A blog covering the health/care ecosystem and people.

The topline of this year’s annual Gallup Poll into honesty and ethics of professions finds nurses sustaining their reign as the top trusted profession in America. But it’s also important to point out that four of the top five most ethical professions are people working on the front lines of health care: doctors (#3), pharmacists (#4) and dentists (#5). Engineers rank second this year after nurses, edging ahead of doctors and pharmacists who typically have ranked 2nd and 3rd each year in the past decade. One of these years, pharmacists’ reputation fell as the profession was associated with being a

In CTA’s 2020 Consumer Tech Forecast launched yesterday at Media Day 1 at CES, Steve Koenig VP of Research, said that, “digital health is an ecosystem of ecosystems.” Health, medical and wellness trends featured large in the forecast, which brought together key trends for 5G, robotics, voice tech, AR/VR/XR, and the next iteration of IoT — which Steve said will still be called “IoT,” but in this phase will morph into the “Intelligence of Things.” That speaks to Steve’s phrase, “ecosystem of ecosystems,” because that’s not just “digital” health — that’s now the true nature of health/care, and what is

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

As technology continues to re-shape consumers’ experiences and expectations with health/care, retail, travel and work, peoples’ concerns about data privacy are also growing as observed by a 2020 consumer trends forecast from GlobalWebIndex, Connecting the dots. First, some overall context to the study. GlobalWebIndex “connects the dots” of consumers trends in 2020 including the topics shown in the first graphic including commerce and retail, gaming, travel, human touch, nostalgia, privacy and digital health — the first of these trends discussed in the report. Note that the data discussed in this post include responses from consumers residing in both the U.S.

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

Patients searching online for health information and health care provider reviews is mainstream in 2019.  Digital health tracking is now adopted by 4 in 10 U.S. consumers. Rock Health’s Digital Health Consumer Adoption Report for 2019 was developed in collaboration with the Stanford Medicine Center for Digital Health. Rock Health’s research has tracked peoples’ use of telemedicine, wearable technology, digital health tracking, and online health information since 2015, and the results this round show relative flattening of adoption across these various tools. Rock Health’s top-line findings were that: Patient-generated health data creates opportunity, and potential challenges Online health information is

The market for caregiving is growing and the business community has, finally, begun to pay attention. The Washington Post referred to this market as a “gold rush” to design smart shoes, custom razors and technology for the “over-65 crowd.” Caregiving in the U.S., the seminal report from AARP, estimated that 43,5 million adults in the U.S. had provided unpaid care to an adult or child in the past year, about one in five people being caregivers. Over half of caregivers are women, and are about 49 years of age on average. Caregivers spent over 24 hours a week providing care go

There is no health without mental health. Every 40 seconds, someone loses their life to suicide. So #LetsTalk (the Twitter hashtag to share stories and research and support on the social feed). Today is October 10th, World Mental Health Day. As we go about our lives today and truly every day, we should be mindful that mental health is all about each of us individually, and all of us in our communities and in the world. First, let’s hear from Prince Harry and Ed Sheeran (who, video spoiler alert, decides to pivot his lyrics to a draft song titled “Gingers

SelfCare is health/care, particularly as patients, everyday people, take on greater responsibility for clinical decisions and paying for medical services. We’re convening today through Sunday in Indianapolis with GMDC, the Global Market Development Center and Retail Tomorrow to brainstorm the current and future prospects for SelfCare, health and wellness in the hands, hearts, and homes of consumers. To bolster the message and engage with industry stakeholders, GMDC collaborated with the Hamacher Resource Group to develop a SelfCare Roadmap, an interactive tool that provides insights into twelve conditions where consumers typically looking to DIY their health using over-the-counter medicines, supplies and

        Here’s the latest arithmetic on American workers’ financial trade-off of wages for health care insurance coverage: in the ten years since 2009, family premiums have risen 54% and workers’ contribution to health care spending grew 71%. Wages? They rose 26%, and general price inflation by 20%, according to the Kaiser Family Foundation survey on employer-sponsored benefits for 2019 released yesterday. Survey details for this 21st annual encyclopedia on employer-sponsored health care are published in Health Affairs October 2019 issue in a paper titled, Health Benefits in 2019: Premiums Inch Higher, Employers Respond to Federal Policy. Because this

Turning 13, “we’re an unruly teenager on our hands now,” Matthew Holt invoked the start of the annual Health 2.0 Conference, convening this week in Santa Clara for its 13th year in existence. Started with Co-Founder Indu Subaiya, Health 2.0 was conceived as a “movement,” Matthew explained. “When (we were) younger, we broke some things.” Indu continued on that riff, “we’re breaking barriers now (that) we are older, and it’s time to raise the bar.” In the yin-and-yang riffing style that is the brand of this duo, Matthew continued in that vein of “breaking things,” invoking a metaphor of storming

U.S. employers are tightening their focus on mental and behavioral health, addressing workers’ chronic conditions, emphasizing women’s health, and allocating more resources to digital and telehealth investments, we learn from Optum’s Ten Years of Health and Well-Being at Work: Learning from our past and reimagining the future. Four in five medium, large and jumbo companies expect their spending on health and wellness programs will increase over the next three years. That spending will have a strong focus on behavioral health services: 9 in 10 employers are concerned with the level of access workers have to mental health services. Companies will

When you think “J.D. Power,” your mind probably imagines reviews of automotive performance, retail shopping experiences, or perhaps even health insurance plan customer service. Expanding its report-card role in the health ecosystem. J.D. Power has undertaken a survey on consumer satisfaction with 31 telehealth providers across 15 measures, which will be published in November 2019. In advance of the full report, the organization released a summary on telehealth access and satisfaction, which I’ll discuss in this post. I’ll also weave in the latest insights from the ATA 2019 State of the States report updating legislative/regulatory telemedicine activity at the U.S.

Of the $401 billion that will flow through retailers for consumer technology products, many of the fastest-emerging categories will play a role as platforms for health and medical care at home and in wearable tech. This is my tea-leaf read from reviewing the projections in the report, U.S. Consumer Technology Sales and Forecasts, July 2019, from the Consumer Technology Association (CTA). [CTA is annual convener of CES, the world’s largest consumer electronics meet-up.] Along with artificial intelligence (AI) and fast 5G networking, the forecast also quantifies growth prospects for smart speakers, home robots, wireless earbuds, smartwatches. and in-vehicle technology —

There are many forms of magic inspired by Disney, the company. There’s the obvious attraction, the Magic Kingdom, that was Walt’s original destination vision, “imagineered” in 1932. Then there are other kinds of magic. The one I’m deep into in the moment is inspiration, ideation, and “reimagineering” my own thinking about work, legacy, and social justice. I’m grateful to have had the opportunity to spend much of this week at the inaugural Disney Institute Women’s Leadership Summit. The Institute convened about 300 women (and a handful of brave “He-for-She” men keen on diversity) in Orlando to learn about and brainstorm

Most U.S. healthcare providers are spending more time, effort and capital with an eye to engaging with patients-as-consumers, a trend quantified in the report, the 2019 State of Consumerism in Healthcare: The Bar is Rising from Kaufman Hall, summarizing results from this year’s healthcare consumerism index survey conducted among about 200 healthcare providers. “Legacy organizations will need premier-level consumer capabilities to compete in today’s increasingly consumer-centric environment,” Kaufman Hall recommends. Providers identified the key capability gaps for consumer-centric care as improving the consumer experience, offering a variety of facility-based access points, utilizing digital tools for health engagement, providing price transparency,

Enlightened health/care industry and public policy stakeholders have begun to embrace and address social determinants of health. These are the inputs that bolster health beyond health care services: they include economic stability like job security and income level (and equity), education, and access to healthy food, food security, safe neighborhoods, social support, clean environments (water and air), and in my own update on SDoH factors, access to broadband connectivity. As physician leaders in the AMA, technology advocates from AMIA, and numerous health plans focus efforts on strengthening social determinants, what do people – consumers, patients, caregivers — think about these

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

The vision/optical industry is one piece of the health/care ecosystem, but the segment has not been as directly impacted by patients’ new consumer muscles until just about now. It feels like the vision industry is at an inflection point at this moment, I intuited during yesterday’s convening of Decoding the Consumer: The new science of customer behavior, the theme of the 13th annual global leadership summit hosted by Vision Monday, a program of Jobson Medical Information which is part of the WebMD family. I was grateful to have an opportunity to share my views with attendees on the vision patient as

Just as we experienced “e-business” departments blurring into ecommerce and everyday business processes, so is “telehealth” morphing into, simply, health care delivery as one of many channels and platforms. Telehealth and virtual care are key education topics and exhibitor presences at HIMSS19. Several factors underpin the adoption of telehealth in 2019: Consumers’ demand for accessible, lower-cost health care services as people face greater financial responsibility for paying the medical bill (via high-deductible health plans and greater out-of-pocket costs for co-payments) Some consumers’ lacking or losing health insurance as ACA coverage eroded in the past two years, resulting in these patients

Fewer than one-half of consumers trust in government and media. Three-quarters trust employers, who in 2019 are the top-trusted institution according to the 2019 Edelman Trust Barometer released last week in Davos at the World Economic Forum. Consumers in the U.S. over-index for trust in employers, with 80% of people saying they have a strong relationship with “my employer,” compared with 73% of Britons, 66% of the French, and 59% of people in Japan. What’s underneath this is employers being trusted to provide certainty: most workers look to their employer to be a trustworthy source of information about social issues and

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

If I’m going to spend a week someplace, it usually has to be Italy. So next week in Las Vegas, I’ll deal with that bias by staying at the Venetian Hotel for the entire week to cover all-things-health at CES 2019, the annual convening of electronics retailers and enthusiasts. Most of the 180,000+ folks come to Vegas from over 150 countries to kick the proverbial tires on TVs, autos, games, virtual reality, 3-D printing, drones, and other shiny new things. For me, for the past eight years, CES means consumer-facing health in a person’s hands, on her phone, and increasingly

Organizations that address consumers’ data privacy and access to healthcare create greater social brand equity, inspiring people to say nice things about the companies, recommend them as good employers, and be welcomed as businesses operating in peoples’ community. In The Societal ROI Index: A Measure for The Times We Find Ourselves In, Finn Partners and The Harris Poll measure U.S. companies’ reputations for social good, the project’s press release explains. “Our new data shows that the public has a definite opinion about what issues they feel companies should address and the social impact bar has been set high,” according to Amy Terpeluk,

Eat food, not too much, mostly plants, Michael Pollan advised us on the cover of his breakthrough book on nutrition in America, In Defense of Food.  In Las Vegas, it’s not too easy to live and eat  according to Pollan’s Food Rules. We’re at a fork in the road when it comes to food, retail grocery shopping, and health, which is an intersection I’m increasingly working in these days. The Groceryshop conference is further informing my understanding of the landscape of the technology that’s enabling the consumer’s ability to curate, purchase, and receive the food they want to satisfy hunger and

There’s a shortage of medical providers in the United Kingdom, a nation where healthcare is guaranteed to all Britons via the most beloved institution in the nation: The National Health Service. The NHS celebrated its 70th anniversary in July this year. The NHS “supply shortage” is a result of financial cuts to both social care and public health. These have negatively impacted older people and care for people at home in Great Britain. This article in the BMJ published earlier this year called for increasing these investments to ensure further erosion of population and public health outcomes, and to prevent

When I asked my longtime colleague and friend Robert Mittman, with whom I collaborated at Institute for the Future for a decade, how he managed international travel and jet lag, he said simply, “The time zone you’re in is the time zone you’re in.” This lesson has stayed with me since I received Robert’s advice over twenty years ago. Over the next two weeks, as I work alongside colleagues and clients in the EU and soon-to-Brexit UK, I am in time zones five and six hours later than my home-base of US Eastern Time. But the time zones I’m working

It’s National Health IT Week in the US, so I’m kicking off the week with this post focused on how digital health can bolster economic development. As the only health economist in the family of the 2018 HIMSS Social Media Ambassadors, this is a voice through which I can uniquely speak. In February 2009, President Barack Obama signed into law the American Recovery and Reinvestment Act (ARRA), less formally known as the Stimulus Bill. This was the legislation best known for addressing and helping to bring the U.S. out of the Great Recession. A lesser-known component of ARRA was Title

Most consumers look to every industry sector to help them engage with their health. And those companies include the insurance industry and financial services firms, we found in the 2010 Edelman Health Engagement Barometer. John Hancock, which covers about 10 million consumers across a range of products, is changing their business model for life insurance. Here’s the press release, titled, “John Hancock Leaves Traditional Life Insurance Model Behind to Incentivize Longer, Healthier Lives.” “We fundamentally believe life insurers should care about how long and well their customers live. With this decision, we are proud to become the only U.S. life insurance

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

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

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

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

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.

As I walked by windows with Marvel-inspired superhero characters, I stopped to read their talk-bubbles: “strengthen your savings, power your financial quest, be the hero of your money, be one with your budget.” The top-line message here is that you can be your own fiscal superhero. The sign read, Capital One Cafe with Peet’s Coffee. But was it a bank branch or a cafe? I asked myself, passing by this sign yesterday morning at the corner of Walnut and 18th Streets in center city Philadelphia. It’s both, as it turned out, and when I entered I found a welcoming, beautifully

“Do no harm” has been the professional and ethical mantra of physicians since the Hippocratic Oath was first uttered by medical students. The origins of that three-word objective probably came out of Hippocrates’ Corpus, which included a few additional words: “to do good or to do no harm.” The proliferation and evolution of digital technologies in health care have the potential to do good or harm, depending on their application. Doing good and abstaining from doing harm can engender trust between patients, providers, and other stakeholders in health. Trust has become a key currency in provider/patient/supplier relationships: 94% of health executives

Two weeks in a row, The Economist, the news magazine headquartered in London, included two special reports stapled into the middle of the magazines. Universal health care was covered in a section on 28 April 2018, and coverage on financial inclusion was bundled into the 5th May edition. While The Economist’s editors may not have intended for these two reports to reinforce each other, my lens on health and healthcare immediately, and appreciatively, connected the dots between healthcare coverage and financial wellness. The Economist, not known for left-leaning political tendencies whatsoever, lays its bias down on the cover of the section here: universal healthcare

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

As the nation battles an obesity epidemic that adds $$ costs to U.S. national health spending, there are many opportunities to address this impactful social determinant of health to reduce health spending per person and to drive public and individual health. In this post, I examine a few very current events in the food-as-medicine marketspace. Big Food as an industry gets a bad rap, as Big Tobacco and Big Oil have had. In the case of Big Food, the public health critique points to processed foods, those of high sugar content (especially when cleverly marketed to children), and sustainability. But

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.

“It’s not about shiny new technologies but about designing relationships to truly impact the patient at the center of the disconnected ecosystem,” asserted Amy Cueva, Founder and CXO of the design consultancy Mad*Pow. That patient is a consumer, a caregiver; it’s you and me, Cueva explained. To reconnect the fragmented pieces of healthcare delivery, Cueva said, mantra-style, “collaboration is the new innovation.” And collaboration with patients, caregivers — the people for whom that healthcare is aimed — is the optimal workflow for effectively, enchantingly designing healthcare. In a talk she delivered at the Innovation Summit in a preconference meet-up at the annual

Albertsons, the grocery group with popular brands like Acme, Safeway, and Vons, announced a merger with Rite Aid, the retail pharmacy chain. The deal has been discussed as Albertsons’ move to succeed in light of growing competition from Amazon and Whole Foods, the proposed CVS/Aetna merger, and Walgreens’ possible purchase of AmerisourceBergen (finalizing its acquisition of over 1,900 Rite Aid stores). If played out well, the combination could become an important player in the evolving U.S. health/care ecosystem that brings a self-care front-door closer to consumers, patients and caregivers. “The new company is expected to serve more than 40 million

The fact that the average U.S. employer committed to spend nearly $27,000 a year for a PPO to cover a family of 4 in America in 2017 is the most important rationale underlying the announcement that Amazon, Berkshire-Hathaway, and JP Morgan made on 30th January 2017. That news immediately shook Wall Street trading, sending downward shocks down the proverbial spines of healthcare insurance plans and suppliers to the industry — legacy healthcare companies that scale patient-members and healthcare supplies, like pills and surgical implants. The “new competition” chart published in the Wall Street Journal in the morning illustrates those shock

Two in five U.S. physicians feels burned out, according to the Medscape National Physician Burnout & Depression Report for 2018. This year, Medscape explicitly adds the condition of “depression” to its important study, and its title. In 2017, the Medscape report was about bias and burnout. Physicians involved in primary care specialties and critical care are especially at-risk for burnout, the study found. One in five OBGYNs experience both burnout and depression. Furthermore, there’s a big gender disparity when it comes to feeling burned out: nearly one-half of female physicians feel burnout compared with 38% of male doctors. Being employed by

The biggest healthcare spenders in the United States are households and the Federal government, each responsible for paying 28% of the $3.3 trillion spent in 2016. Private business — that is, employers covering healthcare insurance — paid for 20% of healthcare costs in 2016, based on calculations from the CMS Office of the Actuary’s report on 2016 National Health Expenditures. The positive spin on this report is that overall national health spending grew at a slower rate in 2016, at 4.3% after 5.8% growth in 2015. This was due to a decline in the growth rates for the use of

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

U.S. consumers’ most-valued brands include Apple, Google, Amazon, Netflix, Pinterest, Android, Spotify, PIXAR, Disney and Samsung, according to  the 2017 Brand Relevance Index from Prophet. The top 50 are shown in the first chart. On the second chart, I’ve circled in red the brands that have reach into healthcare, health, fitness, and wellness. Arguably, I could have circled every brand in the top 50 because in one way or another, depending on the individual, people find health “everywhere” that’s relevant to them based on their own definitions and value-systems. This is Prophet’s third year conducting this study, and I was

Old-age inequality among current retirees in the U.S. is already greater than in ever OECD country except Chile and Mexico, revealed in Preventing Ageing Unequally from the OECD. Key findings from the report are that: Inequalities in education, health, employment and income start building up from early ages At all ages, people in bad health work less and earn less. Over a career, bad health reduces lifetime earnings of low-educated men by 33%, while the loss is only 17% for highly-educated men Gender inequality in old age, however, is likely to remain substantial: annual pension payments to the over-65s today are