A blog covering the health/care ecosystem and people.

Reducing health care costs far outranks improving quality and safety, improving the public’s health, and upping the customer experience as Americans’ top priority for President Obama’s health care agenda, according to a post-election poll conducted by PwC’s Health Research Institute. In Warning signs for health industry, PwC’s analysis of the survey results, found that 7 in 10 Americans point to the high costs of health care as their top concern in President Obama’s second term for addressing health care issues. Where would cost savings come from if U.S. voters wielded the accountant’s scalpel? The voters have spoken, saying, Reduce payments

Health benefit costs grew a relatively low 4.1% in 2012 (5.4% for large employers), largely due to companies moving workers into lower-cost consumer-directed health plans. Last year, benefit costs grew at an annual rate of 6.1%, representing about a 30% fall in year-on-year cost growth for companies. And, coverage is up to 59% of employees having ticked down to 55% for the past couple of years. Employers expect about a 5% increase for 2013. Mercer’s National Survey of Employer-Sponsored Health Plans analysis finds that U.S. employers are looking toward 2014, when they’ll be covering more uninsured workers, and using this advance

It’s American Pharmacist Month, so let’s celebrate that key member of the health care team. Most Americans live quite close to a pharmacy, compared with peoples’ proximity to doctors, hospitals and emergency rooms. The pharmacist is not only a trusted health professional in the eyes of consumers: he/she is a key influencer on peoples’ health. And seeing as the #1 barrier to people taking prescription drugs is cost, the community-based pharmacist is in a prime position to educate, influence and motivate people to become more informed and activated health consumers. CVS Caremark’s survey of pharmacists is discussed in the company’s

U.S. health consumers continue their self-rationing behavior, forgoing prescription drug fills and doctor’s appointments due to cost. Consumer Reports annual prescription drug poll echoes the news, consistent with other surveys finding Americans skipping necessary care from Kaiser Family Foundation and the American Osteopathic Association. I’ve discussed the trend of health self-rationing identified in these polls in past Health Populi posts, here and here. Since 2011, nearly 1 in 2 health citizens younger than 65 — that is, those people without Medicare which carries the Part D prescription drug benefit — did not fill a prescription due to cost. This proportion

Among factors that contribute to patients’ positive experiences with health care providers, the doctor’s ability to access ‘my’ overall medical history is nearly as important to consumers as the doctor’s overall knowledge, training and expertise. This enlightening data point comes to us from a Harris Interactive poll conducted in July 2012 and published this week. This news is important because it’s National Health IT Week. I attended the kickoff meeting for #NHITWeek yesterday in Washington, DC, held in the Department of Health and Human Services headquarters building named for Hubert Humphrey – an early public health proponent (and trained pharmacist,

Employee benefits make up one-third of employers’ investments in workers, and companies are looking for positive ROI on that spend. Health benefits are the largest component of that spending, and are a major cost-management focus. In 2012 and beyond, wellness is taking center stage as part of employers’ total benefits strategies. In the 2012 Wellness & Benefits Administration Benchmarking study, a new report from bswift, a benefits administration company, the vast majority of large employers (defined as those with over 500 workers) are sponsoring wellness programs, extending them to dependents as well as active workers. Increasingly, sticks accompany carrots for

While 87% of U.S. adults are familiar with health providers converting paper medical records into digital records, only 26% — 1 in 4 — say they want their own medical records to go digital. This sobering statistic comes as hundreds of thousands of doctors and hospitals are migrating to electronic health records (EHRs), motivated by the U.S. government’s HITECH act which provides incentives for the adoption and so-called meaningful use of EHRs. To gauge U.S. consumers’ views on digital medical records, Xerox polled 2,147 U.S. adults ages 18 and via an online survey in May 2012. The chart illustrates several key

1 in 3 online consumers (36%) is interested in receiving customer service from the pharmaceutical industry. In particular, these engaged health consumers want contact, first and foremost, with a clinical expert associated with a pharmaceutical company: namely, a doctor or a nurse. In third place would be a patient advocate representing the pharmaceutical company. During the recording of a podcast this week hosted by Med Ad News‘s managing editor Josh Slatko, featuring Monique Levy, VP of Research at Manhattan Research, Adam Budish, SVP of Sales with Epocrates, and me, Monique mentioned this data point from the latest ePharma Consumer study conducted by

Calling Don Draper, Donny Deutsch, and the spirit of David Ogilvy: the President needs you. The President must sell the Affordable Care Act to the American people now that Justice Roberts wrote the Supreme Court’s historic 5-4 majority opinion supporting the Act, and especially the individual mandate. He argued for the majority that while the mandate is unconstitutional under the Commerce Clause which would “command people to buy insurance,” he said that the mandate is a de facto tax, as people who would choose to opt out of insurance would have an alternative of paying an IRS fine. Senator Eric

Since the advent of the Great Recession of 2008, more Americans have been splitting pills, postponing needed visits to doctors, skipping dental care, and avoiding recommended medical tests due to the cost of those health care services. Call it health care self-rationing: the Kaiser Family Foundation (KFF) has been tracking this trend for the past several years, and the proportion of American adults rationing health demand is up to 58%. This KFF Health Tracking Poll interviewed 1,218 U.S. adults age 18 and older via landline and cell phone in May 2012. As the chart illustrates, 38% of people are “DIYing” health care

What is a Mom, and especially, who is a “Digital Mom?” I’ve been asked to consider this question in a webinar today hosted by Enspektos, who published the report Digging Beneath the Surface: Understanding the Digital Health Mom in May 2012. I wrote my review of that study in Health Populi here on May 15. In today’s webinar, my remarks are couched as “Caveats About the Digital Mom: a multiple persona.” Look at the graphic. On the left, the first persona is a mother with children under 18. Most “mom segmentations” in market research focus on this segment. But what

  One-third of employers will increase investments in wellness programs in 2013. Employers look to these programs to reduce health care costs, to create a culture of health, to improve workforce productivity, and to enhance employee engagement. Workers say wellness programs are important in their choice of employer. But while employers and employee chasm agree on that point, there’s a gap between how employers see the programs’ benefits, and how aware (or unaware) employees are. Call this a Wellness Literacy Gap, akin to health literacy and health plan literacy. Over one-half of employers believe employees understand the programs they offer,

“Knowing they may need to return at some later time, patients felt they were vulnerable and dependent on the good will of their physicians. Thus, deference to authority instead of genuine partnership appeared to be the participants’ mode of working,” asserts a study into physician-patient relationships published this week in Health Affairs. The study’s title captures the top-line research finding Authoritarian Physicians and Patients’ Fear of Being Labeled ‘Difficult’ Among Key Obstacles To Shared Decision Making.  Researchers at the Palo Alto Medical Foundation Research Institute analyzed data on patients participating in focus grooups, from the age of forty and over, from

Dr. Andrew Weil, the iconic guru of all-things-health, was joined by a panel of health stakeholders at this morning’s Edelman salon discussing Wellness Ignited – Now and Next. Representatives from the American Heart Association, Columbia University, Walgreens, Google, Harvard Business School, and urban media mavens Quincy Jones III and Shawn Ullman, who lead Feel Rich, a health media organization, were joined by Nancy Turett, Edelman’s Chief Strategist of Health & Society, in the mix. Each participant offered a statement about what they do related to health and wellness, encapsulating a trend identified by Jennifer Pfahler, EVP of Edelman. Trend 1: Integrative

Less is more when it comes to health care utilization and outcomes. The U.S. allocates too many resources to a huge line item of waste in the health system – administrative (in terms of too many paper processes and staff to deal with them) and clinically (especially involving duplicated tests and ineffective treatments that aren’t based on evidence based medicine). “Take less” is the tagline of the company called help which is found at the URL http://www.helpineedhelp.com/.  This is a consumer-facing over-the-counter drug supplier. Their product line counts 7 mature products each packaged with the health complaint they target: “Help,” I have

The Big Headline under the banner of Health Economics this week is the statistic that growth in U.S. national health spending slowed to an anemic 3.9%  in 2010 — the slowest rate of growth in the 51-year history of keeping the National Health Expenditure Accounts.   Before American policymakers, providers, plans and suppliers pat themselves on their collective back on a job well-done, the heavy-lifting behind this story was largely undertaken by health consumers themselves in the form of facing greater co-pays, premiums and prices for health services — and as a result, self-rationing off health care services and utilization, which

People enrolled in consumer-directed health plans (CDHPs) are more likely than enrollees in traditional health insurance products to be cost-conscious. In particular, CDHP members check prices before they receive health care services, ask for generic drugs versus branded Rx’s, talk to doctors about treatment options and their costs, and use online cost-tracking tools. Furthermore, CDHP members are also more likely to use wellness programs offered by their employers, and are offered “carrots” to participate in them in the forms of financial rewards and other incentives, as well as reduced health care insurance premiums. The 7th annual Employee Benefits Research Institute

The U.S. public’s views on health reform — the Affordable Care Act (ACT) – remain fairly negative, although the percent of people feeling favorably toward it increased from 34% to 37% between October and November. Still, that represents a low from the 50% who favored the law back in July 2010. It’s quite possible that American health citizens’ views on health reform are largely reflective of their more general feelings about the direction of the country and what’s going on in Washington right now, versus what’s specifically embodied in the health care law, according to the November 2011 Kaiser Health

The vast majority of employers who sponsor health benefits look at those benefits as part of a larger organization culture of health. While one-third are adopting value-based health plan strategies — doubling from 16% in 2010 to 37% in 2011 — only 3% of employers are taking an integrated view of value-based benefits and corporate wellness. This is the second year for the International Foundation of Employee Benefit Plans (IFEBP) and Pfizer to examine employers’ approaches to value-based health care (VBHC). As explained by Michael Porter, the guru on health value chains, value in health care focuses on the patient at

The growth in prescription drug costs covered by employers and Rx plan sponsors are driving them to adopt a long list of utilization management and price-tiering strategies looking to 2012, according to the 2011-2012 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda Pharmaceuticals. The average drug trend for 2011 — that is, the average annual percentage increase in drug cost spending — was 5.5%, 1.5 percentage points greater than general price inflation of about 4%. The generic fill rate was 73% of prescription drugs purchased at retail. While drug price inflation is expected to increase in 2012, plan

A picture’s not only worth the proverbial thousand words, but can save a life. So can a t-shirt…er, TeachShirt. At the Unniched meeting held on 25 October 2011 in NYC, I spent a few minutes talking with two members of Zemoga‘s brain trust: Sven Larsen, Chief Marketing Office, and the firm’s Principal Design guru, Dan Licht. We discussed how design is so critical a factor in health, and in life — particularly, in DIY health, where we are all taking on more responsibility for our own health care — clinical, financial, mental, social. Among Zemoga’s colorful and uber-creative portfolio is its concept, the

The recessionary, sluggish U.S. economy has had an impact on Americans’ mental and physical health. The least healthy citizens have experienced a disproportionately hard hit on their health and health care. But necessity being the mother of invention, some people are re-inventing their personal workflows in health care — and many of these tactics may well benefit their health in the long run. The Economy and Health: 10 Observations is the analysis from Euro RSCG‘s survey of U.S. adults’ views on their personal health in light of the continued economic downturn. The first chart shows the economy’s impact on the overall mood of

Representatives from eight U.S. Federal government agencies, including the FDA and Veterans Administration, among others; health financiers (VCs, angels); health tech start-ups; providers, life science companies, and analysts, attended the Health Care Innovation Day DC sponsored by West Wireless Health Institute on April 28, 2011. The meeting had the tagline, A Discussion with the FDA, setting the stage for a day-long consideration of the role of regulation vis-a-vis health innovation. The $2.5+ trillion question (annual spending on health care in the U.S.) is: can innovation drive making health care “cheaper?” This was the underlying theme of the panel on which I sat

Today’s kickoff of the National eHealth Collaborative‘s Consumer Consortium on eHealth convened the most diverse workgroup of over 70 stakeholders with various lenses on consumers and health, rarely seen at similar meetings, as Lygeia Ricciardi (@lygeia) of the Office of the National Coordiantor for Health IT (ONC) in the Department of Health and Human Services, observed. However, although representing every conceivable segment of health consumer stakeholders, from seniors (AARP)  and physicians (MGMA) to people with disabilities (AAPD), women (National Partnership for Women and Families) and people who fall through the health safety net (the National Health IT Collaborative for the Underserved), there was concurrence

The environmental landscape for pharmaceutical manufacturers and retail pharmacies is marked with landmines, yield signs, and cautionary wild cards: health reform, supply chain dynamics, specialty drug pricing, pharmacogenomics, and the high burden of chronic disease among them. But the crux of the challenge for achieving optimal outcomes has less to do with these factors than it does with consumer behavior: specifically, the chasm between what people/health consumers say they want versus what people actually do. Express Scripts calls this “The Intent-Behavior Gap,” and it’s the theme of the company’s 2010 Drug Trend Report, Complex Challenges, New Solutions. The cost of sub-optimal pharmacy behaviors are huge: in 2010, pharmacy-related waste

  About 1 in 10 people in the U.S. suffer from migraine headaches. The direct cost to business for medical care and wage replacement is over $1 bn, but this underestimates the total economic impact of lost productivity to the economy and personal lives (for more on  whole-health costs, read yesterday’s Health Populi, Lost Costs: Lost Productivity Represents One-Half of Health Costs for U.S. Employers). There are actually 14 kinds of headaches, as classified by the International Headache Society (IHS). Among these, there are four primary headache types: migraine, tension-type headaches, cluster headaches and trigeminal autonomic cephalagias, and a fourth

While 8 in 10 U.S. adult internet users seek health information online, they’re not the people you might assume would take advantage of the opportunity to do so. This lightbulb moment is brought to you by the Pew Internet & American Life Project’s latest survey analysis,  Health Topics: 80% of internet users look for health information online. For example, while 2 in 3 U.S. adults with one or more chronic condition go online, only one-half of them are looking online for health information. Among the 54% of online adults with disabilities, only 42% of them seek health information online. Among the 88%

I’m talking today at the 2011 Annual PPO Forum held by the American Association of Preferred Provider Organizations (AAPPO) on the track called, “Technology Changing the Face of Health Care: What Does 21st Century Care Look Like?” It looks like consumers connecting for health, which is the topic of my discussion. People already DIY-many aspects of daily living online, from financial management through Schwab and eTrade online to buying travel via Priceline and shopping for shoes on Zappos. A growing number of health citizens are engaging with health online — way past the tipping point for health search online, as Susannah

1 in 2 people who use the internet to seek health information do so to self-diagnose; this is highest in China, US, UK, Russia, and Australia. Furthermore, health citizens in emerging economies including India, Russia, China, Brazil, and Mexico, may rely more on online health searches than people in developed countries. In these regions, health seekers face high costs of face-to-face visits with medical professionals. These global findings come out of the report, Online Health: Untangling the Web, from Bupa. Bupa is a health company based in the UK that serves 10 million members in 190 countries, and another 20 million

In a ballroom at the Hilton Union Square in San Francisco on October 6, 2010, several hundred people shared ideas, debated, and painted a multi-faceted picture of the NewPatient: the networked patient. The meeting was convened, in “unconference” style, in conjunction between the Health 2.0 Conference and Gilles Frydman, founding father of ACOR, the Association of Cancer Online Resources. Gilles knows a lot about the NewPatient: he’s organized people focused on cancer for over 15 years through his organization, which has helped tens of thousands of health citizens connect to clinical trials, researchers, information, and each other – all seeking to

People in the U.S. covered by employer-sponsored health insurance assess their health insurance choices with the help of their human resource departments. Here, Blondie and Dagwood are having a discussion about three alternatives: A low cost plan A higher cost plan with better coverage A high-deductible health plan for doctors who are outside of the plan’s network. Dagwood’s solution? “Stay healthy.” Would that it were so easy! Evaluating health insurance options is no simple task, even for the savviest, Consumer Reports-reading consumers. Health citizens who want to engage as health care consumers look for trusted sources on how to make rational

Detractors of direct-to-consumer advertising (DTC) contend that the ads promote consumers asking for pills they don’t often need, medicalize normal life conditions (such as menopause and sleeplessness), and drive up unnecessary medical spending. A team of researchers now finds that DTC can play an important, positive role in motivating health consumers to adopt healthy behaviors. “The intention to engage in healthy lifestyles was strengthened by exposure to familial risk cues in DTC ads and this effect was mediated through enhanced efficacy to take healthy actions,” the paper concludes. Familial risk cues engendered positive self-efficacy. This is the first empirical study that

It’s not news that most Americans seek health information online; 9 in 10 do so, and that number plateaued in the past few years. What is news, though, is that people are seeking health information more frequently. 1 in 3 Americans looks online for health information often, compared with just over 1 in 5 just one year ago. The Harris Poll conducted in July discovered that health information seekers are more intense than ever. On average, so-called Cyberchondriacs seek health info 6 times a month. And they’re pretty satisfied with the information they’ve found. Only 9% say their searches have

People foresee that, in the future, the most trusted ‘channel’ for their engaging in their health will be…conversations with my doctor. This was found in the 2008 Edelman Health Engagement Barometer survey of health citizens polled in five countries — China, Germany, Russia, the United Kingdom and the United States. Those health citizens favoring the physician-conversation channel will welcome OpenNotes into their doctor-encounters behind the exam room door. The July 20, 2010, issue of the Annals of Internal Medicine talks about an initiative to, literally, open up doctors’ notes to their patients. As Dr.Tom DelBanco, et. al., attest in the article, “‘open notes’

  Did you ever play the whac-a-mole game? As Wikipedia describes it, “A typical Whac-A-Mole machine consists of a large, waist-level cabinet with five holes in its top and a large, soft, black mallet. Each hole contains a single plastic mole and the machinery necessary to move it up and down. Once the game starts, the moles will begin to pop up from their holes at random. The object of the game is to force the individual moles back into their holes by hitting them directly on the head with the mallet, thereby adding to the player’s score.”   Health care

Health care delivered in today’s model can be thought of as a mass market product. There’s not much customization, even though to each of us, our health is extremely personal to us.   Welcome to the emerging era of personalized medicine: “the right treatment for the right person at the right time.” This is just-in-time, customized, measure-twice-cut-once care bespoke for the individual.   Read more about this transformational market in PricewaterhouseCoopers’ report, The new science of personalized medicine: Translating the promise into practice.   Personalized medicine includes several segments: Personalized medical care, such as telemedicine, health information technology and disease

“A nation that continues year after year to spend more money on military defense than on programs of social uplift is approaching spiritual doom.” So spoke Martin Luther King, Jr. on April 4, 1967 — one year before his assassination.   In this week that’s sure to be inspirational and aspirational, I ponder Dr. King and the state of health care in America.   Health disparities continue to mar the State of American Health Care. “Race remains a significant factor in determining whether an individual receives care, whether an individual receives high quality care, and in determining health outcomes,” according

The reputation of the pharma industry continues to lag behind other consumer-facing businesses, based on Harris Interactive’s latest survey into corporate reputations. The 9th annual Reputation Quotient survey is out. Technology is king; other industries, like airlines, consumer products, insurance/financial services, pharmaceutical and retail – have plummeted over the past two years, according to Harris Interactive. Harris points out in its press release that it’s more than profits that consumers rate highly for corporate reputation. It’s a combination of social responsibility, vision, and how employees are treated. This combo can generate trust between a company and its consumers. The Top

Health plan illiteracy is alive and well, according to J.D. Power and Associates. The consumer market research firm’s 2008 National Health Insurance Plan Study finds that 1 in two plan members don’t understand their plan. In this second year of the survey, J.D. Power notes that, as consumers understand the benefits of their Benefit, their satisfaction with the plan increases. Thus, there is a virtuous cycle that happens between a plan and an enrollee when communication is clear and understood.   J.D. Power looked at member satisfaction in 107 health plans throughout the U.S. in terms of 7 key metrics:

The annual financial burden of health illiteracy costs between $106 and $238 billion. This is enough money to cover the 47 million uninsured people in America.   That metric, and many other insights, were published this week in an important new report called, Low Health Literacy: Implications for National Health Policy. The report was written by Dr. John Vernon, a professor of finance at the University of Connecticut, and three colleagues from the University of Central Florida, George Washington University, and an executive from Pfizer. This research was sponsored by Pfizer, which has been promoting health literacy as part of