A blog covering the health/care ecosystem and people.

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.

Looking for health information online is just part of being a normal, mainstream health consumer, according to the third Rock Health Digital Health Consumer Adoption Survey published this week. By 2017, 8 in 10 U.S. adults were online health information hunters. Six in 10 Americans looked for reviews of healthcare providers online, another new-normal consumer digital health activity. But only one in four people had used wearable technology for health, and one in five had participated in a live video telemedicine encounter. The Rock Health team observes that “the needle has not moved equally across every type of digital health solution.” Thus the

The two top stressors in American life are jobs and finances. “My weight” and my family’s health follow just behind these across the generations. Total Well-Being, a research report from Fidelity Investments, looks at the inter-connections between health and wealth – the combined impact of physical, mental, and fiscal factors on our lives. The first chart summarizes the study’s findings, including the facts that: One-third of people have less than three months of income in the bank for emergency Absenteeism is 29% greater for people who don’t have sufficient emergency funds saved People who are highly stressed tend not to

  There’s growing evidence that a majority of U.S. voters, across the three-party landscape, agree on two healthcare issues this year: coverage of pre-existing conditions, and lowering the consumer-facing costs of prescription drugs. A new poll jointly conducted by Politico and the Harvard Chan School of Public Health bolsters my read on the latter issue – prescription drug pricing, which has become a mass popular culture union. There may be no other issue on voters’ collective minds for the 2018 mid-term election that so unites American voters than the demand for lower-cost medicines. This is directly relates to consumers’ tri-party

If you live in one of nine U.S. states, your chances of having heart disease are greater than living in the 41 others. This geography-as-destiny for heart conditions is examined in The Burden of Cardiovascular Diseases Among US States, 1990-2016 published in JAMA Cardiology. Researchers analyzed data on cardiovascular disease mortality, nonfatal health outcomes, and risk factors by age, sex, and year from 1990 to 2016 for the U.S. population. The outcome used to measure health by state was cardiovascular disease disability-adjusted life-years, or DALYs (FYI, “DALYs” are a commonly used metric in health economics research).   Pennsylvania While overall cardiovascular

Lady Liberty beckons to welcome the tired, the weary, and the ambitious to America in this Shinola video, made in my hometown Detroit. May this bring you joy and positive vibes on Independence Day 2018.  

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

What if you went to visit a Vermeer still life with fruit, vegetables, and flowers, and the only image you saw in the famous painting was the flower and an urn? What if you heard the sounds of a juicing machine whirring as you reflected on a Rembrandt? That’s exactly what happened to museum-goers visiting Amsterdam’s Rijksmuseum. These art patrons witnessed a museum guard literally pulling an apple out of a painting, to leave a barren portrait of an urn and little else. Roll over, Anthony Oberman, the artist of “Still Life with Fruit in a Terracotta Dish,” one of

While the use of medicines continues to rise in the U.S., spending grew by only 0.6% in 2017 after accounting for discounts and rebates. In retail and mail-order channels, net spending fell by 2.1%. Prescription drug spending on branded products grew nearly $5 billion less than in 2016; generic drug spending fell by $5.5 billion, according to Medicine Use and Spending in the U.S., a report from the IQVIA Institute for Health Data Science. The report reviews medicines spending in 2017 looking forward to 2022. There were over 5.8 billion prescriptions dispensed in 2017, and generic drugs accounted 90% of

Walmart has been a health/care destination for many years. The company that defined Big Box stores in their infancy grew in healthcare, health and wellness over the past two decades, pioneering the $4 generic prescription back in 2006. Today, that low-cost generic Rx is ubiquitous in the retail pharmacy. A decade later, can Walmart re-imagine primary care the way the company did low-cost medicines? Walmart is enhancing about 500 of 3500 stores, and health will be part of the interior redecorating. Walmart has had ambitious plans in healthcare since those $4 Rx’s were introduced. Here’s a New York Times article from

U.S. consumers rank supermarkets, fast food chains, retailers, and banks as their top performing industries for experience according to the 2018 Temkin Experience Ratings. Peoples’ experience with health plans rank at the bottom of the roster, on par with rental cars and TV/Internet service providers. If there is any good news for health plans in this year’s Temkin Experience Ratings compared to the 2017 results, it’s at the margin of “very poor” performance: last year, health plans has the worst performance of any industry (with the bar to the furthest point on the left as “low scoring”). This year, it

Amazon is planning to extend Prime subscriptions to people enrolled in Medicaid for the discount price of $5.99 a month instead of the recent price increase to $12.99/month or $99 a year. The $5.99 a month calculates to a 27% break on the annual Prime membership cost. Medicaid enrollees who want to take advantage of the deal must provide Amazon with a scan or image of the card they use for their benefit (either Medicaid or EBT). These consumers can enroll annually, for a maximum of four years. Here’s what the Seattle Times, Amazon’s hometown newspaper, said about the program.

Stories about three fashion brands have me thinking about women and their health economics. Stay with me. Target unveiled its new line of clothing, Universal Thread, which features pieces that are accessible to women who may be dealing with physical limitations or sensory challenges. I first read about Universal Thread on The Mighty website, which is a community of over 1 million people interested in connecting on health and disabilities. As The Mighty described, the brand Universal Thread, “is centered around denim since it is a staple in many women’s wardrobes, but denim can be uncomfortable for many people with disabilities

Picture this scenario: you, the consumer, take a dollar and spend it, and you get 90 cents back. In what industry is that happening? Here’s the financial state of healthcare in America, explained in the 2016 Health Care Cost and Utilization Report from the Health Care Cost Institute (HCCI). We live in an era of Amazon-Primed consumers, digital couponing, and expectations of free news in front of paywalls. We are all in search of value, even as the U.S. economy continues to recover on a macroeconomic basis. But that hasn’t yet translated to many peoples’ home economics. In this personal

While a phrase containing the words “health” and “Las Vegas” may seem a dichotomy, there will be a lot of health-tangent goods and services I’ll be seeking next week at the annual CES. This year, health will be ubiquitous at this huge conference, whose three-letter acronym for “consumer electronics show” typically conjures up images of shiny new things in the guise of automobiles, video games, big TV screens, and drones. At CES 2018, health will go beyond wearable tech and the first phase of fitness that’s been growing at the meeting over the past five years since I began attending

The nation’s largest retail pharmacy chain signed a deal to combine with one of the top three health insurance companies. The deal is valued at $69 billion. I wrote about this inflection point for U.S. healthcare four weeks ago here in Health Populi. CVS is both the biggest pharmacy and pharmacy benefit manager in the U.S., as the first chart shows. In my previous post, I talked about the value of vertical integration bringing together the building blocks of retail pharmacy and pharmacist care, retail clinics, the PBM (Caremark), along with Aetna’s health plan member base and business. As Amazon and other

It takes more than enrolling in a high-deductible health plan (HDHP) for someone to immediately morph into an effective health care “consumer.” Research from Dr. Jeffrey Kullgren and his team from the University of Michigan found that enrollees in HDHPs could garner more benefits from these plans were people better informed about how to use them, including how to save for them and spend money once enrolled in them. The team’s research letter was published in JAMA Internal Medicine on 27 November 2017. The discussion details results of a survey conducted among 1,637 people 18 to 64 years of age

The math is straightforward. Assume “A” equals $59.039, the median household income in 2016. Assume “B” is $18,142, the mean employer-sponsored family insurance premium last year. B divided by A equals 30.7%, which is the percent of the average U.S. family’s income represented by the premium cost of health insurance. Compare that to what American households spent on food: just over $7,000, including groceries and eating out (which is garnering a larger share of U.S. eating opportunities, a topic for another post). Thus, health care represents, via the home’s health insurance premium, represents 2.5 times more than food for the

“With Mad Men still in charge, ad campaigns miss the mark,” an editorial published this week in the Financial Times asserts. Leave it to a fiscally conservative British publication to be spot-on about a particularly, but not uniquely, American challenge, in this post-Weinstein (Miramax), -Price (Amazon), and today, -Halperin (MSNBC) moment of sexual harassment revelations. In health/care, women are key consumers, buyers and influencers, yet under-represented in the Mad Men demographic of senior advertising executives, as the data-driven FT essay points out. So it’s especially heartening to find this month a few examples of empowering, inspiring ad campaigns getting health/care marketing

Most consumers access the Internet for health information before they ask their doctor for the same information. But virtually everyone who goes online for health information would trust a website recommended to them by their doctor, according to the dotHealth Consumer Health Online – 2017 Research Report. This survey was conducted on behalf of dotHealth, an internet registry company channeling “.health” domains to organizations in the broad health and healthcare landscape. [FYI, both Health Populi and JaneSarasohnKahn are also registered with .health domains, having availed ourselves of this service at launch]. Six in 10 consumers who have used the internet in the

While more U.S. patients are use digital health tools and take on more clinical and financial decision making for their health care, people also have gaps in health engagement and health literacy. Three studies published in early October 2017 provide insights into the state of healthcare consumerism in America. The 2017 UnitedHealthcare Consumer Sentiment Survey found that a plurality of Americans (45%) turn first to primary care providers (doctors or nurses) as their source for the first source of information about specific health symptoms, conditions or diseases. 28% of people also use the internet or mobile health apps as their

“Wellness is a way to cope with the demands and rigors of new modern lifestyles,” according to Ogilvy in their latest report, The Wellness Movement Pioneers: New Global Research Findings. The report makes the case that the mass public are project-managing life adopting mental health, nutrition, physical activity and sleep to boost personal wellness. There is a big business model underneath this, which has inspired Ogilvy to start up the company’s Health & Wellness Practice. Think of this report as the group’s own business case to address the $3.7 trillion global wellness economy, illustrated by the first image. The report

When a family eats together, they eat more nutritiously, A family that shares 3 or more meals together each week has a 24% greater consumption of nutritious food. Yet only one-half of families in the U.S. with kids under 18 eat dinner together every night of the week, a Gallup poll found. It’s National Family Meals Month. Eating together as a family is a social determinant of health, and the Food Marketing Institute dedicates the month of September to promote the old school concept of the “family meal.” Nutrition habits are built from early childhood. More kids are showing interest

Most U.S. consumers support the idea of price-shopping for healthcare, but don’t practice it. While patients “should” shop for health care and perceive differences in costs across providers, few seek information about their personal out-of-pocket costs before getting treatment. Few Americans shop around for health care, even when insured under a high-deductible health plan, conclude Ateev Mehrotra and colleagues in their research paper, Americans Support Price Shopping For Health Care, But Few Actually Seek Out Price Information. The article is published in Health Affairs‘ August 2017 issue. The bar chart shows some of the survey results, with the top-line finding

The business and mission of pharmacies are being re-shaped by several major market forces, most impactful being uncertain health reform prospects at the Federal level — especially for Medicaid, which is a major payor for prescription drugs. Medicaid covered 14% of retail prescriptions dispensed in 2016, according to QuintilesIMS; Medicare accounted for 27% of retail prescriptions. “But if affordability, accessibility, quality, innovation, responsiveness and choices are among the standards that will be applied to any future changes, pharmacy has strong legs to stand on,” Steve Anderson, president and CEO of the National Association of Chain Drug Stores, said in the PoweRx Top 50

There’s more evidence of shopping behavior among patients: there’s new data showing that patients-as-consumers switch healthcare providers not due to quality of care or costs, but because of lack of service. I discovered one key verb and feature patient-consumers expect from doctors: it’s the ability to text, for appointment reminders, alerts, treatments, and communicating with the practice. SolutionReach, in the business of patient engagement, conducted a survey among 500 consumers asking about primary care providers, communication experience and satisfaction levels. The company presented the research results in a webinar on 29 June 2017. The research was also written up in

Patient satisfaction should be baked into healthcare provider service goals, according to Prioritizing the Patient Experience from West Corporation, the communications company. West is in the business of improving communications systems, and has a vested interest in expanding comms in health. This research polled patients and providers to assess how each healthcare stakeholder perceives various patient satisfaction issues, which when done well are grounded in sound communications strategy and technologies. Patient satisfaction is directly linked to the bottom lines of healthcare organizations, West contends, due to two key drivers: Evolving payment models are increasingly tying patient satisfaction to reimbursements; and,

U.S. consumers consider Consumer Electronics to be the most innovative industry they know. But people believe that Health & Wellness should be the most innovative sector in the economy. Welcome to the 2017 Klick Health Consumer Survey, which focuses on health innovation in the context of peoples’ hopes for technology to improve health and healthcare. 1 in 2 people say that technology has had a positive impact on their health and wellness, skewing slightly more toward younger people (although 45% of people 55 years of age and older agree that tech positively contributes to health. 41% of consumers say they’ve

In the past few weeks, two announcements from Amazon point to a strategy, whether intended or my dot-connecting, that the ecommerce leader has the health of its customers in its sights. In late May, CNBC first published the news that Amazon was seeking out a candidate to be a general manager for a pharmacy business. Here’s the video telling the story. Getting into the retail pharmacy channel is in itself a huge message to this health industry segment, which is very competitive between chain pharmacies (led by CVS, Walgreens, and Rite-Aid), grocery pharmacies (the largest of which are Kroger and

While Americans’ financial worries are softening in 2017, one issue tops the list of fiscal fears: not having enough money to pay the costs involved in a serious illness or accident, Gallup found in a consumer poll fielded in early April 2017. 54% of Americans fear an inability to cover healthcare costs in the event of an accident or serious illness. This percentage was 60% in 2016, and 55% in 2015. This year’s data point ties with Americans financial worry about not having enough money for retirement, but healthcare cost concerns rank higher in terms of being “very worried” versus

The most trusted stewards for protecting consumers’ health data are “my providers:” “my” physician (88%), “my” pharmacy (85%), and “my” hospital” (84%). according to the Accenture 2017 Consumer Survey on Healthcare Cybersecurity and Digital Trust. Who’s least-trusted? Government (56%) and tech companies (57%). Note, though, that most Americans (over 50%) trust these health data holders — it’s just that fewer people trust them than healthcare providers, who are top health information protectors in health consumers’ trust rosters. Accenture commissioned Nielsen to conduct this survey in November 2016 in seven countries. The results discussed here in Health Populi focus on the

The top healthiest eating communities tend to circle the perimeter of the map of the lower 48 U.S. states. In these towns, more than 72% of health citizens report healthy eating. These areas are located in California, Florida, and Massachusetts, among others. Areas with the lowest rates of healthy eating are concentrated generally south of the Mason-Dixon Line, in places like Arkansas, Kentucky, and Mississippi, and other states. In these places, fewer than 57% of people eat healthy. Eating healthy foods in moderation is a mighty contributor to personal and public health, discussed in the report, State of American Well-Being

CNN called it, “the ancient perfume store you never heard of,” but the Officina Profumo-Farmaceutica di Santa Maria Novella had its literal roots in medicinal herbs. With scents wafting onto a 13th century Florence piazza, the Farmacia now operates as a pharmacy storefront for homeopathic and herbal supplements, along with perfumes and home scents. A visit to the pharmacy today is a journey into medicinal time-travel, back to the year 1221. I spent time in the pharmacy today to learn about the literal roots of the shop in medicinal herbs cultivated in a monastery garden and reformulated by monks into

People want to live healthier lives, and consumer good companies are responding to these demands to keep and gain market share and profit margins. Consumer product firms reformulated over 180,000 consumer products in 2016 for in response to consumers’ health and wellness wishes, based on data collected by Deloitte for The Consumer Goods Forum project (CGF) and published in The CGF Health & Wellness Progress Report. The CGF is an industry network of some 400 consumer goods, retail, and service companies supporting the global adoption of standards and practices. This Report focused on the CGF members’ progress toward health and wellness

The non-vote for and withdrawal of The American Health Care Act on March 24, 2017, was a win for the retail health market, at least in the short-run. Before the vote, there had been some pronouncements that the passage of the AHCA would have been a boon to retail health. Here’s one story stating that, “A boom in medical tourism to Mexico predicted if Obamacare ends.” Another article asserts, “Why the American Health Care Act Works for Retailers,” a public policy statement from the National Retail Federation (NRF). But NRF, please don’t fret. Retail health is consumer-driven and will persist beyond the

Yesterday, the Tweeter-in-Chief President Donald Trump tweeted, “I am working on a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down!” Those 140 characters sent pharma stocks tumbling, as illustrated by the chart for Mylan shares dated 7 March 2017. This is one issue that Americans across the political spectrum agree on with the POTUS. The latest Zogby poll into this issue, conducted for Prescription Justice, found 3 in 4 Americans agree that pharmaceutical companies are “getting away with murder,” as President Trump said in a TIME magazine interview

Telehealth has come of age at HIMSS in 2017. No longer is the concept relegated to footnote or edge-booth status on the conference floor. Instead, telehealth, broadly defined, is now a mainstream concept embraced by healthcare providers, payors and, increasingly, consumers. I spent time brainstorming telehealth with one of the pioneers of modern telehealth in the U.S., Dr. Roy Schoenberg, who co-founded American Well with his brother Ido Schoenberg, in 2007. As such, the company is among the most mature telehealth entities operating in America, delivering live video health visits to millions of health consumers through the American Well telehealth

Nine in 10 U.S. consumers think pharma and biotech put profits above patient interests, according to the latest Harris Poll studying reputation equity across organizations serving health care. Notice the relatively low position of the green bars in the first chart (with the exception of the impression for “strong financial performance); these are the pharma/biotech consumer impressions. The health industry stakeholders consumers believe would more likely place them above making money are health care providers, like doctors and nurses, hospitals, and pharmacists. Health insurance companies fare somewhat better than pharma and biotech in this Poll, although rank low on social

Consumer electronics (CE) aren’t just big screen TVs, sexy cars, and videogames anymore. Among the fastest-growing segments in CE is digital health, and health-tech will be prominently featured at the 2017 CES in Las Vegas hours after the champagne corks have popped at the start of the new year. On the second day of 2017, I’ll be flying to Las Vegas for several days of consumer technology immersion, learning about connected and smart homes and cars, and shiny new things all devoted to personal health. Welcome to my all-health lens on CES 2017, once referred to as the Consumer Electronics

Why can’t the healthcare consumer experience be as easy as online banking? asks Tom Skelton, the CEO of Surescripts. That’s the expectation of most U.S. healthcare consumers, based on Surescripts latest survey results, summarized in the 2016 Connected Care and the Patient Experience report. The key findings are that U.S. consumers, Want their medical information delivered electronically, easily accessible and shareable; Are dissatisfied with the time and effort they spend on dealing with their medical information and waiting times in health care offices, both doctors and pharmacies; and, Prefer and expect innovative ways to get care and prescriptions. People are getting

Think “Hormel,” and you may have visions of SPAM, Chi-Chi’s salsa, Skippy peanut butter, and Dinty Moore corned beef hash. So what’s Hormel doing in the title of a Health Populi post, anyway, you might ask? Like many food companies, Hormel is broadening its product portfolio expanding with health. The company isn’t just moving to healthy eating for wellness’s sake, but boldly going where most food companies haven’t yet gone: developing products for people battling cancer. Vital Choices, a well-titled line of frozen meals, was developed by Hormel in collaboration with the American Cancer Society, Cancer Nutrition Consortium, the Culinary Institute

“The patient is the best sensor,” asserted Jamie Heywood, founder of Patients Like Me, during the perennial meeting sponsored by PwC, the 180° Health Forum. This event featured several panels of PwC’s curated group of so-called “provocateurs” in healthcare, and I was grateful to be one of nine selected for the event. Heywood joined Dr. Leanna Wen, Baltimore City Health Commissioner, and me in a panel called, “Strange Bedfellows or Soul Mates? The New Dating Game in Health.” The theme of our collective brainstorm was how collaborations across the ecosystem could help make health and healthcare better. The drawing is

It’s the 9th of November, 2016, and Donald Trump has been elected the 45th President of the United States of America. On this morning after #2016Election, Health Populi looks at what we know we know about President Elect-Trump’s health policy priorities. Repeal-and-replace has been Mantra #1 for Mr. Trump’s health policy. With all three branches of the U.S. government under Republican control in 2018, this policy prescription may have a strong shot. The complication is that the Affordable Care Act (aka ObamaCare in Mr. Trump’s tweet) includes several provisions that the newly-insured and American health citizens really value, including: Extending health

People feel like get-no-respect Rodney Dangerfield when they deal with health insurance, government agencies, or pharma companies. Consumers feel much more love from personal care and beauty companies, grocery and fitness, according to a brand equity study by a team from C Space, published in Harvard Businss Review. As consumer-directed health care (high deductibles, first-dollar payments out-of-pocket) continues to grow, bridging consumer trust and values will be a critical factor for building consumer market share in the expanding retail health landscape. Nine of the top 10 companies C Space identified with the greatest “customer quotient” are adjacent in some way to health:

Technology is high on U.S. consumers’ holiday shopping lists for the 2016 holiday season, according to the CTA (Consumer Technology Association). And wearable activity trackers are a fast-growing segment of consumer technology purchases expected in shoppers’ carts (both physical and online virtual) this fourth quarter of 2016, CTA notes in its 23rd Annual Holiday Outlook consumer survey research. The line graph illustrates the hot categories in this year’s holiday gift mix, led by smart phones (in red), tablets, laptops, and video game systems. But the proportion of people intending to purchase smartwatches now ties with video game system sales, closely followed

  1 in 3 consumers track health or fitness via an app, wearable technology, or smartwatch, according to GfK’s global survey on Health and fitness tracking published in September 2016. The key reasons people monitor health or fitness are to maintain or improve physical condition/fitness (for 55%) and to motivate oneself to exercise (for 50%), across the 16 countries GfK surveyed. Improving energy level, feeling motivated to eat and drink more healthfully, improving sleep, making tracking part of a daily routine, losing weight, and being more productive were cited as reasons to health-track by at least one-fourth of health citizens

More U.S. patients are faced with spending more out-of-pocket for health care services, to meet high-deductible health plans and rationally spend their health savings account investments. As rational economic men and women, some are seeking care outside of the United States where many find transparently priced, high-value, lower-cost healthcare. Check out the table from the Medical Tourism Association, and you can empathize with cash-paying patients looking for, say, gastric bypass surgery or a heart valve replacement. My latest column in the Huffington Post discussed this trend, which points first to the Cleveland Clinic — a top-tier American healthcare brand that’s

Walmart is already in the healthcare business, serving 140 million customer visits weekly, millions of whom fill prescriptions at the store pharmacy, seek personal care in the health and beauty aisles, track blood pressure using a Higi health kiosk, and shop for healthier foods in the grocery aisles. The world’s largest company on the Global Fortune 500 list hosted a Retail Health Summit in June, the details of which have been published in . The Summit, produced by Dan Mack’s Mack Elevation Forum and , convened stakeholders from across the retail health landscape: including over-the-counter medicines, personal care, aging-at-home, caregiving, genomics, disease

  Some 18% of U.S. consumers use a wearable device, according to the 2016 UPS Pulse of the Online Shopper survey. UPS researched tech-savvy shoppers with an eye to understanding where and how people buy stuff – and of course, how they ship it given the company’s core logistics business. (“Tech-savvy” in this study means consumers had purchased at least two items online in a typical 3-month period). Overall, Millennials adopt devices and do more tech-shopping compared with other generations, but UPS notes that other groups are indeed shopping for tech and shipping it, too. Millennials are leading the way,