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The Pandemic’s Death Rate in the U.S.: High Per Capita Income, High Mortality

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

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Emerging with A Stronger Healthcare System Post-COVID: NAM’s Lessons Learned

The coronavirus pandemic exposed weaknesses in the U.S. health care system that existed before the public health crisis. What lessons can be learned from the COVID-19 stress-test to build American health care back better? The National Academy of Medicine is publishing nine reports addressing health stakeholder segments impacted and re-shaped by COVID-19 — for public health, quality and safety, health care payers, clinicians, research, patients-families-communities, health product manufacturers, digital health, and care systems. The report on health care systems and providers was released this week:  COVID-19 Impact Assessment: Lessons Learned and Compelling Needs was authored by experts on the front-line

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Housing as Prescription for Health/Care – in Medecision Liberation

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

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How Grocery and Retail Companies Are Delivering Health and Healthcare

The Wall Street Journal featured the grocery chain Kroger in an article yesterday titled, COVID-19 Vaccinations, Tests Give Boost to Kroger’s Health Ambitions. “With 2,250 pharmacies and 220 clinics largely in the Midwest and the southern U.S., Kroger is the fourth-largest pharmacy operator by script count,” the Journal noted, adding details about Walmart, CVS Health, and Walgreens all fast-expanding their respective health care footprints. As more consumers view their homes as personal and safe health havens, there is no shortage of suppliers in the food, retail, and mobility sectors working fast to meet that demand for convenient and accessible services.

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2020 Was Our Year of COVID; 2021 Will Be Our Year of Vaccines and Excess Deaths in America

With a third vaccine approved by the FDA for licking COVID-19, brought to market by Johnson & Johnson, the U.S. can expect an uptick in vaccinations among fellow health citizens. That’s such welcome news and a positive outlook for a healthier 2021. But there’s another angle on 2021 for which health care providers and health citizens alike should prepare: that is the excess deaths that will happen due to patients postponing needed health care, diagnostic tests, and preventive services that stem from people avoiding care in doctor’s offices and hospitals. The chart here comes from IQVIA’s latest study into COVID-19’s

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Hospitals Continue to Lose Money in Year 2 of the Pandemic

U.S. hospitals’ operating margins went negative in January 2021 after turning north for the first time in December 2020 since the start of the coronavirus pandemic, according to the February 2021 Hospital Flash Report from Kaufman Hall, commissioned by AHA, the American Hospitals Association. The first chart illustrates the importance of CARES Act funding to keep hospitals financially afloat during the public health crisis through most of last year. The start of 2021 was difficult for hospitals and health systems, Kaufman Hall explains, with falling outpatient revenues and increasing expenses resulting in that below-the-line blue bar for January 2021’s operating

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The Health Care Cost Curve is Bending Down – A New View from Deloitte

Over the next 20 years, health care spending in the U.S. will migrate toward well-being and the early detection of disease, away from the funding of America’s sick-care system, according to Breaking the cost curve, a forecast of U.S. health economics in the year 2040 from Deloitte. Current spending on health care in America is roughly $4 trillion (with a “t”) dollars, approaching 20% of the nation’s economy. By 2040, spending is projected to be $8.3 trillion based on future health trends — not historic workflows and delivery mechanisms which would consume an additional $3.5 trillion — close to what we

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The Digital Transformation of Home for Health – Brainstorming with Karsten Russell-Wood of Philips

At the start of CES 2021, I had the opportunity to catch up with Karsten Russell-Wood, Portfolio Marketing Leader, Post Acute & Home, Connected Care at Philips. We brainstormed just as CES 2021 was going to “open,” virtually, for the consumer electronics conference’s first all-virtual meeting. Philips, a longtime major exhibitor at CES, created an entirely new online experience for the CES attendees – a sort of virtual gallery of different exhibits that are accessed from a single point in a “room” with various entry points. One of the company’s key messages for CES 2021 was health care delivered outside

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Call It Deferring Services or Self-Rationing, U.S. Consumers Are Still Avoiding Medical Care

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

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Dr. Burnout – The 2021 Medscape Physician Burnout & Suicide Report

Physicians in the U.S. are experiencing “death by 1,000 cuts,” according to the 2021 Medscape Physician Burnout & Suicide Report. Medscape polled 12,339 physicians representing over 29 specialties between late August and early November 2020 to gauge their feelings about work and life in the midst of the coronavirus pandemic. Medscape researched its first Physician Lifestyle Report in 2012. That research focused on physician “happiness” and work-life satisfaction. In 2013, the issue of burnout was called out on the cover of the report, shown here with the question, “does burnout affect lifestyle?” In 2015, the Physician Lifestyle Report was titled,

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Our Homes Are Health Delivery Platforms – The New Home Health/Care at CES 2021

By Jane Sarasohn-Kahn on 18 January 2021 in Aging, Aging and Technology, Baby health, Big data and health, Bio/life sciences, Bioethics, Boomers, Broadband, Business and health, Connected health, Consumer electronics, Consumer experience, Consumer-directed health, Coronavirus, COVID-19, Data analytics and health, Demographics and health, Dental care, Design and health, Diagnostics, Digital health, Digital therapeutics, Electronic medical records, Exercise, Fitness, Food and health, GDPR, Grocery stores, Guns and health, Health and Beauty, Health at home, Health care marketing, Health citizenship, Health Consumers, Health costs, Health disparities, Health Economics, Health ecosystem, Health engagement, Health equity, Health marketing, Health media, Health Plans, Health policy, Health politics, Health privacy, Health regulation, Healthcare access, Healthcare DIY, Heart disease, Heart health, HIPAA, Home care, Hospitals, Housing and health, Internet and Health, Internet of things, Medical device, Medical innovation, Nutrition, Obesity, Oral care, Patient engagement, Patient experience, Pharmacy, Physicians, Popular culture and health, Prevention and wellness, Primary care, Privacy and security, Public health, Remote health monitoring, Retail health, Robots and health, Safety net and health, SDoH, Self-care, Sensors and health, Sleep, Smartwatches, Social determinants of health, Social responsibility, Sustainability, Telehealth, Telemedicine, Transparency, Trust, Virtual health, Wearable tech, Wearables, Wellbeing

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

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The Digital Consumer, Increasingly Connected to Health Devices; Parks Associates Kicking Off #CES2021

In 2020, the COVID-19 pandemic drove U.S. consumers to increase spending on electronics, notably laptops, smartphones, and desktop computers. But the coronavirus era also saw broadband households spending more on connecting health devices, with 42% of U.S. consumers owning digital health tech compared with 33% in 2015, according to research discussed in Supporting Today’s Connected Consumer from Parks Associates. developed for Sutherland, the digital transformation company. Consumer electronics purchase growth was, “likely driven by new social distancing guidelines brought on by COVID-19, which requires many individuals to work and attend school from home. Among the 26% of US broadband households

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Preparing for a Long-COVID Lifestyle in 2021 – A Health-At-Home Focus for CES 2021

In the U.S., the latest read on supply-and-demand for COVID-19 vaccines illustrates a gap between what had been promised for the first phase of vaccine rollout versus the reality of supply chain challenges, cold storage, and 50-state and local fragmentation at the last mile for U.S. health citizens. An op-ed published in yesterday’s Washington Post by Dr. Robert Wachter of UCSF and Dr. Ashish Jha of Brown University found these two wise physicians feeling “punched in the face” with the state of coronavirus vaccination in America. As a result, they soberly, pragmatically recommended administering just the first jab of vaccine

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Nurses, doctors, pharmacists join with teachers in Gallup’s 2021 honest and ethics poll

Each year, Americans rank nurses as the most honest and ethical professionals along, generally followed by doctors and pharmacists. In the middle of the coronavirus pandemic in the U.S., grade school teachers join the three medical professions in the annual Gallup Poll on the top-ranked professions for honest and ethical behavior in America as we enter 2021 with many U.S. hospitals’ intensive care units at full capacity….and schools largely emptied of students. The three health care professions scored their highest marks ever achieved in this Gallup Poll, which has been assessing honesty and ethics in America since 1999. Nurses are

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The 2021 Health Populi TrendCast – Health Care, Self-Care, and the Rebirth of Love in Public Health

In numerology, the symbolic meaning behind the number “21” is death and re-birth. In tarot cards, 21 is a promise of fulfillment, triumph, and victory. How apropos that feels right now as we say goodbye and good riddance to 2020 and turn the page for a kinder, gentler, healthier New Year. It would be sinful to enter a New Year as challenging as 2021 promises to be without taking the many lessons of our 2020 pandemic life and pain into account. For health care in America, it is a time to re-build and re-imagine a better, more equitable landscape for

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Will 2021 Be the Year of Sicker Americans? Pondering Late 2020 Data from IQVIA

Yesterday, IQVIA presented their end-of-year data based on medical claims in the U.S. health care system tracking the ups, downs, and ups of the coronavirus in America. IQVIA has been tracking COVID-19 medical trends globally from early 2020. The plotline of patient encounters for vaccines, prescribed medicines, foregone procedures and diagnostic visits to doctors begs the question: in 2021, will Americans be “sicker,” discovering later-stage cancer diagnoses, higher levels of pain due to delayed hip procedures, and eroded quality of life due to leaky guts? Here are a few snapshots that paint a picture for greater morbidity and potentially more “excess

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Home Is the Health Hub for Older People – Learning from Laurie Orlov

By April 2020, over one million Medicare members were receiving health care via telemedicine. The graph here shows you the hockey-stick growth for virtual care use by older Americans into the second month of the coronavirus pandemic. The COVID-19 public health crisis up-ended all aspects of daily living in America for people of all ages. For older Americans, avoiding the risk of contracting the tricky virus in public, and especially, in health care settings, became Job 1. The pandemic thus nudged older people toward adopting digital lifestyles for daily life, for shopping, for praying, and indeed, for health care. Laurie

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The Comforts of Home Drive Demand for Healthcare There

Two in three U.S. consumers skipped or delayed getting in-person medical care in 2020. One in 2 people had a telehealth visit int he last year. Most would use virtual care again. The coronavirus pandemic has mind-shifted how patients envision a health care visit. Today, most consumers prefer the idea of getting health care at home compared with going to a doctor’s office. Most Americans also like the idea of recovering at home instead of at a medical facility after a major medical event, according to the report, Health-at-Home 2020: The New Standard of Care Delivery from CareCentrix. COVID-19 has

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Rebuilding Resilience, Trust, and Health – Deloitte’s Latest on Health Care and Sustainability

The COVID-19 pandemic has accelerated health care providers’ and plans’ investment in digital technologies while reducing capital spending on new physical assets, we learn in Building resilience during the COVID-19 pandemic and beyond from the Deloitte Center for Health Solutions. What must be built (or truly re-built), health care leaders believe, is first and foremost trust, followed by financial viability to ensure long-term resilience and sustainability — for the workforce, the organization, the community, and leaders themselves. For this report, Deloitte interviewed 60 health care chief financial officers to gauge their perspectives during the pandemic looking at the future of

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Healthcare Costs, Access to Data, and Partnering With Providers: Patients’ Top User Experience Factors

As patients returned to in-person, brick-and-mortar health care settings after the first wave of COVID-19 pandemic, they re-enter the health care system with heightened consumer expectations, according to the Beryl Institute – Ipsos Px Pulse report, Consumer Perspectives on Patient Experience in the U.S. Ipsos conducted the survey research among 1,028 U.S. adults between 23 September and 5 October 2020 — giving consumers many months of living in the context of the coronavirus. This report is a must-read for people involved with patient and consumer health engagement in the U.S. and covers a range of issues. My focus in this

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The Coronavirus Pandemic Turbocharged Digital Health Investment in 2020

2020 will be remembered for disruption and dislocation on many fronts; among the major blips in the year will be it remembered as the largest funding year for digital health recorded, according to Rock Health’s report on the 3Q2020 digital health funding. This funding record (“already” before year-end, tallied by the third quarter as Rock Health notes) was driven by “mega”-deals accelerated during the public health crisis of COVID-19. In the third quarter of 2020, some $4 billion was invested in U.S. based digital health start-ups adding up $9.4 billion in 2020….so far. This is $1.2 billion more than two

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Pharma’s Future Relevance Depends on Empathy, Messaging, Partnering, and Supporting Patients and Providers

COVID-19 is re-shaping all industries, especially health care. And the pharma industry is challenged along with other health care sectors. In fact, the coronavirus crisis impacts on pharma are especially accelerated based on how the pandemic has affected health care providers, as seen through research from Accenture published in Reinventing Relevance: New Models for Pharma Engagement with Healthcare Providers in a COVID-19 World. For the study, Accenture surveyed 720 health care providers in general practice, oncology, immunology, and cardiology working in China, France, Japan, the United Kingdom, and the U.S., in May and June 2020. Top-line, Accenture points to four

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My ABCovid-19 Journal – Day 3 of 5, Letters “K” through “O”

Welcome back to my ABCovid-19 Journal, which I created/curated in the early weeks of the coronavirus pandemic. This week, I’m sharing all the letters of the alphabet with you which reminded me keywords and themes emerging as we were learning about this dastardly public health threat beginning early in 2020. In today’s Health Populi blog I bring you letters “K” through “O,” continuing through the rest of the alphabet tomorrow and Friday while I’m on a lake-side holiday that’s good for mind, body, and spirit. K is for Kirkland, Washington state In the U.S., one of the earliest hotspots for

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The Next Site for Hospital Care Is the Original One — Your Home

The coronavirus pandemic accelerated many trends and new workflows for patients and consumers, and health care providers, too. The convergence of basic needs like hygiene and safety, financial and health security, and living-working-learning-and-cooking-at-home has turbocharged a migration of more acute care delivered at home. I explore this growing concept in my latest essay on Medecision’s Liberation blog, How the Pandemic Is Accelerating the Hospital-At-Home Concept. The key points are that: Hospital-at-home services (H-a-H) combine home visits with virtual care and remote monitoring Think: advanced home care, enabled through virtual health technologies and wrap-around services both clinical and scaled social determinants

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We Are All About Hygiene, Groceries, and Personal Care in the Midst of the Coronavirus Pandemic

Pass me the Clorox…tip the UPS driver…love thy grocer. These are our daily life-flows in the Age of COVID-19. Our basic needs are reflected in the new 2020 Axios-Harris Poll, released today. For the past several years, I’ve covered the Harris Poll of companies’ reputation rankings here in Health Populi. Last year, Wegmans, the grocer, ranked #1; Amazon, #2. In the wake of the COVID-19 pandemic, U.S. consumers’ basic needs are emerging as health and hygiene, food, and technology, based on the new Axios-Harris Poll on the top 100 companies. This year’s study was conducted in four waves, with the

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A New Era of Virtual Care Has Begun, Accenture Finds

Patients embraced virtual care and communications at very high rates in the first months of the pandemic, and want to continue to use telehealth platforms after the pandemic ends. The new era of virtual care has begun and is here to stay, Accenture expects in its latest look at How COVID-19 will permanently alter patient behavior, a patient survey conducted in May 2020. Accenture polled 2,700 patients around the world, 450 participants each from China, France, Germany, Japan, the U.K., and the U.S. Patients represented one of three conditions, with one-third each managing cardiovascular, immunology/rheumatology, and oncology. Topline, consumers “faced

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The Median Hospital Charge In the U.S. for COVID-19 Care Ranges From $34-45K

The median charge for hospitalizing a patient with COVID-19 ranged from $34,662 for people 23 to 30, and $45,683 for people between 51 and 60 years of age, according to FAIR Health’s research brief, Key Characteristics of COVID-19 Patients published July 14th, 2020. FAIR Health based these numbers on private insurance claims associated with COVID-19 diagnoses, evaluating patient demographics (age, gender, geography), hospital charges and estimated allowed amounts, and patient comorbidities. They used two ICD-10-CM diagnostic codes for this research: U07.1, 2019-nCoV acute respiratory disease; and, B97.29, other coronavirus as the cause of disease classified elsewhere which was the original code

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Trust Is a Key Social Currency for COVID-Embattled Consumers

The coronavirus pandemic has re-shaped patients into consumers, concerned about managing the risk of contracting the virus, millions of people experiencing months of sheltering, working, learning, and cooking at home. Combine these new life-flows with conflicting information about the nature, severity, and life-span of COVID-19: From three levels of government leaders: The President and the Executive Branch at the Federal Level, Governors of States, and Mayors of cities; Public health agencies, especially the U.S. Centers for Disease Control and the World Health Organization; Mass media; and, Social media. Re-entering life in the “next normal” requires a large dose of trust,

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Beyond Care and Outcomes, Hospitals Must Deliver on Civics, Inclusivity, Equity, and Value – Lown Institute’s Best Hospitals

The core business of hospitals is patient care, often baked with teaching and research. But wait — there’s more, asserts the Lown Institute in their approach to ranking America’s Best Hospitals in 2020. The Institute’s methodology for assessing what’s “best” addresses ten pillars. Several of these are the “stick-to-the-knitting” components of the Webster Dictionary definition of hospital work: patient outcomes, clinical outcomes, avoiding overuse, patient safety, and a recent focus, patient satisfaction. Community benefit has been part of a hospital’s life, especially in the not-for-profit world where hospitals must demonstrate goodwill generated for and provided in the neighborhoods in which

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U.S. Hospitals Will Lose $323 Billion in 2020 – Before Accounting for Growing COVID Cases

U.S. health systems are projected to lose $323 billion in 2020 due to declining inpatient and outpatient volumes caused by the COVID-19 pandemic’s impact on the “normal” hospital business. Hospitals racked up over $200 bn in losses between March and June 2020. according to the American Hospital Association’s report, Hospitals and Health Systems Continue to Face Unprecedented Financial Challenges Due to COVID-19. AHA suggests that the $323 bn loss figure may be underestimated, as growing coronavirus cases are emerging in certain states: as of this writing, Arizona, Arkansas, Florida, Louisiana, South Carolina, Texas, and Utah among those states heating up.

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

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

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An Airline, A Hospital and A Disinfectant Brand Walk Into A(n Airport) Bar–the New Health/Care Collaboration in the Age of COVID

You’ve heard the one about three characters walking into a bar. A new collaboration between United Airlines, Cleveland Clinic and Clorox reminded me of that scenario, and that in the age of the coronavirus pandemic, collaboration can bolster our health. In the era of COVID-19, people — consumers. patients managing chronic conditions, and caregivers (whether for younger or older loved ones) — are concerned about contracting the virus. In U.S. states where governors mandated shelter-at-home for much of the first half of 2020, millions of people have become conditioned to physically distance, wear face coverings, and #StayHome. In particular, workers

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How Philips Has Pivoted In the COVID-19 Pandemic: Connected Care From Hospital to Home

What a difference 90 days makes. I was scheduled to meet with Roy Jakobs, Chief Business Leader of Connected Care at Philips, at HIMSS in Orlando on 9th March 2020. I’d interviewed Roy at CES 2020 in Las Vegas in January to catch up on consumer health developments, and the March meeting was going to cover Philips’ innovations on the hospital and acute care side of the business, as well as to learn more about Roy’s new role as head of Connected Care. HIMSS cancelled the conference just days before it was to commence….due to the great disruption of COVID-19.

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Telehealth Is Just Healthcare Now – One Post-COVID Certainty, Three Reports

As we wrestle with just “what” health care will look like “after COVID,” there’s one certainty that we can embrace in our health planning and forecasting efforts: that’s the persistence of telehealth and virtual care into health care work- and life-flows, for clinicians and consumers alike and aligned. There’s been a flurry of research into this question since the hockey-stick growth of telemedicine visits were evident in March 2020, just days after the World Health Organization uttered the “P-word:” pandemic. Three recent reports (among many others!) bolster the business and clinical cases for telehealth in America in terms of: A

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

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

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What $6,553 Buys You in America: A Luxury Watch, a Year at Valdosta State, or a PPO for One – the 2020 Milliman Medical Index

Imagine this: you find yourself with $6,553 in your pocket and you can pick one of the following: A new 2020 Breitling Navitimer watch; A year’s in-state tuition at Valdosta State University; or, A PPO for an average individual. Welcome to the annual Milliman Medical Index (MMI), which gauges the yearly price of an employer-sponsored preferred-provider organization (PPO) health insurance plan for a hypothetical American family and an N of 1 employee. That is a 4.1% increase from the 2019 estimate, about twice the rate of U.S. gross domestic product growth, Milliman points out in its report.   Milliman bases

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Honor Your Doctor – It’s National Doctors Day Today (and EveryDay)

Today, March 30, is National Doctors Day. We honor doctors annually on this day. But every day, we must honor physicians for bolstering the health and wellness of our fellow Americans, our beloved families and friends, and our selves. The Coronavirus Pandemic reminds us of the precious and scarce resource that is our national supply of physicians in America — numbering about 750,000 active clinicians in the U.S. according to the U.S. Bureau of Labor Statistics. Even before the COVID-19 crisis, physicians in America had been feeling increasingly burned out and depressed. The 2020 WebMD survey on the state of

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Wistful Thinking: The National Health Spending Forecast In a Land Without COVID-19

U.S. health care spending will grow to 20% of the national economy by 2028, forecasted in projections pre-published in the April 2020 issue of Health Affairs, National Health Expenditure (NHE) Projections. 2019-28: Expected Rebound in Prices Drives Rising Spending Growth. NHE will grow 5.4% in the decade, the model expects. But…what a difference a pandemic could make on this forecast. This year, NHE will be $3.8 trillion, growing to $6.2 trillion in 2028. Hospital care spending, the largest single component in national health spending, is estimated at $1.3 trillion in 2020. These projections are based on “current law,” the team

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Lockdown Economics for U.S. Health Consumers

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

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Telehealth and COVID-19 in the U.S.: A Conversation with Ann Mond Johnson, ATA CEO

Will the coronavirus inspire greater adoption of telehealth in the U.S.? Let’s travel to Shanghai, China where, “the covid-19 epidemic has brought millions of new patients online. They are likely to stay there,” asserts “The smartphone will see you now,” an article in the March 7th 2020 issue of The Economist. The article returns to the advent of the SARS epidemic in China in 2003, which ushered in a series of events: people stayed home, and Chinese social media and e-commerce proliferated. The coronavirus spawned another kind of gift to China and the nation’s health citizens: telemedicine, the essay explains. A

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Waking Up a Health Consumer in the COVID-19 Era

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

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Outpatient is the New Inpatient – The Future of Hospitals in America

Outpatient revenue is crossing the curve of inpatient income. This is the new reality for U.S. hospitals and why I’ve titled this post, “outpatient is the new inpatient,” a future paradigm for U.S. hospitals This realization is informed by data in a new report from Deloitte, Where have the many hospital inpatient gone? The line chart illustrates Deloitte’s top and bottom line: “The shift toward outpatient is happening and will likely have a tremendous impact on operations, business models, staffing, and capital. Health systems should prepare for the future today and start thinking not only about how to manage their

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Tools for Paying Medical Bills Don’t Help Health Consumers Manage Their Financial Health

There’s a gap between the supply of digital health tools that hospitals and health systems offer patients, and what patients-as-consumers need for overall health and wellbeing. This chasm is illustrated in The future of the digital patient experience, the latest report from HIMSS and the Center for Connected Medicine (CCM). The big gap in supply to patients vs. demand by health consumers is highlighted by what the arrow in the chart below points to: managing payments and paying bills. Nowhere in the top 10 most commonly provided digital tools is one for price transparency, cost comparing or cost estimating.  In the

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The Ill Health of Rural Hospitals in Four Charts

There are 1,844 rural hospitals operating in the U.S. That number is down by 19 in the 2019 calendar year, the worst year of rural hospital closings seen in the past decade. That hockey-stick growth of closures is shown in the first chart, where 34 rural hospitals shut down in the past 2 years. Rural U.S. hospitals are in poor fiscal health. “The accelerated rate at which rural hospitals are closing continues to unsettle the rural healthcare community and demands a more nuanced investigation into rural hospital performance,” threatening the stability of the rural health safety net, according to the

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Income Inequality is Fostering Mis-Trust, the Edelman 2020 Trust Barometer Observes

Economic development has historically built trust among nations’ citizens. But in developed, wealthier parts of the world, like the U.S., “a record number of countries are experiencing an all-time high ‘mass-class’ trust divide,” according to the 2020 Edelman Trust Barometer. For 20 years, Edelman has released its annual Trust Barometer every year at the World Economic Forum in Davos, recognizing the importance of trust in the global economy and society. Last year, it was the employer who was the most-trusted touch-point in citizens’ lives the world over, I discussed in Health Populi one year ago. This year, even our employers can’t

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The 2020 Social Determinants of Health: Connectivity, Art, Air and Love

Across the U.S., the health/care ecosystem warmly embraced social determinants of health as a concept in 2019. A few of the mainstreaming-of-SDoH signposts in 2019 were: Cigna studying and focusing in on loneliness as a health and wellness risk factor Humana’s Bold Goal initiative targeting Medicare Advantage enrollees CVS building out an SDOH platform, collaborating with Unite US for the effort UPMC launching a social impact program focusing on SDoH, among other projects investing in social factors that bolster public health. As I pointed out in my 2020 Health Populi trendcast, the private sector is taking on more public health

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In 2020, PwC Expects Consumers to Grow DIY Healthcare Muscles As Medical Prices Increase

The new year will see a “looming tsunami” of high prices in healthcare, regulation trumping health reform, more business deals reshaping the health/care industry landscape, and patients growing do-it-yourself care muscles, according to Top health industry issues of 2020: Will digital start to show an ROI from the PwC Health Research Institute. I’ve looked forward to reviewing this annual report for the past few years, and always learn something new from PwC’s team of researchers who reach out to experts spanning the industry. In this 14th year of the publication, PwC polled executives from payers, providers, and pharma/life science organizations. Internally,

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Being Transparent About Healthcare Transparency – My Post on the Medecision Blog

With new rules emanating from the White House this month focusing on health care price transparency, health care costs are in the spotlight at the Centers for Medicare and Medicaid Services. A hospital transparency mandate will go into effect in January 2021 as a final rule, and a second rule with a focus on health plans and friendly explanations-of-benefits will receive comments in the Federal Register until January 14, 2020. As patients continue to grow muscles as payors and health consumers, transparency is one key to enabling people to “shop” for those health care and medical products and services that

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Despite Greater Digital Health Engagement, Americans Have Worse Health and Financial Outcomes Than Other Nations’ Health Citizens

The idea of health care consumerism isn’t just an American discussion, Deloitte points out in its 2019 global survey of healthcare consumers report, A consumer-centered future of health. The driving forces shaping health and health care around the world are re-shaping health care financing and delivery around the world, and especially considering the growing role of patients in self-care — in terms of financing, clinical decision making and care-flows. With that said, Americans tend to be more healthcare-engaged than peer patients in Australia, Canada, Denmark, Germany, the Netherlands, Singapore, and the United Kingdom, Deloitte’s poll found. Some of the key behaviors

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Hospitals Suffer Decline in Consumer Satisfaction

While customer satisfaction with health insurance plans slightly increased between 2018 and 2019, patient satisfaction with hospitals fell in all three settings where care is delivered — inpatient, outpatient, and the emergency room, according to the 2018-2019 ACSI Finance, Insurance and Health Care Report. ACSI polls about 300,000 U.S. consumers each year to gauge satisfaction with over 400 companies in 46 industries. For historic trends, you can check out my coverage of the 2014 version of this study here in Health Populi. The 2019 ACSI report bundles finance/banks, insurance (property/casualty, life and health) and hospitals together in one document. Health

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Social Determinants of Health – My Early Childhood Education and Recent Learnings, Shared at the HealthXL Global Gathering

My cousin Arlene got married in Detroit at the classic Book Cadillac Hotel on July 23, 1967, a Sunday afternoon wedding. When Daddy drove us back out to our suburban home about 30 minutes from the fancy hotel, the car radio was tuned to WWJ Newsradio 950, all news all the time. As soon as Daddy switched on the radio, we were shocked by the news of a riot breaking out in the city, fires and looting and gunshots and chaos in the Motor City. Two days later, my father, who did business with Mom-and-Pop retail store owners in the

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More Evidence of Self-Rationing as Patients Morph into Healthcare Payors

Several new studies reveal that more patients are feeling and living out their role as health care payors as medical spending vies with other household line items. This role of patient-as-the-payor crosses consumers’ ages and demographics, and is heating up health care as the top political issue for the 2020 elections at both Federal and State levels. In research from HealthPocket, 2 in 5 Americans said they needed to reduce other household expenses to be able to afford their monthly insurance premiums. Four in ten consumers said their monthly health insurance premiums were increasing. One in four people in the

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A Tale of Two Americas as Told by the 2019 OECD Report on Health

It was the best of times, It was the worst of times, It was the age of wisdom, it was the age of foolishness, It was the epoch of belief, it was the epoch of incredulity, … starts Dickens’ Tale of Two Cities.  That’s what came to my mind when reading the latest global health report from the OECD, Health at a Glance 2019, which compares the United States to other nations’ health care outcomes, risk factors, access metrics, and spending. Some trends are consistent across the wealthiest countries of the world, many sobering, such as: Life expectancy rates fell in 19 of the

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Great Expectations for Health Care: Patients Look for Consumer Experience and Trust in Salesforce’s Latest Research

On the demand side of U.S. health care economics, patients are now payors as health consumers with more financial skin in paying medical bills. As consumers, people have great expectations from the organizations on the supply side of health care — providers (hospitals and doctors), health insurance plans, pharma and medical device companies. But as payors, health consumers face challenges in getting care, so great expectations are met with frustration and eroding trust with the system, according to the latest Connected Healthcare Consumer report from Salesforce published today as the company announced expansion of their health cloud capabilities. This is

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Will Consumers Cross the Cost-and-Trust Chasm Between Prescription Drugs and Hospitals?

People in the U.S. rank prescription drugs, lab tests, emergency room visits, dental and vision care, preventive services, chronic disease management and mental health care as the “most essential” health care services, according to the 2019 Survey of America’s Patients conducted by The Physicians Foundation. When asked what factors contribute to rising health care costs in America, most consumers cite the cost of prescription drugs. Taken together, these two data points demonstrate the potent political import of prescription drug prices as the U.S. approaches the 2020 Presidential election. The Physicians Foundation surveyed 2,001 U.S. adults between 27 and 75 years

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Learning from Dr. Eric Topol, Live from Medecision Liberation 2019

“Bold thinking is great. Bold doing is better,” Dr. Eric Topol introduced his talk yesterday at Medecision’s Liberation 2019 conference. I have the opportunity, for which I’m so grateful, of not only attending this meeting but playing a role as a speaker, a sometimes stage “emcee,” and a keynote speaker. And as an attendee, I learn so much from other speakers, fellow attendees, and Medecision staff all sharing perspectives during breakouts and networking breaks. In mode of attendee (and self-confessed collegial-groupie of Dr. Topol’s), I took in his remarks taking notes as fast as I could thanks to Mom teaching

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Wasted: $1 of Every $4 Spent on Health Care In America

A study in JAMA published this week analyzed research reports that have measured waste in the U.S. health care system, calculating that 25% of medical spending in America is wasted. If spending is gauged at $3.8 trillion, waste amounts to nearly $1 trillion. If spending is 18% of the American gross domestic product (GDP), then some 4.5% of the U.S. economy is wasted spending by the health care system and its stakeholders. In “Waste in the US Health Care System,” a team from Humana and the Univrsity of Pittsburgh recalibrated the previous finding of 30% of wasted spending to the 25%,

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The Hospital CFO in the Anxiety Economy – My Talk at Cerner’s Now/Next Conference

As patients have taken on more financial responsibility for first-dollar costs in high-deductible health plans and medical bills, hospitals and health care providers face growing fiscal pressures for late payments and bad debt. Those financial pressures are on both sides of the health care payment transaction, stressing patients-as-payors and health care financial managers alike. I’m speaking to health industry stakeholders on patients-as-payors at Cerner’s Now/Next conference today about the patient-as-payor, a person primed for engagement. That’s as in “Amazon-Primed,” which patients in their consumer lives now use as their retail experience benchmark. But consumers-as-patients don’t feel like health care today

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Prelude to Health 2.0 2019: Thinking Consumers At the Center of Digital Health Transformation

“Digital transformation” is the corporate strategy flavor of the moment across industries, and the health are sector isn’t immune from the trend. As this 13th year of the annual Health 2.0 Conference kicks off this week, I’m focused on finding digital health innovations that engage people — consumers, caregivers, patients, health citizens all. This year’s conference will convene thought leaders across a range of themes, and as is the Health 2.0 modus operandi, live demo’s of new-new things. As Health 2.0 kicks off today in pre-conference sessions, there is useful context described in a new report from the American Hospital

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Health Care Providers Grow Consumer-Facing Muscles Driven by Retail & Tech-Health Competition

As patients continue to morph into health care payers, they’re increasingly expecting value-for-money, transparency, and customer experiences that show respect, bolster trust, and deliver quality services. Is that so much to ask from health care providers? Sure is, as it turns out, based on this year’s annual report from Kaufman Hall, the 2019 State of Consumerism in Healthcare: The Bar is Rising. For several years, Kaufman Hall have developed an Index of healthcare consumerism based on several pillars that, together, gauge health care providers’ performance on consumer health engagement. Providers fall into one of four tiers, ranging from Tier 1

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Milliman Finds PPO for Family of 4 in 2019 Will Cost $28,386

This year, an employer-sponsored PPO for a family of four in the U.S. will cost $28,386, a 3.6% increase over 2018, according to the 2019 Milliman Medical Index (MMI). Based on my annual read of this year’s Index, the PPO costs roughly the same as a new Dodge Charger or a year attending the engineering school at Alfred University. The Milliman MMI team has updated the methodology for the Index; the chart shown here is my own, recognizing that the calculations and assumptions beneath the 2019 data point differ from previous years. The key points of the report are that:

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Health Care and the Democratic Debates – Round 2 – Battle Royale for M4All vs Medicare for All Who Want It – What It Means for Industry

Looking at this photo of the 2020 Democratic Party Presidential candidate debater line-up might give you a déjà vu feeling, a repeat of the night-before debate. But this was Round 2 of the debate, with ten more White House aspirants sharing views — sometimes sparring — on issues of immigration, economic justice, climate change, and once again health care playing a starring role from the start of the two-hour event. The line-up from left to write included: Marianne Williamson. author and spiritual advisor John Hickenlooper, former Governor of Colorado Andrew Yang. tech company executive Pete Buttigieg, Mayor of South Bend,

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Health Care and the Democratic Debates – Part 1 – Medicare For All, Rx Prices, Guns and Mental Health

Twenty Democratic Presidential candidates each have a handful of minutes to make their case for scoring the 2020 nomination, “debating” last night and tonight on major issues facing the United States. I watched every minute, iPad at the ready, taking detailed notes during the 120 minutes of political discourse conducted at breakneck speed. Lester Holt, Savannah Guthrie, and Jose Diaz-Balart asked the ten candidates questions covering guns, butter (the economy), immigration, climate change, and of course, health care — what I’m focusing on in this post, the first of two-debate-days-in-a-row. The first ten of twenty candidates in this debate were,

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Two-Thirds of Americans Say Healthcare Doesn’t Work Well, in RealClear Politics Poll

Health care is the top issue facing the U.S. today, one in three Americans says, with another one-fourth pointing to the economy. Together, health care + the economy rank the top issues for 62% of Americans. Health care and the economy are, in fact, intimately tied in every American’s personal household economy I assert in my book, HealthConsuming: From Health Consumer to Health Citizen. This poll from RealClear Politics, conducted in late April/early May 2019, makes my point that the patient is the consumer and, facing deductibles and more financial exposure to footing the medical bill, the payor.   Fully

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When Will Self-Service Come to Health Care?

At least one in three people who have tried out virtual health care have done so because they use technology in all aspects of life and want to do the same with their healthcare. This data point has informed my vision for self-care and the home as our health hub, bolstered in part through the research of Accenture from which this first graphic comes. A common theme at health care meetings these days is how and when health care will meet its Amazon, Apple, or Uber moment? Lately, one of my speaking topics is the “Amazon Prime-ing” of health consumers,

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Scaling the Social Determinants of Health – McKinsey and Kaiser’s Bold Move

People who are in poor health or use more health care services are more likely to report multiple unmet social needs, such as food insecurity, unsafe neighborhoods, lack of good housing, social isolation, and poor transportation access, found through a survey conducted by McKinsey. The results are summarized in Addressing the Social Determinants of Health. The growing recognition of the influence of social determinants reached a tipping point last week with the news that Kaiser-Permanente would work with Unite US to scale services to people who need them. The mainstreaming of SDoH speaks to the awareness that health is made

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Assessing the GAO’s Report on Single-Payer Healthcare in America: Let’s Re-Imagine Workflow

Calls for universal health care, some under the banner of Medicare for All,” are growing among some policy makers and presidential candidates looking to run in 2020. As a response, the Chairman of the House Budget Committee in the U.S. Congress, Rep. John Yarmuth (D-Ky.), asked the Congressional Budget Office (CBO) to develop a report outlining definitions and concepts for a single-payer health care system in the U.S.         The result of this ask is the report, Key Design Components and Considerations for Establishing a Single-Payer Health Care System, published on 1st May by the CBO. The report provides

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The Convergence of Health/Care and Real Estate

There’s no denying the growth of telehealth, virtual visits, remote health monitoring and mHealth apps in the healthcare landscape. But these growing technologies don’t replace the role of real estate in health, wellness and medical care. Health care is a growing force in retail real estate, according to the ICSC, the acronym for the International Council of Shopping Centers, which has been spending time analyzing, in their words, “what landlords should know in eyeing tenants from a $3.5 trillion industry.” Beyond the obvious retail clinic segment, the ICSC points out a key driving growth lever for its stakeholders, recognizing that,

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Americans’ Trust in U.S. Healthcare Lags Tech — and Women Are Particularly Cynical

The 2019 Edelman Trust Barometer measured the biggest gap in trust for the healthcare industry between the U.S. “informed public” and the mass population. Fewer American women, too, trust the healthcare industry than men do. “This inequality of trust may be reflective of the mass population continuing to feel left behind as compared to others, even as they recognize the advances that are being made that could benefit them. Given tone and tenor of the day, and particularly among mass population, healthcare may continue to see increasing demands for change and regulation,” Susan Isenberg, Edelman’s head of healthcare, notes in

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Health/Care Everywhere – Re-Imagining Healthcare at ATA 2019

“ATA” is the new three-letter acronym for the American Telemedicine Association, meeting today through Tuesday at the Convention Center in New Orleans.  Ann Mond Johnson assumed the helm of CEO of ATA in 2018, and she’s issued a call-to-action across the health/care ecosystem for a delivery system upgrade. Her interview here in HealthLeaders speaks to her vision, recognizing, “It’s just stunning that there’s such a lag between what is possible in telehealth and what is actually happening.” I’m so keen on telehealth, I’m personally participating in three sessions at #ATA19. On Monday 15th April (US Tax Day, which is relevant

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Medical Costs Are Consuming Americans’ Financial Health

Spending on medical care costs crowded out other household spending for millions of Americans in 2018, based on The U.S. Healthcare Cost Crisis, a survey from West Health and Gallup. Gallup polled 3,537 U.S. adults 18 and over in January and February 2019. One in three Americans overall are concerned they won’t be able to pay for health care services or prescription drugs: that includes 35% of people who are insured, and 63% of those who do not have insurance.   Americans borrowed $88 billion in 2018 to pay for health care spending, West Health and Gallup estimated. 27 million Americans

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Most Americans Blame Drug Companies, Insurers, and Hospitals for High Health Care Costs

There’s little agreement between Democrats and Republicans on a plethora of issues in American public life. But one issue that brings U.S. citizens together is agreement that the cost of health care is too high in the country, and that pharma, health plans, and providers are to blame. Welcome to health politics in America as of March 2019, according to The Public and High U.S. Health Care Costs, a poll conducted by POLITICO and the Harvard T.H. Chan School of Public Health. The first chart illustrates the common ground shared by Americans by party affiliation, with vast majorities across parties playing

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How Genomics Can Battle Killer Bacterial Infections in the Hospital – Talking With Philips at HIMSS19

When you think “genomics,” your mind probably pictures a human DNA strand. Well, my mind did, prior to meeting with Dr. Joseph Frassica and Dr. Felix Baader at HIMSS19 to discuss Philips’ approach to the tragic problem of healthcare-acquired infections that kill patients. Ever since that conversation, my mind’s eye is filled with images of MRSA cells like those shown here. At HIMSS19, Philips launched a solution that couples clinical informatics with genomic sequencing of bacteria to quickly identify and treat patients that are affected with tough-to-treat infections that, so often, result in death. Healthcare-acquired infections (HAIs) are a worldwide

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National Health Spending Will Reach Nearly 20% of U.S. GDP By 2027

National health spending in the U.S. is expected to grow by 5.7% every year from 2020 to 2027, the actuaries at the Centers for Medicare and Medicaid Services forecast in their report, National Health Expenditure Projections, 2018-2927: Economic And Demographic Trends Drive Spending And Enrollment Growth, published yesterday by Health Affairs. For context, note that general price inflation in the U.S. was 1.6% for the 12 months ending January 2019 according to the U.S. Bureau of Labor Statistics. This growth rate for health care costs exceeds every period measured since the high of 7.2% recorded in 1990-2007. The bar chart illustrates the

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“Telehealth is a digital distribution channel for health care” – catching up with Roy Schoenberg, President and CEO of American Well

Ten years ago, two brothers, physicians both, started up a telemedicine company called American Well. They launched their service first in Hawaii, where long distances and remote island living challenged the supply and demand sides of health care providers and patients alike. A decade later, I sat down for a “what’s new?” chat with Roy Schoenberg, American Well President and CEO. In full  transparency,  I enjoy and appreciate the opportunity to meet with Roy (or very occasionally Ido, the co-founding brother-other-half) every year at HIMSS and sometimes at CES. In our face-to-face brainstorm this week, we covered a wide range

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The Expectation Gap Between What Patients Want Vs What They Get

Talk to me, patients are demanding in unison. Most health consumers expect providers to communicate about routine health care and prevention; this is especially true among those patients trying to manage chronic conditions we learn from 10 Ways to Fulfill Patients’ Communication Wish List, a report based on a consumer survey from West, the communications and network infrastructure company. Four in five patients say that talking to “me” means they want personalized recommendations to their unique needs – but only one-third of patients say they’re getting that level of service from their healthcare providers. Most health consumers expect providers to communicate about

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Consumers’ and Physicians’ Growing Embrace of Digital Health via PwC

Most consumers would be willing to try an FDA-approved app or online to treat a medical condition, as well as receiving hospital care at home if would be less costly. We’ve reached an inflection point on the demand side among consumers for digital health options, PwC suggests in their report on the New Health Economy coming of age. The report outlines health/care industry issues for 2019, with a strong focus on digital health. Whether a menu of care options including virtual health to access specialists across the U.S., post-hospital virtual visits, or hospital care at-home, a majority of Americans supports

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A Smarter Home for Healthy Living at CES 2019….and a nod to Microsoft

Health begins at home. I found evidence for that, beyond my own N of 1 understanding, in a research article published in the UK in 2000 by Lyn Harrison and Frances Heywood. Lyn and Frances tested three assumptions that they believed linked housing and health: that housing contributes to health; that housing is not routinely included in health or social planning;’ and that the potential contribution of primary care is wasted. Their conclusion: that the housing-health link was not receiving the recognition that connection needs. Nearly two decades later, that housing-health link still isn’t universally embraced by health care stakeholders. But

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Costs, Consumerism, Cyber and Care, Everywhere – The 2019 Health Populi TrendCast

Today is Boxing Day and St. Stephens Day for people who celebrate Christmas, so I share this post as a holiday gift with well-wishes for you and those you love. The tea leaves have been brewing here at THINK-Health as we prepared our 2019 forecast at the convergence of consumers, health, and technology. Here’s our trend-weaving of 4 C’s for 2019: costs, consumerism, cyber and care, everywhere… Health care costs will continue to be a mainstream pocketbook issue for patients and caregivers, with consequences for payors, suppliers and ultimately, policymakers. Legislators inside the DC Beltway will be challenged by the

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Koen Kas, the Gardener of Health Tech Delights

The future of healthcare is not about being sick, Prof. Dr. Koen Kas believes. Having spent many years in life sciences in both research and as an entrepreneur, Koen now knows that getting and staying healthy isn’t about just developing medicines and med-tech: optimally, health requires a tincture of delight, Koen advises in his breakthrough, innovative book, Your Guide to Delight. Healthcare must go beyond traditional user-centered design, Koen’s experience has shown, and aspire toward design-to-delight. The concept of “delight” in healthcare, such as we experience in hospitality, grocery stores, and entertainment, is elusive. I’ve observed this, too, in my

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How MedModular Fits Into the New Lower-Cost, High-Quality, Consumer-Enchanted Healthcare World

In American health economics, there’s a demand side and a supply side. On the demand side, we’ve done a poor job trying to nudge patients and consumers toward rational economic decision making, lacking transparency, information symmetry, and basic health literacy. On the supply side, we’ve engaged in a medical arms race allocating capital resources to shinier and shinier new things, often without cost-benefit rationale or clinical evidence. On that supply side, though, I met up with an innovation that can help to bend the capital cost curve of how we envision and build new hospitals and clinics. This week, I

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Sicker Consumers Are More Willing to Share Health Data

People dealing with chronic conditions are keener to share personally-generated data than people that don’t have a chronic disease, Deloitte’s 2018 Survey of U.S> Health Care Consumers learned. This and other insights about the patient journey are published in Inside the patient journey, a report from Deloitte that assesses three key touch points for consumer health engagement. These three patient journey milestones are searching for care, using new channels of care, and tracking and sharing health data, Deloitte maps. What drives people to engage on their patient journeys has a lot  more to do with practical matters of care like convenience,

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Prescription Drugs: From Costs and Bad Reputation to Civica Rx and Amazon to the Rescue

The prices of medicines prescribed in outpatient settings rose, on average, 10.3% in 2018. Wages increased about 2.6%, and consumer prices, 1.3%, based on the 2019 Segal Health Plan Cost Trend Survey. Segal forecasts that medical cost trends will moderate for 2019, lower than 2018 rates. But to the patient, now feeling like a consumer dealing with high-deductibles and the growing sticker shock of specialty drug prices, a so-called “moderate” trend still feels like a big bite in the household budget. Specifically, specialty drug trend is expected to be 14.3% in 2019, compared with 17.7% in 2018 — still several

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Self-Care is Healthcare for Everyday People

Patients are the new healthcare payors, and as such, taking on the role of health consumers. In fact, health and wellness consumers have existed since a person purchased the first toothpaste, aspirin, heating pad, and moisturizing cream at retail. Or consulted with their neighborhood herbalista, homeopathic practitioner, therapeutic masseuse, or skin aesthetician. Today, the health and wellness consumer can DIY all of these things at home through a huge array of products available in pharmacies, supermarkets, Big Box stores, cosmetic superstores, convenience and dollar stores, and other retail channels – increasingly, online (THINK, of course, of Amazon — more on

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The Top Pain Point in the Healthcare Consumer Experience is Money

Beyond the physical and emotional pain that people experience when they become a patient, in the U.S. that person becomes a consumer bearing expenses and financial pain, as well. 98% of Americans rank paying their medical bills is an important pain point in their patient journey, according to Embracing consumerism: Driving customer engagement in the healthcare financial journey, from Experian Health. Experian is best known as the consumer credit reporting agency; Experian Health works with healthcare providers on revenue cycle management, patient identity, and care management, so the company has experience with patient finance and medical expense sticker shock. In the

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Surprise, Surprise: Most Americans Have Faced a “Surprise” Medical Bill

Most Americans have been surprised by a medical bill, a NORC AmeriSpeak survey found. Who’s responsible? Nearly all Americans (86% net responsible) first blame health insurance companies, followed by hospitals (82%). Fewer U.S. patients blamed doctors and pharmacies, although a majority of consumers still put responsibility for surprise healthcare bills on them (71% and 64% net). Most of the surprise bills were for charges associated with a physician’s service or lab test. Most surprise charges were not due to the service being excluded from a health plans provider network. The poll was conducted among 1,002 U.S. adults 18 and over

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Disruption Is Healthcare’s New Normal

Googling the words “disruption” and “healthcare” today yielded 33.8 million responses, starting with “Riding the Disruption Wave in Healthcare” from Bain in Forbes, Accenture’s essay on “Big Bang Disruption in Healthcare,” and, “A Cry for Encouraging Disruption” in the New England Journal of Medicine Catalyst. This last article responded to the question, “Can we successfully deliver better quality care for patients at a lower cost?” asked by François de Brantes, Executive Director of the Health Care Incentives Improvement Institute. “Disruption” as a noun and an elephant in our room has been with us in healthcare since the September/October 2000 issue of

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Hospitals Work to Address Customer Experience Gap With Consumers, Kaufman Hall Finds

Hospital and healthcare providers are getting real about improving patient and health consumer experience, the latest Kaufman Hall research finds. The company’s 2018 State of Consumerism in Healthcare report is out, subtitled, “Activity in Search of Strategy.” Kaufman Hall has developed a Healthcare Consumerism Index for healthcare providers based on four pillars: access to care, consumer experience, pricing, and a strong foundation of consumer insights. Based on their assessment of providers on these components, Kaufman Hall found identified four tiers of performance: The top-performing group, Tier 1, includes only 8% of providers. These are the early adopters who allocate resources

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Patients have ambitious health goals, and look to doctors for help

Consumers have health goals across many dimensions, topped with eating well, getting fit, reducing stress, sleeping better, feeling mentally well, and improving personal finances. That’s an ambitious health-and-wellness list, identified in the Health Ambitions Study, the first such research Aetna has published. Six in ten people are looking to food and nutrition for health, whether as “medicine” to deal with chronic conditions, for weight loss or general wellness, which is a frequent theme here on Health Populi. Consumers embrace their food habits as a key self-care determinant of health. Fitness, cited by most consumers, is also a can-do, self-powered activity

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As Medical Cost Trend Remains Flat, Patients Face Growing Health Consumer Financial Stress

When it comes to healthcare costs, lines that decline over time are generally seen as good news. That’s how media outlets will cover the top-line of PwC’s report Medical cost trend: Behind the numbers 2019. However, there are other forces underneath the stable-looking 6.0% medical trend growth projected for 2019 that will impact healthcare providers, insurers, and suppliers to the industry. There’s this macro-health economic story, and then there’s the micro-economics of healthcare for the household. Simply put: the impact of growing financial risk for healthcare costs will be felt by patients/consumers themselves. I’ve curated the four charts from the

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Pope Francis is a Public Health Advocate

“The world today is mostly deaf,” the Pontiff observes in Pope Francis: A Man of His Word, Wim Wenders’ documentary on this religious leader who likes to quote Dostoevsky, joke about mothers-in-law, and advocate for the sick, the poor, the disenfranchised, and Planet Earth. He is, I realized while watching this film and hearing this man of words, a public health advocate. Throughout the film, we see clips of Pope Francis washing the feet of prisoners in Philadelphia, comforting dying children in a pediatric clinic in central Africa, and speaking out to the U.S. Congress about the dangers of climate

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Doing Less Can Be Doing More for Healthcare – the Biggest Takeaway From ASCO 2018

Less can lead to more for so many things: eating smaller portions, lowering sugar consumption, and driving less in favor of walking or cycling come to mind. When it comes to healthcare utilization, doing less can also result in equal or even better outcomes. Groundbreaking research presented at this week’s ASCO meeting found that some women diagnosed with certain forms of cancer do not benefit from undergoing chemotherapy. The American Society of Clinical Oncology (ASCO) is one of the largest medical meetings annually, and at this huge meeting these research results for the TAILORx trial were huge news with big

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Health Care for a Typical Working Family of Four in America Will Cost $28,166 in 2018

What could $28,166 buy you in 2018? A new car? A year of your child’s college education? A plot of land for your retirement home? Or a year of healthcare for a family of four? Welcome to this year’s edition of the Milliman Medical Index (MMI), one of the most important forecasts of the year in the world of the Health Populi blog and THINK-Health universe. That’s because we’re in the business of thinking about the future of health and health care through the health economics lens; the MMI is a key component of our ongoing environmental analysis of the

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Consumers Shop Food for Health, But Cost Is a Barrier to Healthy Eating

One-third of Americans are following a specific eating pattern, including intermittent fasting, paleo gluten-free, low-carb, Mediterranean diet, and Whole 30, among dozens of other food-styles in vogue in 2018. It’s mainstream now that Americans are shopping food for health, with eyes focused on heart health, weight, energy, diabetes, and brain health, according to the 2018 Food & Health Survey from IFIC, the International Food Industry Council Foundation. But underneath these healthy eating intentions are concerns about the cost of nutritious foods, IFIC reports. And this aspect of home health economics can sub-optimize peoples’ health. Consider the first graph on consumers’

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Having Health Insurance Is a Social Determinant of Health: the implications of growing uninsured in the U.S.

The rolls of the uninsured are growing in America, the latest Gallup-Sharecare Poll indicates. The U.S. uninsurance rate rose to 12.2% by the fourth quarter of 2017, up 1.3 percentage points from the year before. 2017 reversed advancements in health insurance coverage increases since the advent of the Affordable Care Act, and for the first time since 2014 no states’ uninsured rates fell. The 17 states with declines in insurance rates were Arizona, Colorado, Florida, Hawaii, Illinois, Indiana, Iowa, Missouri, New Mexico, New York, North Carolina, South Carolina, Texas, Utah, Washington, West Virginia, Wisconsin, and Wyoming. Among these, the greatest

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Healthcare Information In-Security Is the New Normal

Three-fourths of healthcare providers experienced a data breach in 2017, according to the HIMSS 2018 Cybersecurity Survey. Health data insecurity is the new normal. A big piece of addressing the cybersecurity healthcare challenge is educating people who work in healthcare settings, and that has been under-funded. Only 41% of healthcare workers say they receive security training, a Forrester study learned in January 2018. Forrester also found that while healthcare organizations have experienced some of the most egregious cyberattacks, the industry allocates a smaller proportion of IT budgets to security compared with than other organizational types at a rate of 22%

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Americans’ Trust in the Healthcare System Low Compared to Rest-of-World’s Health Citizens

In the U.S., trust in the healthcare industry declined by 9 percentage points in just one year, declining from 62% of people trusting — that’s roughly two-thirds of Americans — down to 53% — closer to one-half of the population. I covered the launch of the 2018 Edelman Trust Barometer across all industries here in Health Populi in January 2018, when this year’s annual report was presented at the World Economic Forum in Davos as it is each year. The Edelman team shared this detailed data on the healthcare sector with me this week, for which I am grateful. Check

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How We Spend Versus What We Get: America’s Healthcare Spending Makes for Poor Health

The U.S. spent nearly twice as much as other wealthy countries on healthcare, mostly due to higher prices for both labor and products (especially prescription drugs). And, America spends more on administrative costs compared to other high-income countries. What do U.S. taxpayers get in return for that spending? Lower life spans, higher maternal and infant mortality, and the highest level of obesity and overweight among our OECD peer nations. These sobering statistics were published in Health Care Spending in the United States and Other High-Income Countries this week in JAMA, the Journal of the American Medical Association. The study analyzes

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The $4 Trillion Health Economy of 2020

In 2020, national health expenditures (NHE) in the United States will exceed $4 trillion to cover 334.5 million Americans. That equates to 18.4% of the Gross Domestic Product (GDP) and $12,230.40 of health spending per person. I sat in on a press call today with researchers from the Office of the Actuary working in the Centers for Medicare and Medicaid Services (CMS) to review the annual forecast of the NHE, published in Health Affairs in a statistically-dense eleven page article titled, National Health Expenditure Projections, 2017-2026: Despite Uncertainty, Fundamentals Primarily Drive Spending Growth. What are those “fundamentals” pushing up healthcare spending?

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The United States of Care Launches to Promote Healthcare for All of US

Let’s change the conversation and put healthcare over  politics.  Sounds just right, doesn’t it? If you’re reading Health Populi, then you’re keen on health policy, health economics, most of all, patients: now playing starring roles as consumers, caregivers, and payors in their own care. Andy Slavitt, former Acting Administrator of the Centers for Medicare and Medicaid Services (CMS), has assembled a diverse group of health care leaders who care about those patients/people, too, appropriately named the United States of Care. Founders include Dr. Bill Frist, former Republican U.S. Senator from Tennessee, Dave Durenberger, former Republican U.S. Senator from Minnesota, and

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