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The Cost of Healthcare Can Drive Medical Rationing and Crowd Out Other Household Spending

One in five people in the U.S. cannot afford to pay for quality health care — an especially acute challenge for Black and Hispanic Americans, according to a West Health-Gallup poll conducted in March 2021, a year into the COVID-19 pandemic. “The cost of healthcare and its potential ramifications continues to serve as a burdensome part of day-to-day life for millions of Americans,” the study summary observed. Furthermore, “These realities can spill over into other health issues, such as delays in diagnoses of new cancer and associated treatments that are due to forgoing needed care,” the researchers expected. The first table

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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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Value-Based Health Care Needs All Stakeholders at the Table – Especially the Patient

2021 is the 20th anniversary of the University of Michigan Center for Value-Based Insurance Design (V-BID). On March 10th, V-BID held its annual Summit, celebrating the Center’s 20 years of innovation and scholarship. The Center is led by Dr. Mark Fendrick, and has an active and innovative advisory board. [Note: I may be biased as a University of Michigan graduate of both the School of Public Health and Rackham School of Graduate Studies in Economics].   Some of the most important areas of the Center’s impact include initiatives addressing low-value care, waste in U.S. health care, patient assistance programs, Medicare

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Ten Forces Shaping Health Care in 2021: A View from CVS Health

Expanding omni-channel, data-driven, cost-effective health care in the community, tailoring that care, and attending to mental health paint the picture of health through the lens of CVS Health. The company published the Health Trends Report 2021 today, calling out ten forces shaping health care this year. Those themes are, The Year of the Pharmacist The Next Step Forward in Cardiac Care Cancer Needs a Better Roadmap The EHR Hits Its Stride The Mental Health Shadow of COVID-19 Tailor Care to the Older Patient More Agents that Predict Disease Paying for the New Medical Miracle Virtual Care Goes Mainstream, and Diabetes

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Retail Health Gains Consumer Kudos in the Pandemic

The more health consumers use health and wellness services at retail, the greater their satisfaction and brand-love, according to a new report from J.D. Power. J.D. Power found that peoples’ Net Promoter Scores were higher among those folks who used at least one health and wellness service at a brick-and-mortar pharmacy, shown in the first chart. That NPS-delta was 15 points between consumers who used no services (rating an NPS of 55) versus people using at least 2 services (awarding an NPS score of 70). Consumers using more health and wellness services also spent more money at the drug store, a

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The Remarkable Rise of Pharma’s Reputation in the Pandemic

The reputation of the pharmaceutical industry gained a “whopping” 30 points between January 2020 and February 2021, based on the latest Harris Poll in their research into industries’ reputations. The study was written up by Beth Snyder Bulik in FiercePharma. Beth writes that, “a whopping two-thirds of Americans now offer a thumbs-up on pharma” as the title of her article, calling out the 30-point gain from 32% in January 2020 to 62% in February 2021. Thanks to Rob Jekielek, Managing Director of the Harris Poll, for sharing this graph with me for us to understand the details comparing pharma’s to

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The Social Determinants of Prescription Drugs – A View From CoverMyMeds

The COVID-19 pandemic forced consumers to define what were basic or essential needs to them; for most people, those items have been hygiene products, food, and connectivity to the Internet. There’s another good that’s essential to people who are patients: prescription drugs. A new report from CoverMyMeds details the current state of medication access weaving together key health care industry and consumer data. The reality even before the coronavirus crisis emerged in early 2020 was that U.S. patients were already making painful trade-offs, some of which are illustrated in the first chart from the report. These include self-rationing prescription drug

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Ten In Ten: Manatt’s Healthcare Priorities to 2031

The coronavirus pandemic has exposed major weaknesses in the U.S. health care system, especially laying bare inequities and inertia in American health care, explained in The Progress We Need: Ten Health Care Imperatives for the Decade Ahead from Manatt Health. The report details the ten objectives that are central to Manatt’s health care practice, a sort of team manifesto call-to-action and North Star for the next decade. Their ten must-do’s for bending the cost curve while driving constructive change for a better health care system are to: Ensure access Achieve health equity Stability the safety net and rebuild public health

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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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Addressing Lives and Livelihoods with a Whole-of-Government Approach – The First Wave of Biden Health Policy

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

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The 2021 Shkreli Awards: Lown Institute Counts Down the Top 10 Healthcare Industry Abuses in the Coronavirus Pandemic

The first year of the coronavirus pandemic in America was a kind of stress test on the U.S. health care system, revealing weak links and opportunities for bad behavior. “These are not just about individual instances or bad apples,” Dr. Vikas Saini, President of The Lown Institute, explained, referring to them as “cautionary tales” of the current state of U.S. health care. Dr. Saini and his colleague Shannon Brownlee released the annual Lown Institute 2020 Shkreli Awards this week, highlighting their ten most egregious examples of the worst events in U.S. health care that happened in the past year —

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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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Voting for Health in 2020

In the 2018 mid-term elections, U.S. voters were driven to polls with health care on their minds. The key issues for health care voters were costs (for care and prescription drugs) and access (read: protecting pre-existing conditions and expanding Medicaid). Issue #2 for 2018 voters was the economy. In 2020, as voting commences in-person tomorrow on 3rd November, U.S. voters have lives and livelihoods on their minds. It’s the pandemic – our physical lives looming largest in the polls – coupled with our fiscal and financial lives. Health is translating across all definitions for U.S. voters in November 2020: for

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Women’s Health Policy Advice for the Next Occupant of the White House: Deal With Mental Health, the Pandemic, and Health Care Costs

2020 marked the centennial anniversary of the 19th Amendment to the U.S. Constitution, giving women the right to vote. In this auspicious year for women’s voting rights, as COVID-19 emerged in the U.S. in February, women’s labor force participation rate was 58%. Ironic timing indeed: the coronavirus pandemic has been especially harmful to working women’s lives, the Brookings Institution asserted last week in their report in 19A: The Brookings Gender Equality Series. A new study from Tia, the women’s health services platform, looks deeply into COVID-19’s negative impacts on working-age women and how they would advise the next occupant of

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DIY Health Care and Self-Care Accelerating in the Pandemic

The coronavirus pandemic has spawned many side-effects re-shaping consumers’ everyday lives. Among them, more time at home, DIY life-flows, and financial well-being are driving growth of self-care health care. An article in the latest Drug Store News talks about consumers growing more health-conscious, adopting natural, homeopathic products. “It’s about more than washing your hands,” David Salazar explains. “Fending off illness has become a state of mind for many consumers throughout the COVID-19 pandemic.” In feeling dis-empowered in the face of the pandemic – with the first shock of the Great Lockdown and stay-at-home mandates – we’ve taken on more do-it-yourself behaviors, from

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Americans Worry About Medical Bankruptcy, As Prescription Drug Costs Play Into Voters’ Concerns

One in two people in the U.S. are concerned that a major health event in their family would lead to bankruptcy, up 5 percent points over the past eighteen months. In a poll conducted with West Health, Gallup found that more younger people are concerned about medical debt risks, along with more non-white adults, published in their study report, 50% in U.S. Fear Bankruptcy Due to Major Health Event. The survey was fielded in July 2020 among 1,007 U.S. adults 18 and older. One of the basic questions in studies like these is whether a consumer could cover a $500

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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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Pharmacies Grow for Primary Care On-Ramps – And J.D. Power Says Consumers Like That

The use of health and wellness services delivered in retail pharmacies is growing, and health consumers’ satisfaction increases with use. That’s the headline for J.D. Power’s 2020 U.S. Pharmacy Study. This is the 12th year of J.D. Power’s U.S. Pharmacy Study, this year based on a survey of 13,378 pharmacy customers who filled a prescription between June 2019 and February 2020. The study assessed four retail prescription drug channels for consumers: brick and mortar chain drug stores, brick and mortar mass merchandisers, supermarket pharmacies, and mail order. The top ranked brands were: For brick and mortar chains, Good Neighbor Pharmacy

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The Racial Divide Due to COVID-19 Also Applies to Healthcare and Pharma Costs

Into the sixth month of the coronavirus pandemic in the U.S., it’s clear that COVID-19 has wreaked a greater mortality and morbidity impact on people of color than on white adults. A new Gallup-West Health poll found that the coronavirus also concerns more non-white Americans than whites when it comes to the cost of health care and medicines to deal with the effects of COVID-19. Considering the cost of COVID-19 treatment, across all U.S. adults, 40% of people are concerned (extremely/concerned), and 41% are “not at all concerned.” Broken down by race, there is a stark difference in levels of

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Americans Across Political Party Worry About Prescription Drug Prices – Especially to Deal with COVID-19

Nine in ten Americans is concerned about the price of prescription drugs in the wake of the coronavirus pandemic, Gallup and West Health found in their survey on the cost of healthcare, published today. A majority of people across political party share this concern: overall, 88% of U.S. adults are concerned about rising drug prices in response to COVID19, split across party ID with: 94% of Democrats, 86% of Independents, and 84% of Republicans. By demographics, more women than men are concerned about rising costs for the three health care spending categories the survey studied: drug prices, insurance premiums, and

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Americans’ Concerns About the US Healthcare System Loom Larger Than Worries About Their Own Care

The coronavirus pandemic has further opened the kimono of the U.S. healthcare system to Americans: four months into the COVID-19 outbreak, most consumers (62%) of people in the U.S. are more concerned about other people not having access to high quality health care versus themselves. This is a 16 point increase in concern in May 2020 compared with the response to the same question asked in February in a poll conducted by the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research (the AP-NORC Center). The AP-NORC Poll found more of this

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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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Sex, Drugs, Mental Health and COVID Tests – A DTC Reboot for Health?

This week, Hims & Hers announced they would be a new consumer-facing retail channel for coronavirus testing. You can order the test here for $150 cash out-of-pocket. The packaging states that this is a saliva test, “to detect current presence of COVID-19.” The fine print on the Hims website states: This test has been authorized by the FDA under an Emergency Use Authorization for use by authorized laboratories. This test has not been FDA cleared or approved. This test has been authorized only for the detection of nucleic acid from SARS-CoV-2, not for any other viruses or pathogens. This test

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How COVID-19 Has Re-Shaped Health Care Delivery So Far

COVID-19 is re-shaping health care in America across many dimensions. In Shifts in Healthcare Demand, Delivery and Care During the COVID-19 Era, IQVIA presents a multi-faceted profile of the early impacts of the pandemic on U.S. health care. In the report, published in April 2020, IQVIA mined the company’s many data bases that track real-time data, including medical claims, flu data, sales data, oncology medical and pharmacy claims, formularies, among other sources. Top-line, IQVIA spotted the following key shifts in U.S. health care since the start of the coronavirus pandemic: Patients’ use of health services Impacts on medicine use, influenced

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Americans’ Top 2 Priorities for President Trump and Congress Are To Lower Health Care and Rx Costs

Health care pocketbook issues rank first and second place for Americans in these months leading up to the 2020 Presidential election, according to research from POLITICO and the Harvard Chan School of Public Health published on 19th February 2020. This poll underscores that whether Democrat or Republican, these are the top two domestic priorities among Americans above all other issues polled including immigration, trade agreements, infrastructure and regulations. The point that Robert Blendon, Harvard’s long-time health care pollster, notes is that, “Even among Democrats, the top issues…(are) not the big system reform debates…They’re worried about their own lives, their own

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[email protected] Update: Kroger and Hy-Vee Morph Grocery into Health, Walmart’s Health Center, CVS/housing and More

With our HealthConsuming “health is everywhere” ethos, this post updates some of the most impactful recent retail health developments shaping consumers’ health/care touchpoints beyond hospitals, physicians, and health plans. For inspiration and context, I’ll kick off with Roz Chast’s latest New Yorker cartoon from the February 3rd 2020 issue — Strangers in the Night, taking place in a Duane Reade pharmacy. Roz really channels the scene in front of the pharmacy counter, from Q-tips to vitamins and tea. And it’s hummable to the tune of, well, Strangers in the Night. Check out the 24-hour pharmacist under the pick-up sign. Now,

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Come Together – A Health Policy Prescription from the Bipartisan Policy Center

Among all Americans, the most popular approach for improving the health care in the U.S. isn’t repealing or replacing the Affordable Care Act or moving to a Medicare-for-All government-provided plan. It would be to improve the current health care system, according to the Bipartisan Policy Center’s research reported in a Bipartisan Rx for America’s Health Care. The BPC is a truly bipartisan organization, co-founded by Former Democratic Senate Majority Leaders Tom Daschle and George Mitchell, and Former Republican Senate Majority Leaders Howard Baker and Bob Dole. While this political week in America has revealed deep chasms between the Dems and

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The State of the Union for Prescription Drug Prices

Tonight, President Trump will present his fourth annual State of the Union address. This morning we don’t have a transcript of the speech ahead of the event, but one topic remains high on U.S. voters’ priorities, across political party – prescription drug prices. Few issues unite U.S. voters in 2020 quite like supporting Medicare’s ability to negotiate drug prices with pharmaceutical companies, shown by the October 2019 Kaiser Family Foundation Health Tracking Poll. Whether Democrat, Independent, or Republican, most people living in America favor government intervention in regulating the cost of medicines in some way. In this poll, the top

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A Uniting Issue in the United States is Lowering Prescription Drug Costs

Health care continues to be the top-ranked voting issue in the U.S. looking to the November 2020 Presidential and Congressional elections. The Kaiser Family Foundation conducts the monthly poll which gauges U.S. adults’ perspectives on health care, and this month’s January 2020 Kaiser Health Tracking Poll explores Americans’ views on broad healthcare reform plans and specific medical policy issues. Overall, Americans point to prescription drug costs and the preservation of the Affordable Care Act’s protections for people with pre-existing conditions, the first chart tells us. Third and fourth on voters’ minds are protecting patients from surprise medical bills and better

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Most Americans Regardless of Income Say It’s Unfair for Wealthier People to Get Better Health Care

In America, earning lower or middle incomes is a risk factor for having trouble accessing health care and/or paying for it. But most Americans, rich or not, believe that it’s unfair for wealthier people to get better health care, according to a January 2020 poll from NPR, the Robert Wood Johnson Foundation and Harvard Chan School of Public Health, Life Experiences and Income Equality in the United States. The survey was conducted in July and August 2019 among 1,885 U.S. adults 18 or older. Throughout the study, note the four annual household income categories gauged in the research: Top 1%

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What HealthyThinker Is Thinking About Health at CES 2020

Next week, the Consumer Technology Association (CTA) will convene CES, the Consumer Electronics Show, where over 180,000 tech-minded people from around the world will convene to kick the tires on new TVs, games, smart home devices, 5G connections, 3-D printing, drones, and to be sure, digital health innovations. At #CES2020, exhibitors in the health/care ecosystem will go well beyond wearable devices for tracking steps and heart rate. I’ll be meeting with wearable tech innovators along with consumer electronics companies and retailers. I’ve also scheduled get-togethers with pharma and life science folks, health plan people, and execs from consumer health companies.

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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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Medicare Members Are Health Consumers, Too – Our AHIP Talk About Aging, Digital Immigrants, and Personalizing Health/Care

As Boomers age, they’re adopting mobile and smart technology platforms that enable people to communicate with loved ones, manage retirement investment portfolios, ask Alexa to play Frank Sinatra’s greatest hits, and manage prescription refills from the local grocery store pharmacy. Last week, the Giant Eagle grocery chain was the first pharmacy retailer to offer a new medication management skill via Alexa. That program has the potential to change our Medicare members manage meds at home to ensure better adherence, supporting better health outcomes and personal feelings of efficacy and control. [As an aside, consumers really value pharmacies embedded in grocery

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Food As Medicine: Grocery Stores Expand as Health Destinations While the Federal Government Cuts Food Stamps

There’s something like cognitive dissonance as I prepare my 2020 Health Populi TrendCast of what to expect in the health/care ecosystem in the new year. One of my key pillars for health-making is food-as-medicine, and that opportunity in this moment resonates in this holiday season with Dickens’ “Best of Times, Worst of Times” context-setting that kicks off Great Expectations. In the “best of times” part of the food+health equation, we recognize the growing role of grocery stores, food-tech and food manufacturers in the health/care landscape. A current example comes from Kroger, partnering with Ascension’s health system in Tennessee, enhancing the organization’s

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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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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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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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Americans’ Top Sources of Stress are Money, Money, Money and Family

ABBA sang the song “Money Money Money” back in 1976. The lyrics feel, sadly, spot-on when thinking about health care costs, job-lock and Americans’ home economics in 2019. “Work all night, I work all day, to pay the bills I have to pay Ain’t it sad And still there never seems to be a single penny left for me That’s too bad… Money, money, money must be funny In the rich man’s world.” That year, ’76, wasn’t just the U.S. bicentennial — it was a year when the U.S. allocated 8.6% of the nation’s Gross Domestic Product for health care.

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Patients Growing Health Consumer Muscles Expect Digital Services

Patients’ experiences with the health care industry fall short of their interactions with other industries — namely online retail, online banking and online travel, a new survey from Cedar, a payments company, learned. Survata conducted the study for Cedar among 1,607 online U.S. consumers age 18 and over in August and September 2019. These study respondents had also visited a doctor or hospital and paid a medical bill in the past year. One-third of these patients had a health care bill go to collections in the past year, according to Cedar’s 2019 U.S. Healthcare Consumer Experience Study. Among those people

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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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Health @ Retail – Prelude to GMDC SelfCare Summit with Updates from Hims & Hers, GoodRx, Sam’s Club and Amazon Care

“We knew millions of people weren’t getting the care they needed — they were either too embarrassed to seek help or felt stuck in a system that was confusing and intimidating. Digital health has the potential to radically change the way people approach their wellness and, since launching in 2017, we’ve outpaced even our own expectations, delivering more than 1 million Hims & Hers products to our customers. In collaboration with highly-qualified doctors and healthcare providers, we’ve built a digital health platform that is changing the way people talk about and receive the care they need.” That’s  a verbatim paragraph

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The Pharma Industry Hits Bottom of Consumers’ Industry Rankings, and Healthcare Is Only Marginally Higher on the List

from Gallup’s 2019 survey into Americans’ Views of U.S. Business Industry Sectors. Since reaching a relative high regard in 2015, the pharma industry reputation among consumers has declined each year since to the low this year with 58% of Americans having a negative view. This was a 31 percentage point drop in reputation in one year. This is one negativity point above peoples’ low regard for the Federal government. Gallup notes that Americans are over two times more likely to rank the pharmaceutical industry negatively (58%) as positively (27%). The healthcare industry, apart from pharma, didn’t fare well this year in

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Happy National CBD Day! How CBD Fits Into the Retail Health Ecosystem

August 8 is National CBD Day. Who knew? Well, now you do, and I’m going to explain how this three-letter-acronym is rolling into the retail health landscape, opportunities, risks, and other issues I like to cover when forecasting the future of a new-new thing in health/care. “CBD” stands for cannabidiol, which is a derivative of cannabis, marijuana and hemp plants. CBD is the non-psychoactive compound derived from cannabis plants. CBD is being fast-adopted by consumers in retail and regulated shopping channels. One in seven Americans (14%) use CBD products, according to Gallup‘s new well-being research. One-third of U.S. consumers weren’t

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Talking “HealthConsuming” on the MM&M Podcast

Marc Iskowitz, Executive Editor of MM&M, warmly welcomed me to the Haymarket Media soundproof studio in New York City yesterday. We’d been trying to schedule meeting up to do a live podcast since February, and we finally got our mutual acts together on 6th August 2019. Here’s a link to the 30-minute conversation, where Marc combed through the over 500 endnotes from HealthConsuming‘s appendix to explore the patient as the new health care payor, the Amazon prime-ing of people, and prospects for social determinants of health to bolster medicines “beyond the pill.” https://www.pscp.tv/MMMnews/1eaJbvgovBYJX Thanks for listening — and if you

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100 Million People in America Lack Broadband — an On-Ramp to Health and Safety

One in three Americans does not have a broadband connection, according to a new report from the NPD Group. This means that about 100 million people in the U.S. can’t benefit from telehealth and other digital health connections that can bolster self-care, home care, and lower cost care. Most of these folks in the broadband-digital divide live in rural America/ “The so-called digital divide, between those that can or cannot make the best use of the Internet, can be clearly felt in rural markets where the lack of broadband impacts everything from entertainment to the educational system,” Eddie Hold, President

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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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Finances Are the Top Cause of Stress, and HSAs Aren’t Helping So Much…Yet

If you heed the mass media headlines and President Trump’s tweets, the U.S. has achieved “the best economy” ever in mid-July 2019. But if you’re working full time in that economy, you tend to feel much less positive about your personal prospects and fiscal fitness. Nearly nine in 10 working Americans believe that medical costs will rise in the next few years as they pondering potential changes to the Affordable Care Act. The bottom line is that one-half of working people are more concerned about how they will save for future health care expenses. That’s the over-arching theme in PwC’s

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Health Care and Consumers in 2030: A Profile from KPMG

A “one layered delivery network through which patients can move seamlessly as they age and their needs evolve” will be the new health care platform to meet patients’ demands by 2030, according to a forecast from KPMG’s Healthcare and Life Sciences Institute. In Healthcare 2030: The consumer at the center, the KPMG team explores the demographic shifts and market drivers that will challenge the health care industry in the current U.S. delivery and financing system. The lens on that 2030 future is a consumer-centric delivery model that KPMG believes will be a solution to dealing with a demographic divide between

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On Amazon Prime Day, What Could Health Care Look Like?

Today is July 15, and my email in-box is flooded with all flavors of Amazon Prime’d stories in newsletters and product info from ecommerce sites — even those outside of Amazon from beauty retailers, electronics channels, and grocery stores. So I ask on what will probably be among the top ecommerce revenue generating days of all time: “What could health care look like when Amazon Prime’d?” I ask and answer this in my book, HealthConsuming, as chapter 3. For context, this chapter follows two that explain how patients in the U.S. have been morphing into health consumers based on how health

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Retail Pricing in U.S. Health Care? Why Transparency Is Hard to Do

“It’s the prices stupid,” Uwe Reinhardt and Gerard Anderson and colleagues asserted in the title their seminal Health Affairs manifesto on U.S. healthcare spending. Sixteen years later, yesterday on 8th July 2019, a Federal U.S. judge blocked, in the literal last-minute, a DHHS order mandating prescription drug companies to publish “retail prices” of medicines in direct-to-consumer TV ads. I was getting this post on transparency together just before that announcement hit the press, so this post would have had a different nuance yesterday compared with today. And that’s how health care politics and economics in America roll these days. Welcome to

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Prescription Drugs Are Becoming A Luxury Good in America – Join the #HCLDR Chat Tonight

“Drugmakers Push Their Prices Higher” is the top story under the Business & Finance banner in today’s Wall Street Journal. That’s in terms of drugs’ list prices, which most patients don’t pay. But drug costs to patients are in the eye of the beholder, who in a high-deductible plan or Medicare Part D donut hole becomes the first-dollar payer. Patients continue to face rising drug costs, pushing them into what I’ve been thinking about as luxury-goods territory. The economic definition of a luxury good is a product for which demand increases more than proportionally as income rises, so that spending

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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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Kroger Health Thinks Food is Medicine – Nutrition at the Grocery Store Via FMI’s Insights

In reading the July/August issue of Eating Well magazine this week, I came across this ad which I scanned for you to see yourself: “We believe in food as medicine.” Signed, Kroger Health. Here’s the introductory text in the full-page ad: “As Kroger Health, our vision is to help people live healthier lives. And now, more than ever, through our experts, innovation, and technology, we’re uniquely positioned to bring that vision to life,” the copy read. “We know food,” the text continued, as part of The Kroger Co. which is the largest grocery chain in the U.S. celebrating 135 years

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Americans Could Foster a Health Consumer Movement, Families USA Envisions

Employers, health care providers, unions, leaders and — first and foremost, consumers — must come together to build a more accessible, affordable health care system in America, proposes a call-to-action fostered by a Families USA coalition called Consumers First: The Alliance to Make the Health Care System Work for Everyone. The diverse partners in this Alliance include the American Academy of Family Physicians, AFSCME (the largest public service employees’ union in the U.S.), the American Benefits Council (which represents employers), the American Federation of Teachers (AFT), First Focus (a bipartisan children’s advocacy organization), and the Pacific Business Group on Health

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Prescription Drug Costs In America Through the Patient Lens, via IQVIA, GoodRx and a New $2 Million Therapy

Americans consumed 17.6 prescriptions per person in 2018, two in three of which treated chronic conditions. Welcome to Medicine Use and Spending in the U.S. , the annual review of prescription drug supply, demand and Rx pricing dynamics from the IQVIA Institute for Human Data Science. In a call with analysts this week in which I participated, the Institute’s Executive Director Murray Aitken discussed the report which looks back at 2018 and forward to 2023 with scenarios about what the U.S. prescription drug market might look like five years from now. The report is organized into four sections: medical use

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Will Health Consumers Morph Into Health Citizens? HealthConsuming Explains, Part 5

The last chapter (8) of HealthConsuming considers whether Americans can become “health citizens.” “Citizens” in this sense goes back to the Ancient Greeks: I return to Hippocrates, whose name is, of course, the root of The Hippocratic Oath that physicians take. Greece was the birthplace of Democracy with a capital “D.” Hippocrates’ book The Corpus is thought to be one of the first medical textbooks. The text covered social, physical, and nutritional influences, and the concept of “place” for health and well-being. Here, the discussion detailed the roles of air and water for health. The Hippocratic texts also coached doctors to

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Health Consumers Are Now Amazon-Primed for Healthcare – HealthConsuming Explains, Part 2

As patients now assume the role of health consumer, they rationally expect retail-level experiences with greater first-dollar payment for health insurance, health care services and medical products like prescription drugs. Consumers know what good retail looks and feels like, and are focusing that experiential lens on health care, Aflac found when their Workforces Survey polled Americans on their desirable health insurance shopping experience. One in two people said it should feel, “like Amazon,” and another 20% of folks said, “like retail.” Chapter 3 of HealthConsuming is titled, “How Amazon Has Primed Health Consumers,” and explains this re-shaping of patient expectations.

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Across All Political Parties, Likely Voters Over 50 Favor Cutting Prescription Drug Prices

People over 50 in the U.S. that are likely to vote in the 2020 Presidential election are keenly interested in lowering the cost of prescription drugs, according to a survey conducted by AARP in February and March 2019. Most people over 50 take prescription drugs daily; one-third take two or three Rx’s regularly, and one in five older people take six or more prescription medicines regularly. Thus, prescription drugs are part of most older Americans’ daily life-flows and household spending considerations. About two-thirds of older people who are likely to vote say that Rx prices are “unreasonable,” including 67% of

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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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Listen Up, Healthcare: Hear The Patient’s Voice!

Consider the voice of a patient before the advent of the Internet in the digital 1.0 world, and then the proliferation of social networks in v 2.0. One patient could talk with another over their proverbial neighborhood fence, a concerned parent at the PTA meeting with others dealing with a children’s health issue, or a recovering alcoholic testifying in person at an AA session. Today, the voice of the patient is magnified one-to-many, omnichannel and multi-platform — via video, blogs, podcasts, social networks, listservs….and, yes, still in live forums like AA meetings, church basements, Y-spaces, and the Frazzled Cafe meet-ups

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The United States of Diabetes: a $1,240 Tax on Every American

Pharmaceutical company executives are testifying in the U.S. Congress this week on the topic of prescription drug costs. One of those medicines, insulin, cost a patient $5,705 for a year’s supply in 2016, double what it cost in 2012, according to the Health Care Cost Institute. Know that one of these insulin products, Lilly’s Humalog,  came onto the market in 1996. In typical markets, as products mature and get mass adoption, prices fall. Not so insulin, one of the many cost components in caring for diabetes. But then prescription drug pricing doesn’t conform with how typical markets work in theory.

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In the Modern Workplace, Workers Favor More Money, New Kinds of Benefits, and Purpose

Today, April 2nd, is National Employee Benefits Day. Who knew? To mark the occasion, I’m mining an important new report from  MetLife, Thriving in the New Work-Life World, the company’s 17th annual U.S. employee benefit trends study with new data for 2019. For the research, MetLife interviewed 2,500 benefits decision makers and influencers of companies with at least two employees. 20% of the firms employed over 10,000 workers; 20%, 50 and fewer staff. Companies polled represented a broad range of industries: 11% in health care and social assistance, 10% in education, 9% manufacturing, 8% each retail and information technology, 7%

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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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Having Health Insurance Is A Social Determinant of Health

Health insurance was on the collective minds of American voters in the 2018 midterm elections. Health care, broadly defined, drove many people to the polls voting with feet and ballots to protect their access to a health plan covering a pre-existing condition or to protest the cost of expensive prescription drugs. These were the two top health care issues among voters in late 2018, a Kaiser Family Foundation poll at the time assessed. Yesterday, President Trump verbally re-branded the Republican Party as “the party of healthcare.” That Presidential pronouncement was tied to a letter written on U.S. Department of Justice

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Patients, Health Consumers, People, Citizens: Who Are We In America?

“Patients as Consumers” is the theme of the Health Affairs issue for March 2019. Research published in this trustworthy health policy publication covers a wide range of perspectives, including the promise of patients’ engagement with data to drive health outcomes, citizen science and participatory research where patients crowdsource cures, the results of financial incentives in value-based plans to drive health care “shopping” and decision making, and ultimately, whether the concept of patients-as-consumers is useful or even appropriate. Health care consumerism is a central focus in my work, and so it’s no surprise that I’ve consumed every bit of this publication. [In

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Most Americans Across Party ID Favor U.S. Government Negotiation to Lower Rx Drug Costs

There’s little Americans, by political party, agree upon in 2019. One of the only issues bringing people together in the U.S. is prescription drug prices — that they’re too high, that the Federal government should negotiate to lower costs for Medicare enrollees, and that out-of-pocket costs for drugs should be limited. The Kaiser Family Foundation has been tracking this topic for a few years, and this month, their March 2019 Health Tracking Poll shows vast majorities of Democrats, Independents and Republicans all share these sentiments. It’s not that patients who take prescription drugs don’t appreciate them – most (58%) say medicines

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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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Cost and Convenience Underpin Patient Demands As Health Consumers

Across generations, from younger to older patients, cost, transparency and convenience drive consumer satisfaction, Accenture’s latest health consumer survey found. I had the opportunity to brainstorm the study’s findings in real-time on the day of survey launch, 12 February, with Dr. Kaveh Safavi, Brian Kalis, and Jenn Francis at HIMSS19. Our starting point was the tipping-point statistic that over 50% of people in the U.S. have chosen to use a non-traditional health care setting. Those non-traditional sites of care include walk-in and retail clinics, outpatient surgery centers, virtual health (whether on the phone, on video or via mobile apps), on-demand services,

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The Cost of Prescription Drugs, Doctors and Patient Access – A View from HIMSS19

Most patient visits to doctors result in a prescription written for a medicine that people retrieve from a pharmacy, whether retail in the local community or via mail order for a maintenance drug. This one transaction generates a lot of data points, which individually have a lot of importance for the individual patient. Mashed with other patients’, prescription drug utilization data can combine with more data to be used for population health, cost-effectiveness, and other constructive research pursuits. At HIMSS19, there’s an entire day devoted to a Pharma Forum on Tuesday 12 February, focusing on pharma-provider-payor collaborations. Allocating a full

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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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In 2023, the U.S. Will Still Be the #1 Prescription Drug Spender in the World, IQVIA Forecasts

Today, as Congress kicks off hearings about the cost of prescription drugs in the United States, IQVIA published its 2019 report on The Global Use of Medicine in 2019 and Outlook to 2023. The top-line of the research is the robust pharma market growth will be driven by two factors, and limited by two others: spending in the U.S. and emerging markets (coined “pharmerging” by IQVIA) will push up spending, while limiting factors on growth will be increasing generics and expiration of brand patents. The U.S. will continue to be the number 1 prescription drug spender in the world to

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In U.S. Health Care, It’s Still the Prices, Stupid – But Transparency and Consumer Behavior Aren’t Working As Planned

I’m glad to be getting back to health economic issues after spending the last couple of weeks firmly focused on consumers, digital health technologies and CES 2019. There’s a lot for me to address concerning health care costs based on news and research published over the past couple of weeks. We’ll start with the centerpiece that will provide the overall context for this post: that’s the ongoing research of Gerard Anderson and colleagues under the title, It’s Still The Prices, Stupid: Why The US Spends So Much On Health Care, And A Tribute To Uwe Reinhardt. It is bittersweet to

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The Consumer as Payor – Retail Health at CES 2019

All health/care is retail now in America. I say this as most people in the U.S. who have health insurance must take on a deductible of some amount, which compels that insured individual to spend the first dollar on medical services up until they meet their financial commitment. At that point, health insurance kicks in, and then the insured may have to spend additional funds on co-payments for general medicines and services, and coinsurance for specialty drugs like injectables and high-cost new therapies. The patient is a consumer is a payor, I asserted today during my talk on the expanding

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Heart Health at #CES2019 – Food and Tech as Medicine

Self-care is the new health care as patients, now consumers at greater financial risk for medical spending, are learning. At #CES2019, I’m on the lookout for digital technologies that can help people adopt and sustain healthy behaviors that can help consumers save money on medical care and enhance quality of life-years. This week’s heart-and-food tech announcements at #CES2019 coincide with an FDA recall on a popular drug prescribed to treat hypertension (high blood pressure). Using food and tech as medicine can help people avoid going on medications like statins and others for heart health. An important example of this self-care

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What #CES2019 5 Tech Trends to Watch Mean for Health/Care

As #CES2019 kicks off in Las Vegas with today’s first Media Day, the Consumer Technology Association presented its forecast on the 5 Technology Trends to Watch in 2019 — and they all play into health, wellness, and medical care. The five trends are: Artificial Intelligence on the Rise Envisioning the Smart Home of the Future Digital Health Tech Empowers Patients Esports and Sports Technology, and Smart Cities Promote Resilience. Here are how these five mega-trends can bolster our health and healthcare products and services over the next decade. AI is indeed on-the-rise in healthcare: as I have begun planning my agenda for

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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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Retail Health Ends 2018 With Big Plans for 2019

As the CVS + Aetna merger crosses its last regulatory hurdle at the close of 2018, we enter 2019 facing a fast-growing and -morphing retail health landscape. I brainstormed retail health yesterday with Patrick Freuler, CEO of Audicus (developer of hearing aids sold direct-to-consumer over-the-counter) and Shai Gozani, CEO of NeuroMetrix, maker of the Quell device for pain management. The three of us will be on a panel addressing retail health disruption at CES 2019 on 9th January 2019 at the Digital Health Summit. I explained to Shai what I’m going to say in my talk about retail health at

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The Ultimate Health Outcome, Mortality, Is Rising in America

How long can people living in the U.S. expect to live? 78.6 years of age, if you were born in 2017. That’s a decline of 0.1 year from 2016. This decline especially impacted baby boys: their life expectancy fell to 76.1 years, while baby girls’ life expectancy stayed even at 81.1 years. That’s the latest data on Mortality in the United States, 2017, soberly brought to you by the Centers for Disease Control and Prevention, part of the U.S. Department of Health and Human Services. Underneath these stark numbers are the specific causes of death: in 2017, more Americans died

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Healthcare Is Local: Channeling Tip O’Neill in the 2018 Midterm Election Results

As Tip O’Neill’s mantra goes, “All politics is local.” In the U.S. 2018 midterm elections, healthcare voting seems to have translated as a local issue, falling into O’Neill’s axiom. In this election, healthcare was the most important voting issue for consumers, PwC found, ranking above the economy, national security, and education. On this morning after 2018 midterm election results are (mostly) out, it looks like healthcare was a local and state issue for U.S. 2018 midterm voters. The Democrats flipped more than 23 seats in the U.S. House of Representatives to gain control of that chamber. The Senate is up

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On World Food Day 2018, Imagine A Chef Cooking for Patients

Today, October 16, is World Food Day. At Health Populi and THINK-Health, we celebrate the birthday of the Food and Agriculture Organization (FAO), allied with the United Nations. FAO was founded to address malnutrition and bolster a sustainable, healthy food supply for people. World Food Day 2018 has four objectives: Don’t waste food Produce more food with fewer resources Advocate for #ZeroHunger by 2030, and, Adopt a healthier, more sustainable diet. All four of these pillars play a role in health, but I’ll focus today on the fourth: the role of food as a major social determinant of health. Hunger

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CVS + Aetna: Inflection Point in US Healthcare, Merger Approved Update

    CVS Health’s acquisition of Aetna was approved this week by U.S. Federal regulators after months of scrutinizing the antitrust-size-market control implications of the deal. I wrote this post on the deal as an inflection point in American healthcare on 3rd December 2017 when CVS and Aetna announced their marriage intentions. This post updates my initial thoughts on the deal, given the morphing US healthcare market on both the traditional health services front and fast-evolving retail health environment. The nation’s largest retail pharmacy chain signed a deal to combine with one of the top three health insurance companies. The deal

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As Workers’ Healthcare Costs Increase, Employers Look to Telehealth and Wearable Tech to Manage Cost & Health Risks

Family premiums for health insurance received at the workplace grew 5% in 2018: to $19,616, according to the 2018 KFF Employer Health Benefits Survey released today by the Kaiser Family Foundation (KFF). These two trends combine for a 212% increase in workers’ deductibles in the past decade. This is about eight times the growth of workers’ wages in the U.S. in the same period. Thus, the main takeaway from the study, KFF President and CEO Drew Altman noted, is that rising health care costs absolutely remain a burden for employers — but a bigger problem for workers in America. Given that

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The Importance of Broadband and Net Neutrality for Health, to the Last Person and the Last Mile

California’s Governor Jerry Brown signed into law a net neutrality bill this weekend. Gov. Brown’s proverbial swipe of the pen accomplished two things: he went back to the Obama-era approach to ensure that internet service providers treat all users of the internet equally; and, he prompted the Department of Justice, representing the Trump Administration’s Federal Communications Commission (FCC), to launch a lawsuit. California, home to start-ups, mature tech platform companies (like Apple, Facebook and Google), and countless digital health developers, is in a particularly strategic place to fight the FCC and, now, the Department of Justice. Nearly two dozen other states

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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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Pharmacies Continue to Earn Consumer-Love

Among industries that consumers frequent, one continues to delight people more than most: pharmacies. J.D. Power’s 2018 ratings on U.S. pharmacies finds that consumers do indeed still love their pharmacies after ten years of rating customer satisfaction with brick-and-mortar and mail order channels. “U.S. consumers love their pharmacies,” J.D. Power asserts in its first study finding. In terms of total points across all pharmacies, Wegmans pharmacy was the overall top-ranked Rx retail channel with a total ranking of 906 out of 1,000 points. J.D. Power evaluated four categories of pharmacy: Brick-and-mortar chain drug stores, ranking Good Neighbor Pharmacy number one.

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Going Digital for Health Is a New-Normal for Consumers

Using digital health tech is a new normal for U.S. consumers, including Seniors, found in the 2018 digital health consumer survey from Deloitte. The title of the report, “Consumers are on board with virtual health options,” summarizes the bullish outlook for telehealth. That’s the consumer-demand side of the equation. But the tagline begs the supply side question: “Can the health care system deliver?” For a decade or longer, we’ve noted the slow uptake of telehealth and digital health tools among healthcare providers. But the consumer pressures, along with evidence-based self-service options for health – both for “care” and for wellness,

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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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Employers Take on Health Activism, Embracing Behavioral Health, Virtual Care, AI, and Transparency

More U.S. employers are growing activist roles as stakeholders in the healthcare system, according to the 2019 Large Employers Health Care Strategy and Plan Design Survey from the National Business Group on Health (NBGH). Consider the Amazon-Berkshire Hathaway-JPMorgan Chase link up between Jeff Bezos, Warren Buffet, and Jamie Dimon, as the symbol of such employer-health activism. The NBGH report is based on survey results collected from 170 large employers representing 13 million workers and 19 million covered lives (families/dependents). This annual survey is one of the most influential such reports released each year, providing a current snapshot of large employers’ views

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FANGs & MAGA – Meet WaWa for Health, Walgreens and Walmart

While Amazon and Google get lots of positive PR and media attention as major healthcare industry disruptors, don’t forget about two big “W’s,” Walgreens and Walmart, in the healthcare innovator mix. I recently read The Four in which Scott Galloway explains the dominance of Amazon, Apple, Google and Facebook in consumers’ everyday lives. These four tech-behemoths each have their particular designs on healthcare innovation, or disruption in the eyes of, say, Epic and Cerner working on health IT systems, or GE and IBM if you’ve been pioneers in health data or big-iron information technology. Then in the past week, the

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Diabetes and Independence Day: An Inflection Point for Rising Blood Sugar

In the USA, July 4th celebrates the adoption of the Declaration of Independence on that day in 1776. For people with diabetes, July 4th is also an inflection point when blood glucose spikes and kicks off a rise in blood sugar levels through autumn to New Year’s Eve. The team at Livongo observed this by mining 20 million blood glucose measures among its community of people with diabetes. This research debuted in the inaugural Insights Report, Diabetes Across America: Seasons, Regions & More. I appreciated the opportunity to discuss these findings with Dr. Jennifer Schneider, Chief Medical Officer at Livongo. I

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What the Pew Data on Americans’ Views on Technology Means for Healthcare

Most Americans say that pharmaceutical manufacturers, banks, advertisers, energy firms, and tech companies have too much power and influence in today’s American economy, according to Public Attitudes Toward Technology Companies, a research report from the Pew Research Center. A plurality of Americans says labor unions and farming and agriculture have too little power, along with a majority of people who believe that small business lacks sufficient power in the current U.S. economy. This data point is part of a larger consumer survey on Americans’ attitudes about the growing role of technology in society, particularly with respect to political and social impacts.

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The True Costs of Diabetes Go Well Beyond the Wallet

The daily life of a person managing diabetes feels many costs: at work, on relationships, at play, during sleep, on time, on mental health, and to be sure, on personal finances. The True Cost of Diabetes report from Upwell details the many tolls on the person with diabetes. The first-order impact for a patient engaging in self-care to manage diabetes is time that the many tasks in a day borrow from work, sleep, home-keeping, and relationships. Seventy percent of PwD (people with diabetes) checks blood sugar at least once a day (41% one to two times, 29% three to five

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Consumers Grow to View Food as the Prescription

Taking a page out of Hippocrates, “let food be thy medicine and medicine be thy food,” consumers are increasingly shopping for groceries with an appetite for health, found in research published this week by the International Food Information Center cleverly titled, An Appetite for Health. The top line: over two-thirds of older adults are managing more than one chronic condition and looking to nutrition to help manage disease. Most consumers have that “appetite for health” across a wide range of conditions, with two rising to the top as “extremely important:” heart health and brain function. Other top-ranked issues are emotional/mental

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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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Technology, Aging and Obesity Drive Healthcare Spending, BEA Finds

The U.S. Department of Commerce Bureau of Economic Analysis (BEA) released, for the first time, data that quantifies Americans’ spending to treat 261 medical conditions, from “A” diseases like acute myocardial infarction, acute renal failure, ADHD, allergic reactions, anxiety disorders, appendicitis and asthma, to dozens of other conditions from the rest of the alphabet. High Spending Growth Rates For Key Diseases In 2000-14 Were Driven By Technology And Demographic Factors, a June 2018 Health Affairs article, analyzed this data. This granular information comes from the BEA’s satellite account, using data from the Medical Expenditure Panel Survey which nationally examines expenditures by disease;

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