store Be Your Health Provider?

“Gas ‘N’ Health Care” is one of my most-used cartoons these days as I talk with health/care ecosystem stakeholders about the growing and central role of consumers in health care. You may be surprised to learn that the brilliant cartoonist Michael Maslin created this image back in 1994. That’s 22 years ago. When I first started using this image in my meetings with health care folks, they’d all giggle and think, ‘isn’t that funny?’ Legacy health care players — hospitals, doctors, Pharma, and medical device companies — aren’t laughing at this anymore. At a Costco a 20 minutes’ drive from

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Prescriptions for Food: the New Medicine

Hippocrates is often quoted as saying, “Let food be thy medicine and medicine be thy food.” While some researchers argue that Hippocrates knew the difference between ‘real’ medicine and clinical therapy, there’s no doubt he appreciated the social determinant of health and wellness that food was 1,000 years ago and continues to be today. Taking a page, or prescription note, from the good doctor’s Rx pad, food retailers, healthcare providers, local food banks, and State healthcare programs are working the food-as-medicine connection to bolster public health. One approach to food-as-medicine is promoting the purchase of fresh fruits and vegetables — the

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Are We Health Engaged Yet? Frost & Sullivan Responds “Meh”

The top health-related activities among U.S. adults include routinely taking vitamins and supplements, and prescription medicines, according to Frost & Sullivan’s report, Are We Engaged Yet? Their response to the titular question lies in in the subtitle: “US consumers appear confused or ambivalent about what it means to be proactive or engaged in their health.” 1 in 2 U.S. adults says they’re “somewhat engaged” in their healthcare, according to Reenita Das’s write-up on the study in Forbes magazine. She notes that: Consumers with higher incomes have more confidence in their access to health care services and quality of care Budget-constrained consumer

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Connecting Mental Health Spending to Job Creation in the U.S.

Heart disease and cancer may be the top killers of people who live in the U.S., but the top health spending line item was for mental disorders: $201 billion in 2013. The chart explains a critical aspect of the spending in that top green portion of the bar: the turquoise segment was for spending on “civilian noninstitutionalized” people, and the green was for “institutionalized and active-duty military.” Mental health issues account, by far, for the largest medical spending in a single condition as shown by the top green bar segment in the chart. These insights come from the Commerce Department’s Bureau

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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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Most Americans Favor A Federally-Funded Health System

6 in 10 people in the US would like to replace the Affordable Care Act with a national health insurance program for all Americans, according to a Gallup Poll conducted on the phone in May 2016 among 1,549 U.S. adults. By political party, RE: Launch a Federal/national health insurance plan (“healthcare a la Bernie Sanders”): Among Democrats, 73% favor the Federal/national health insurance plan, and only 22% oppose it; 41% of Republicans favor it and 55% oppose it. RE: Repeal the ACA (“healthcare a la Donald Trump”): Among Democrats, 25% say scrap the ACA, and 80% of Republicans say to do

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Costs and Connection At the Core of Consumers’ Health-Value Equations

Cost ranks first among the factors of selecting health insurance for most Americans across the generations. As a result, most consumers are likely to shop around for both health providers and health plans, learned through a 2016 Xerox survey detailed in New Insights on Value-Based Care, Healthcare Attitudes 2016. The younger the consumer, the more important costs are, Xerox’s poll found, shown in the first chart. Thus, “shopping around” is more pronounced among younger health consumers — although a majority people who belong to Boomer and Greatest Generation cohorts do shop around for both health providers and health insurance plans —

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One in Two People Use Wearable Tech in 2016

Nearly 1 in 2 people own at least one wearable device, up from 21% in 2014; one-third of people own more than one such device that tracks some aspect of everyday life, according to PwC’s latest research on the topic, The Wearable Life 2.0 – Connected living in a wearable world, from PwC. Wearable technology in this report is defined as accessories and clothing incorporating computer and advanced electronic technologies, such as fitness trackers, smart glasses (e.g., Google Glass), smartwatches, and smart clothing. Specifically, 45% of people own a fitness band, such as a Fitbit, the most popular device in this

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Happy Patients, Healthy Margins – the Hard ROI for Patient-Centered Care

Hospital margins can increase 50% if health providers offer patients a better customer experience, Accenture calculates in the paper, Insight Driven Health – Hospitals see link between patient experience and bottom line. Specifically, hospitals with HCAHPS scores of 9 or 10, the highest recommendations a patient can give in the survey, more likely enjoy higher margins (upwards of 8%). The Hospital Computer Assessment of Healthcare Providers and Systems (HCAHPS) survey is administered by the Centers for Medicare and Medicaid Services (CMS) and measures patients’ exeperiences in hospital post-discharge. The correlation, simply put, is “Happy Patients, Healthy Margins,” Accenture coined in

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