A blog covering the health/care ecosystem and people.

The modern view on wellness is “having it all” in terms of driving physical, emotional, mental and financial health across one’s life, according to CIGNA’s survey report, Health & Financial Well-Being: How Strong Is the Link?  The key elements of whole health, as people define them are: – Absence of sickness, 37% – Feeling of happiness, 32% – Stable mental health, 32% – Management of chronic disease, 15% – Financial health, 14% – Living my dreams, 9%. 1 in 2 people (49%) agree that health and wellness comprise “all of these” elements, listed above. This holistic view of health is

National health spending will comprise 19.3% of U.S. gross domestic product in 2023, nearly $1 in $5 of all American spending. This statistic includes the expenditure categories for health spending as defined by the Centers for Medicare and Medicaid Services (CMS), Office of the Actuary. The number includes hospital care, personal health care, professional services (physicians and other professionals), home health, long term care, retail sales of prescription drugs and durable medical equipment, and investment in capital equipment, among other line items. The forecast was published in Health Affairs article, National Health Expenditure Projections, 2013-23: Faster Growth Expected With Expanded

It’s de rigueur for any organization marketing a product or service in health care to be “patient-centered” these days. “Patient engagement” and “health engagement” are phrases found on health conference agendas, whether pitching to attendees in pharma and life sciences, health IT, health insurance, or healthcare (to hospitals and physicians, alike). One paradigm for patient-centricity that’s more mature than most is IMS Health’s Patient Journey construct, which the data-driven company has been talking about since 2012. While the concept focused mainly on pharmaceutical marketing and medication adherence, it’s useful for all industry segments looking to motivate behavior change in health

Expecting health care cost increases of 5% in 2015, employers in the U.S. will focus on several tactics to control costs: greater offerings of consumer-directed health plans, increasing employee cost-sharing, narrowing provider networks, and serving up wellness and disease management programs. The National Business Group on Health’s Large Employers’ 2015 Health Plan Design Survey finds employers committed to health engagement in 2015 as a key strategy for health benefits. More granularly, addressing weight management, smoking cessation, physical activity, and stress reduction, will be top priorities, shown in the first chart. An underpinning of engagement is health care consumerism — which

In the post-Recession American economy, people shop for value in all things. And that includes health care services like MRIs — when patients are informed of pricing differences among imaging facilities and given free rein to pick-and-choose among them. In addition to lowering imaging costs in a community, price transparency also generated competition between providers. Health Affairs published this research detailed in Price Transparency for MRIs Increased Use of Less Costly Providers And Triggered Provider Competition in August 2014. An Economics 101 course teaches us that a well-oiled (perfect) market depends on lots of sellers of a product and lots of

It costs $23,215 to cover a family of four for health care, according to the 2014 Milliman Medical Index (MMI), the annual gauge of healthcare costs from the actuarial firm. The growth rate of 5.4% from 2013 is the lowest annual change since Milliman launched the Index in 2002. This is equivalent to a new Toyota Prius or a tonne of tin. While employers cover most of these costs, the portion employees bear continues to increase. This year, insured workers will take on 42% of the total, or on average, $9,695. This is up by $552 over 2013, or 6%

The consumer demand side for healthcare transparency is hungry for the light to shine on health care costs, quality and information that’s relevant and meaningful to the individual. The supply side is fast-growing, with websites and portals, government-sponsored projects, commercial-driven start-ups, and numerous mobile apps. These tools endeavor to: Help people find and access services Schedule appointments Compare peer consumers’ reviews for those providers Calculate and prepare for out-of-pocket co-payments deriving from their health plan Negotiate prices with providers Pay for the services, and Reconcile the payment with a high-deductible health plan or health savings account. On the demand side, consumers

Three U.S. health plans cover about 100 million people. Today, those three market-dominant health plans — Aetna, Humana and UnitedHealthcare — announced that they will post health care prices on a website in early 2015. Could this be the tipping point for health care transparency so long overdue? These 3 plans are ranked #1, #4 and #5 in terms of market shares in U.S. health insurance. Together, they will share price data with the Health Care Cost Institute (HCCI), a not-for-profit organization dedicated to research on U.S. health spending. An important part of the backstory is that the HCCI was

As Big Payors continue to shift more costs onto health consumers in the U.S., the importance of and need for transparency grows. 39% of large employers offered consumer-directed health plans (CDHPs) in 2013, and by 2016, 64% of large employers plan to offer CDHPs.  These plans require members to pay first-dollar, out-of-pocket, to reach the agreed deductible, and at the same time manage a health savings account (HSA). In the past several weeks, many reports have published on the subject and several tools to promote consumer engagement in health finance have made announcements. This week of posts provides an update on

The rising costs of health care in America, and consumers’ growing cost burdens, has many impacts on the U.S. health ecosystem. In particular, patients have been self-rationing due to costs, without necessarily paying attention to quality or medical outcomes. Doctors have begun to pay more attention to costs and their impacts on patients in their practices, addressed in today’s New York Times article, Treatment costs could influence doctors’ advice to patients. Andrew Pollack writes in the Times about the morphing role of doctors, some of whom are taking on the mantle of being a “steward of society,” as characterized by

I had the pleasure of spending quality time brainstorming with Mikki Nasch, co-founder of AchieveMint, yesterday. Mikki worked on the early days of building the FICO score with Fair Isaac, so has been involved in Big Data well before it became the well-#hashtagged buzzword it is today. In our conversation, we talked about the history of FICO and how it took about a decade for consumers to understand it, accept it, and use it as a tool for bettering their credit ratings. When a FICO score was below an acceptable threshold to a lender – say, for a new car

With health costs increase increasing at 4.4% in 2014, a slightly higher rate of growth than the 4.1% seen in 2013. While this is lower than the double-digit increases U.S. employers faced in 2001-2004, it’s still twice the rate of general consumer price inflation. That’s what the first graph shows, based on the The 19th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care.  Employers generally want to continue to provide health insurance…for the time being. 92% of companies expect to make changes in health plan provisions in 2014, with 1 in 2 anticipating “significant

Even before stepping into the Orlando Convention Center on Sunday 23 February 2014, my clairvoyant powers know the forecast of the Best in Show: the growing role of patients in health care, reflected in both the education session at the annual 2014 meeting of HIMSS as well as the product/service mix being proffered on the convention show floor. As a member of HIMSS Connected Patient Committee, I know first-hand the conscious effort and energy that the organization has committed to getting real about patients’-peoples’-caregivers’ central role in health care. The organization was built on providers and technology. When I first

While the prescription drug bill makes up about 10% of U.S. national health spending, the fastest-growing component of pharmacy spending is specialty medications. These are categorized as “specialty” drugs because they rarely have generic equivalents, and treat serious or life-threatening diseases (such as cancer, MS, and rheumatoid arthritis). They are also “special” because specialty pharmaceuticals average $3,000 per patient per month and can surpass $100,000 a year for certain products. As a result, the top two goals for managing specialty medications among employers are #1, to reduce inappropriate utilization, and #2, to reduce drug acquisition costs, based on a survey

  More than twice as many people value the opinions of friends and family for health care provider choices than turn to online ratings for doctors’ bedside manner, waiting times, or clinical quality, according to the Altarum Institute Survey of Consumer Health Care Opinions, Fall 2013, released on January 8, 2014. 1 in 3 consumers also looks into the cost and quality of services recommended by nurses, doctors, labs and hospitals before choosing a provider. However, most people (4 in 5) say they are comfortable asking their doctor about how much treatment will cost: 43% are “very comfortable,” and 38% somewhat comfortable,

Gird your wallets, U.S. consumers: watch the dollars flow out-of-pocket for prescription drugs in 2014, as predicted by the 2013-2014 Prescription Drug Benefit Cost and Plan Design Report published by the Pharmacy Benefit Management Institute (PBMI) this week. Constraints covering most plan members are: Step therapy Prior authorization (to get approvals to fill high-cost drugs, notably growth hormones, injectables, controlled substances, Retin-A, and medications for sleep disorders, and Compulsory 90 day refills at retail (90-day dispensing for chronic meds). This Report, sponsored by Takeda, is the gold standard of drug benefit trends, having been published since 1995. Average 30-day copayments

Coast-to-coast, stress is the modus vivendi for most Americans: 55% of people feel stressed in every day life, according to a study from Televox. A Stressful Nation: Americans Search for a Healthy Balance paints a picture of a nation of physically inactive people working too hard and playing too little. And far more women feel the stress than men do. 64% of people say they’re stressed during a typical workday. 52% of people see stress negatively impacting their lives. And nearly one-half of people believe they could better manage their stress. As a result, physicians say that Americans are experiencing negative

Americans love their cars, their houses, and their food. Based on a survey by ING Direct, the financial services company, these are the last 3 things we would sacrifice to save money. On the other hand, the most dispensable things for Americans include day care/nannies, cleaning services, education, and gifts. Women would be more likely to sacrifice health and fitness than men in the U.S. The ING survey compares the U.S. with eight other nations including Australia, Austria, Canada, France, Germany, Italy, Spain, and the United Kingdom. Health and fitness appear more highly valued by people in France and Spain;