A blog covering the health/care ecosystem and people.

In the wake of the pandemic and growing consumer preferences, the hospital-to-home movement is gaining traction among health systems. Amidst bullish forecasts for the promise of hospital-to-home discharges, the ability for many patients to make this migration would be a difficult bridge to cross.           On the promising front, recent studies reviewed through a meta-analysis published in JAMA found that hospital-to-home programs can be clinically and cost-effective for inpatients discharged from hospital. Earlier this year, McKinsey addressed how “Care at Home” ecosystems can reshape the way health systems — and people — envision patient care. This

When we think about the state of Trust in in mid-2022, there is some good news: Trust is rising (at least in democratic countries, while falling in autocratic ones). The bad news: the gap in Trust has dramatically widened between higher-income people compared with those earning lower-incomes, globally.             And that gap is “tinder” that can be quickly sparked into a socio-political fire in countries around the world, Richard Edelman cautioned today when introducing the latest look at the 2022 Edelman Trust Barometer, focusing on geopolitics and business. We have never seen numbers like this

Delivering health care during the heights of the COVID-19 pandemic proved to both patients and their clinicians that virtual care was not only a viable channel for care, but very often a preferable “place” to collaborate for treatment. Even before the coronavirus pandemic emerged in early 2020, telehealth and the hospital-to-home movement were beginning to become part of a portfolio of delivery modes across the continuum of care. Deloitte spells out the current and future prospects for the Hospital in the future “without” walls in a new report that spells out driving forces, future scenarios, and impacts on a business long

The rate of people in the U.S. skipping needed health care due to cost tripled in 2021. This prompted West Health (the Gary and Mary West nonprofit organizations’ group) and Gallup to collaborate on research to quantified Americans’ views on and challenges with personal medical costs. This has resulted in The West Health-Gallup Healthcare Affordability Index and Healthcare Value Index.               The team’s research culminated in the top-line finding that some 112 million people in the U.S. struggle to pay for their care. That’s about 4.5 in 10 health citizens. Furthermore, 93% of people

Four in five U.S. physicians were using telehealth to care for patients at the end of 2021.             Among those doctors who were not providing telehealth by late 2021, just over one half never did so during the COVID-19 pandemic, according to the 2021 Telehealth Survey Report from the AMA. This report provides insightful  context for the upcoming annual ATA Conference for 2022, being held in-person in Boston kicking off May 1st. The meeting will be a strategically important, as the title of the conference asks: “What Now? Creating An Opportunity in a Time of

As health care industry stakeholders and policymakers have begun to recognize and address the underlying drivers of peoples’ health, there’s another acronym that is taking hold in health care beyond SDoH: that is ESG, standing for Environment Social, and Governance pillars of responsibility and activity.               To mark this Earth Day 2022, I’ve written a brief primer on ESG for the health care community published today in the Medecision Liberate Health blog. Here in Health Populi, I’ll give you a few highlights with graphics you won’t see in that essay to illustrate some key

“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

Access to the Internet has been a key determinant of health — or more aptly, death — during the COVID-19 pandemic. Americans lacked Internet access were more likely to die due to complications from the coronavirus, according to a study published in JAMA Network Open this month. The study’s key finding was that for every additional 1% of people living in a county who have access to the Internet, between 2.4 and 6.0 COVID-19 deaths per 100,000 were preventable. The paper asserts that, “More awareness is needed about the essential asset of technological access to reliable information, remote work, schooling

The financial toxicity of health care costs in the U.S. takes center stage in Health Populi this week as several events converge to highlight medical debt as a unique feature in American health care. “Medical debt is the most common collection tradeline reported on consumer credit records,” the Consumer Financial Protection Bureau called out in a report published March 1, 2022. CFPB published the report marking two years into the pandemic, discussing concerns about medical debt collections and reporting that grew during the COVID-19 crisis. Let’s connect the dots on: A joint announcement this week from three major credit agencies,

As we mark the second anniversary of the COVID-19 pandemic, the key themes facing health citizens deal with money, inflation, and war — “piled on a nation stuck in COVID-19 survival mode,” according to the latest poll on Stress in America from the American Psychological Association. Financial health is embedded in peoples’ overall sense of well-being and whole health. Many national economies entered the coronavirus pandemic in early 2020 already marked by income inequality. The public health crisis exacerbated that, especially among women who were harder hit financially in the past two years than men were. That situation was even worse

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

Trust, or really lack thereof, is a killer app for people’s coronavirus health outcomes. That is the through-line found in a very deep dive into 177 countries’ health data published in The Lancet in a research article on pandemic preparedness and COVID-19. The Lancet study, published on 1 February 2022, was funded by the Gates Foundation in partnership with The Bloomberg Philanthropies et al. The study was researched and written up by a team of COVID-19 National Preparedness Collaborators, led by Dr. Joseph Dieleman of the University of Washington’s Institute for Health Metrics and Evaluation, a group that has been long-tracking

A new study from CIGNA and its subsidiary MDLive touts the cost-effectiveness of telehealth to improve health outcomes, reducing the need for unnecessary lab work, reducing duplication of care, and connecting patients with  high-performing providers. It is expected that one in three patient visits will be virtual, CIGNA quotes from an Accenture forecast. As more consumers used telehealth channels during the early phase of the COVID-19 pandemic, patients experienced virtual care. For many people, these visits matched or exceeded expectations compared with in-person encounters with clinicians, as well as satisfying on convenience and access values. How will virtual care play

Members of his congregation kept going to the hospital with diet-related issues, Reverend Dr. Heber Brown, III, realized. “I got tired of praying and hoping they made it and walked out,” Reverend Brown realized. And then… “God gave us an idea and vision to be proactive on the issue of health in our congregation,” Rev. Brown explained to us yesterday on Day 2 of Real Chemistry’s Health Equity Summit. This was the seed for the Black Church Food Security Network, planting a pragmatic vision for health and well-being weaving together local food, civic empowerment, economic development, and faith. “We had

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,

A coalition of health care providers, health plans, technology innovators, NGOs, and medical societies has come together as the Public Health Tech Initiative (PHTI), endorsed by the Consumer Technology Association (CTA) with the goal of advancing the use of trustworthy digital health to proactively meet the challenge of future public health emergencies….like pandemics. At the same time, CTA has published a paper on Advancing Health Equity Through Technology which complements and reinforces the PHTI announcement and objective. The paper that details the PHTI program, Using Heath Technology to Response to Public Health Emergencies, identifies the two focus areas: Digital health

“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

COVID-19 exacted a toll on health citizens’ mental health, worsening a public health challenge that was already acute before the pandemic. It’s World Mental Health Day, an event marked by global and local stakeholders across the mental health ecosystem. On the global front, the World Health Organization (WHO) describes the universal phenomenon and burden of mental health on the Earth’s people… Nearly 1 billion people have a mental disorder Depression is a leading cause of disability worldwide, impacting about 5% of the world’s population People with severe mental disorders like schizophrenia tend to die as much as 20 years earlier

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

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

The Catholic Health Association (CHA) is urging Americans to “love thy neighbor” by getting the COVID-19 vaccine, Sister Mary Haddad wrote in an editorial published in Modern Healthcare, published on September 3, 2021. Sister Mary is CEO and President of CHA. “Some may suggest that there are moral and religious concerns to receiving the COVID-19 vaccine,” Sister Mary observed. “We strongly affirm the position of the leaders of the Catholic Church: the vaccines are morally acceptable and getting vaccinated is “an act of love.” she asserted. CHA launched a portal on the act of love, featuring lots of science-based articles

“Racial and ethnic inequities in the US health care system have been unremitting since the beginning of the country. In the 19th and 20th centuries, segregated black hospitals were emblematic of separate but unequal health care,” begins the editorial introducing an entire issue of JAMA dedicated to racial and ethnic disparities and inequities in medicine and health care, published August 17, 2021. This is not your typical edition of the Journal of the American Medical Association. The coronavirus pandemic has changed so many aspects of American health care for so many people, including doctors. Since the second quarter of 2020,

“We don’t un-learn,” Dr. Amy Abernethy asserted as she shared her pandemic perspectives on a panel with 2 other former U.S. health policy and regulatory leaders. The three spoke about navigating compliance (think: regulations and reimbursement) in an uncertain world. An uncertain world is our workplace in the health/care ecosystem, globally, in this moment. So to give us some comfort in our collective foxhole, my last post for this week of immersion in #HIMSS21 is based on the keynote speech of Michael Dowling, CEO of Northwell Health. Dowling keynoted on the theme of “Leading for the Future,” sharing his lessons

Simply put, is the equation, “Spend more, get less” a sustainable business model? Of course not. But that’s the simple math on U.S. health care spending and what comes from it, according to Mirror, Mirror 2021: Reflecting Poorly, a perennial report from The Commonwealth Fund that compares health system performance across eleven developed countries. The first table details the metrics that the Fund compares across the eleven peer nations, which included Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. The metrics compared were access to care, care process, administrative efficiency, equity,

While women continue to outlive men in the U.S. in terms of life expectancy, the COVID-19 pandemic revealed continued healthcare access, physical and mental health disparities, and economic inequities for women in America. I addressed the changing state of post-pandemic women’s health in my latest contribution to the Medecision Liberation blog. This first graphic illustrates how women interacted with the U.S. health system during the pandemic in 2020. These data come from Kaiser Family Foundation’s women’s health survey conducted from the beginning of the pandemic starting March 1, 2020, and discovered that women in poorer or fair more likely went

Cain Brothers is a 100+ year old financial services firm with a strong health care experience, now part of KeyBanc. A recent “House Calls” memo and podcast from two company analysts detailed the state of Medicaid, Motherhood and America’s Future: Giving Birth to Better Maternity Outcomes. Christian Pesci and David Johnson’s in-depth discussion detailed their bottom-line that, “maternity care in the U.S. is in crisis but poised for rapid evolution…(recognizing) that an uncoordinated system with misaligned incentives harms too many individuals, families, and communities.” They lay out the crisis as follows: Medicaid funds nearly one-half of births in the U.S.

“What if…healthcare happened where we live, work, play, pray and shop, delivering the highest levels of retail experience?” I asked and answered in my book HealthConsuming: From Health Consumer to Health Citizen. The chapter called “The new retail health” began with that “what if,” and much of the book responded with the explanation of patients evolving toward health consumers and, ultimately, health citizens empowered and owning their health and care. This week, Dollar General announced the hiring of its first Chief Medical Officer, Dr. Albert Wu. With that announcement, America’s largest dollar-store chain makes clear its ambitions to join a

Without access to connectivity during the pandemic, too many people could not work for their living, attend school and learn, connect with loved ones, or get health care. The COVID-19 era has shined a bright light on what some of us have been saying since the advent of the Internet’s emergence in health care: that digital literacies and connectivity are “super social determinants of health” because they underpin other social determinants of health, discussed in Digital inclusion as a social determinant of health, published in Nature’s npj Digital Medicine. On the downside, lack of access to digital tools and literacies

Post-pandemic, the consumer’s priority purchases are grocery, nesting, and health, according to David Shah, a leading thinker about social and design trends. David presented the latest Pantone forecast on color and society in NewTopia – A Balance of Color Opposites – Color for a Post-COVID World this week. I had the opportunity to attend the session, and want to share the health and wellness-related insights David shared in his fast-paced view on the role of color in bolstering wellbeing and community looking out to 2022/23. For context, Pantone plays a role in your life you might not realize. In health

Wherever you live in the world touched by the coronavirus pandemic, you felt (and were) stress-tested. Both you were, and your home was as well. In this year’s 2021 annual report by Deloitte into Connectivity & Mobile Trends, their report details How the pandemic has stress-tested the crowded digital home. This analysis was done, as it is every year, by the Deloitte Center for Technology, Media & Telecommunications. Deloitte’s Center commissioned an online survey among 2,009 U.S. consumers to gauge five generations of peoples’ perspectives on connected life in the context of COVID. The report covers the various life-flows of

The hearts and minds of nurses are fertile and inspirational sources and engines for health care innovation. This past weekend, and for the second time, I had the privilege and opportunity to be a panelist for the perennial hackathon meet-up of Nurse Hack 4 Health, sponsored by Microsoft, Johnson & Johnson, Sonsiel, and DevUp. This round, the hackathon attracted hundreds of nurses from at least 20 countries and 30 U.S. states. Even a few students attended, a growing trend as academia recognizes the shortage of workers trained to solve thorny problems of the world. In health care, right here, right

While the “in-person” visit to a doctor or medical professional continues to rank first as consumers’ most-trusted information source, the virtual doc or clinician rose in trust during the COVID-19 pandemic, according to Euromonitor’s latest read on Consumer Health: Changes in Consumer Behaviour during COVID-19 . The first four most-trusted sources for health information in 2021 remained the same short-list from 2020: doctors in-person, pharmacists, nutritionists and dieticians, and government or NGOs. But fifth place slipped from family and friends to the pharma industry, and sixth in line went to virtual doctors or medical professionals rising from 9th place in

In the COVID-19 pandemic, as peoples’ daily lives shifted closer and closer to home, and for some weeks and months home-all-the-time, health care, too, moved beyond brick-and-mortar hospitals and doctors’ offices. The public health crisis accelerated “what’s next” for health care delivery, detailed in A New Era of Virtual Health, a report published by TripleTree. TripleTree is an investment bank that has advised health care transactions since 1997. As such, the team has been involved in digital health financing and innovation for 24 years, well before the kind of platforms, APIs, and cloud computing now enabling telehealth and care, everywhere. The

The United States has among the highest per capita incomes in the world. The U.S. also has sustained among the highest death rates per 100,000 people due to COVID-19, based on epidemiological data from the World Health Organization’s March 28, 2021, update. Higher incomes won’t prevent a person from death-by-coronavirus, but risks for the social determinants of health — exacerbated by income inequality — will and do. I have the good fortune of access to a study group paper shared by Paul Sheard, Research Fellow at the Mossaver-Rahmani Center for Business and Government at the Harvard Kennedy School. In reviewing

Trust in the technology industry has crashed to an all-time low based on the 2021 Edelman Trust Barometer. As Richard Edelman, CEO, concisely asserted, “Tech loses its halo.” The first chart shows the one-year trend on trust across industries through U.S. consumers’ eyes. Most industries lost citizens’ trust between 2020 and 2021, most notably, Technology, dropping the greatest margin at 9 points Retail, falling 7 points, Entertainment. falling 5 points, and, Fashion and automotive declining by 4 points. Several sectors’ trust equity rose in the year, especially healthcare growing by 8 points and food and beverage rose slightly by 2

COVID-19 ushered in the era of our homes as safe havens for work, shopping, education, fitness-awaking, bread-baking, and health-making. In my latest essay written for Medecision, I weave together new and important data and evidence supporting the basic social determinant of health — shelter, housing, home — and some innovations supporting housing-as-medicine from CVS Health, UnitedHealth Group, AHIP, Brookings Institution, the Urban Land Institute, and other stakeholders learning how housing underpins our health — physical, mental, financial. Read about a wonderful development from Communidad Partners, working with the Veritas Impact Partners group, channeling telehealth to housing programs serving residents with

In 2021, racial and ethnic disparities in healthcare are a top patient safety issue, according to ECRI’s annual list of major concerns facing healthcare consumers’ risks to adverse events that can harm them. ECRI has published their annual Top 10 list since 2018, when the list featured diagnostic errors, o behavioral health needs in acute care settings, and patient engagement and health literacy — all of which play into this year’s #1 issue, racial and ethnic disparities in health care. In fact, among the risks in this year’s Top Ten list, eight were accelerated and highlighted by the COVID-19 pandemic

After a year of living with and “in” the coronavirus pandemic, younger people in the U.S. have had to deal with over twelve months of quarantine and lockdown, going to school remotely from home, and distancing from friends. For most young people, the public health crisis has been more about that social distancing from friends, a collective sense of isolation, and mental and behavioral health impacts. These dynamics and these young health citizens’ coping mechanisms are captured in the report, Coping with COVID-19: How Young People Use Digital Media to Manage Their Mental Health. Three organizations collaborated to conduct and

“Without a four-year college diploma, it is increasingly difficult to build a meaningful and successful life in the United States,” according to an essay in PNAS, Life expectancy in adulthood is falling for those without a BA degree, but as educational gaps have widened, racial gaps have narrowed by Anne Case and Angus Deaton. Case and Deaton have done extensive research on the phenomenon of Deaths of Despair, the growing epidemic of mortality among people due to accidents, drug overdoses, and suicide. Case and Deaton wrote the book on Deaths of Despair (detailed here in Health Populi),  Case and Deaton

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

Some people remark about 2020 being a “lost year” in the wake of the coronavirus pandemic. That happens to be a true statement, sadly not in jest: in the U.S., life expectancy at birth fell by one full year over the first half of 2020 compared with 2019, to 77.8 years. In 2019, life expectancy at birth was 78.8  years, according to data shared by the National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention (CDC). Life expectancy at birth declined for both females and males, shown in the first chart. The differences between

Seven in 10 U.S. adults are willing to be vaccinated, and they’re not happy about the process in getting their jab, according to Gallup’s poll taken in the last week of January 2021. The proportion of Americans willing to receive a COVID-19 vaccine has steadily grown since October 2020, which fell to a mere 50% of folks keen to get the shot. That percentage has risen to 71% as of February 1 2021, as the first line chart shows the reversal in public embrace for vaccination against the coronavirus. Now that most people in the U.S. welcome the opportunity to

Patients in the U.S. have been self-rationing medical care for many years, well before any of us knew what “PPE” meant or how to spell “coronavirus.” Nearly a decade ago, I cited the Kaiser Family Foundation Health Security Watch of May 2012 here in Health Populi. The first chart here shows that one in four U.S. adults had problems paying medical bills, largely delaying care due to cost for a visit or for prescription drugs. Fast-forward to 2020, a few months into the pandemic in the U.S.: PwC found consumers were delaying treatment for chronic conditions. In October 2020, The American Cancer

President Biden’s first few days on the job gave us a very clear view on how he sees conquering COVID: through a whole-of-government approach to public policies that bolster directly addressing the virus, along with the many forces shaping how we got here and how to come out of the pandemic era stronger. I cover this first wave of Biden health policy in my latest post for the Medecision Liberation blog titled, “Top Priorities for President Biden: COVID-19, Then Everything Else.” The plotline goes… On the day of inauguration, January 20, 2021, Joseph R. Biden was installed as the 46th

The coronavirus pandemic disrupted and re-shaped the annual CES across so many respects — the meeting of thousands making up the global consumer tech community “met” virtually, both keynote and education sessions were pre-recorded, and the lovely serendipity of learning and meeting new concepts and contacts wasn’t so straightforward. But for those of us working with and innovating solutions for health and health care, #CES2021 was baked with health goodness, in and beyond “digital health” categories. In my consumer-facing health care work, I’ve adopted the mantra that our homes are our health hubs. Reflecting on my many conversations during CES

Citizens around the world unite around the concept that Trust is Dead. This is no truer than in the U.S., where trust in every type of organization and expert has plummeted in the wake of the COVID-19 pandemic, political and social strife, and an economic downturn. Welcome to the sobering 2021 Edelman Trust Barometer, released this week as the world’s technology innovators and analysts are convening at CES 2021, and the annual JP Morgan Healthcare meetup virtually convened. As the World Economic Forum succinctly put the situation, “2020 was the year of two equally destructive viruses: the pandemic and the

“The virus is the boss,” Austan Goolsbee, former Chair of the Council of Economic Advisers under President Obama, told Stephanie Ruhle this morning on MSNBC. Goolsbee and Jason Furman, former Chair of Obama’s Council of Economic Advisers, tag-teamed the U.S. economic outlook following today’s news that the U.S. economy lost 140,000 jobs — the greatest job loss since April 2020 in the second month of the pandemic. The 2020-21 economic recession is the first time in U.S. history that a downturn had nothing to do with the economy per se. As Uwe Reinhardt, health economist guru, is whispering in my

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

Since the spike in hospitalizations and deaths topping 300,000 in the U.S., one day and week at a time, it appears that more Americans are moving on a continuum from being vaccine-hesitant toward vaccine-enthusiasm. The latest Kaiser Family Foundation COVID-19 Vaccine Monitor for December 2020 quantifies this moving sentiment across several perspectives: Most Americans across political party believe the COVID-19 vaccine development process is moving at the right speed The number of Americans who would get a coronavirus vaccine if it were free and seen as safe grew since September, from 34% of people who would “definitely get it” to