A blog covering the health/care ecosystem and people.

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

Artificial intelligence (AI) has begun to play a role in health care for predictive analytics, personalization, and public health. On 26th January, I’ll moderate a tweetchat at 1 pm Eastern time, brainstorming the current and future state of and opportunities for AI in health care. I’ll be co-chatting with Microsoft’s AI leader, Tom Lawry (@TCLawry on Twitter). In advance of that discussion, I wanted to feature remarks shared by Brad Smith, Microsoft President, that I recently heard at CES 2021, the annual (this year, virtual) meeting convening the largest community of consumer electronics stakeholders globally Smith wove a crucial, impactful

Spending on connected health monitoring devices in the U.S. will reach $845 million based on the forecast of the Consumer Technology Association, convening the annual 2021 CES this week in a virtual format. CTA unveiled the 2021 key trends we’ll see presented this week through the online exhibition hall and in educational sessions on the CES.Tech platform. Six major themes emerge at #CES2021: digital health, robotics and drones, 5G connectivity, vehicle technology, smart cities, and over all — digital transformation. All of these have applications in health and health care, especially accelerated in need by the COVID-19 pandemic which has

explained in a new report from EY co-sponsored by the American Hospital Association (AHA) and the AHA Center for Health Innovation. Digital Transformation – Anywhere Care envisions “health care with no address, or bringing care to the consumer or patient rather than expecting the patient to go to the hospital” as a “vital sign” of health care’s changes going into the new year of 2021. COVID-19 accelerated a movement in which I’ve been involved for over a decade, known as “participatory health.” In its early phase in the U.S., Dr. Tom Ferguson identified the emerging role of the internet in

Before the coronavirus pandemic, patients had been transforming into health care payors, bearing high deductibles, greater out of pocket costs, and financial risk shifting to them for medical spending. In the wake of COVID-19, we see health consumers-as-payors impacted by the pandemic, as well as for existing diagnoses and chronic care management. There is weakening in U.S. consumers’ overall household finances, the latest report from the U.S. Bureau of Economic Analysis (BEA) asserted (published 25 November 2020). In John Leer’s look into the BEA report in Morning Consult, he wrote, “Decreases in income, the expiration of unemployment benefits and increased

When it comes to patients, health care providers have been hit hard in two ways in the wake of the COVID-19 pandemic. Hit #1 has been the direct negative impact of the coronavirus on health care volumes and patients not utilizing hospitals and doctors’ services, avoiding physical encounters in health care sites Hit #2 has been the negative impact of patient experience for those health consumers who sought health care services during the pandemic — and had a negative response to the encounter. Accenture explored this phenomenon in their latest report, Elevating the Patient Experience to Fuel Growth. In the

In January 2020, before we knew how to spell “coronavirus,” millions of consumers were already “Amazon-Primed” for everyday life-flows and consumer behaviors. The pandemic has accelerated consumer trends already in motion early this year when the Consumer Technology Association (CTA) convened the annual CES 2020 in Las Vegas. I covered the event here in Health Populi, as I have for most of the past decade, highlighting the growth of digital health and, this year, the expanding Internet of Healthy Things called-out by Dr. Joseph Kvedar in 2015. What a difference a public health crisis makes, accelerating digital health beyond fitness

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

Some 6 in 10 people in the U.S. have been financially impacted by COVID-19. Those most negatively affected by the pandemic tend to be younger, Gen Z age group and African-American, 63% of whom felt financial pressure directly due from the virus and the national economic lockdown. By late May 2020, 34% of black Americans had lost their jobs compared with 21% in late April, compared with 18% of white consumers, reported in The COVID-19 Pandemic’s Financial Impact on U.S. Consumers, survey research from TransUnion. This post describes data from TransUnion’s Wave 9 report, which polled 2,086 U.S. adults 18

The coronavirus pandemic is dramatically impacting and re-shaping our health and wealth, simultaneously. Today, I’ll be brainstorming this convergence in a “collaborative health conversation” hosted by Carium’s Health IRL series.  Here’s a link to the event. Jeanne founded ClearHealthCosts nearly ten years ago, having worked as a journalist with the New York Times and other media. She began to build a network of other journalists, each a node in a network to crowdsource readers’-patients’ medical bills in local markets. Jeanne started in the NYC metro and expanded, one node at a time and through many sources of funding from not-for-profits/foundations,

The coronavirus has shaken U.S. consumer confidence, both in terms of financial markets and personal health risks. COVID-19 is re-shaping peoples’ behavior and daily choices, from using public transit to choosing where to shop, based on Morning Consult’s National Tracking Poll #200276 conducted February 28-March 1, 2020. Morning Consult surveyed 2,200 U.S. adults, finding that 3 in 4 Americans were concerned about the coronavirus outbreak. The first chart from the survey shows various consumer activities by peoples’ likelihood of choosing to do them. Clearly, our daily life-flows outside of our homes have been impacted by our perceived risks of the coronavirus:

As consumers in the U.S. wrestle with accessing and paying for medical benefits, there’s another sort of health benefit people increasingly understand, embrace, and consume: food-as-medicine. More people are taking on the role of health consumers as they spend more out-of-pocket on medical care and insurance, and seeking food to bolster their health is part of this behavior change. One in four Americans seek health benefits from food, those who don’t still seek the opportunity to use food for weight loss goals, heart health and energy boosting, according to the 2019 Food & Health Survey from the International Food Information

Today is Day 1 of two Media Days at #CES2020 in Las Vegas, kicking off this manic week of the Consumer Electronics Show at the Mandalay Bay convention center. For several years, I’ve convened with journalists and industry analysts from around the world for these two days before the “official” opening of CES to hear the latest news from some of the largest tech-focused companies on Earth. Announcements come from across industry sector — from automotive and transportation, telecoms, consumer goods, entertainment, social media, travel, and retail…with platform technologies playing a role including but not limited to AI, AR/VR/XR (the

Workers covered by health insurance through their companies spend 11.5% of their household income on health insurance premiums and deductibles based on The Commonwealth Fund’s latest report on employee health care costs, Trends in Employer Health Coverage, 2008-2018: Higher Costs for Workers and Their Families. The topline of this study is that average annual growth in employer premiums rose faster between 2016 and 2017, by about 5% for both single and family plans. The bottom line for families is that workers’ premium payments grew faster than median incomes did over the ten years 2008 to 2018. Average deductibles also outpaced

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

In the U.S., the theory of and rationale behind consumer-directed health has been that if you give a patient more financial skin-in-the-game — that is, to compel people to spend more out-of-pocket on health care — you will motivate that patient to don the hat of a consumer — to mindfully research, shop around, and purchase health care in a rational way, benefit from lower-cost and high-quality healthcare services. For years, Alegeus found that patients were indeed growing those consumer health muscles to save and shop for health care. In 2019, it appears that patients have backslid, according to the

“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

Among stresses facing people at least 50 years of age, health care costs rank top of mind compared with other issues like long-term care, health insurance, Social Security, taxes, and being read to retire. Worries about health care costs are particularly stressful among future retirees, 8 of 10 of whom share this top concern along with 7 in 10 recent retirees and 6 in 10 people retired for at least a decade. Health care stress cuts in two ways: most people are worried about paying for health care, as well as experienced an unanticipated decline in their health, according to

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

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

              In the U.S., rural residents’ access to broadband at home continues to lag behind urban and suburban dwellers, the Pew Research Group noted in a May 2019 research note on Americans’ use of technology. The Pew survey explored Americans’ adoption of technology and found that rural dwellers are also less likely to have multiple devices than non-rural consumers. Across the four types of tech studied, it’s smartphones that top the list of penetration in rural areas (at 71%), closely followed by computers (desktop or laptop, with 69% adoption), broadband (at 63%) and tablets

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

People want to make health with their health care providers, and they want more than care from them: most patients are looking for support with healthy eating, exercise, emotional support, sleep, stress management, social relationships, and financial health. And in case physicians, nurses and pharmacists aren’t sufficiently business with that punch-list for health, two in three U.S. patients would also like to receive help in finding a higher purpose. This is the health consumer’s mass call-out for holistic health, Welltok discovered in a survey conducted among over 1,600 U.S. adults in March 2019. The results are detailed in the assertively 

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

“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

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

“Seeing is not believing” when it comes to people seeing health information on social networks. Four in five people seeking healthcare information online in social media are concerned about the accuracy of that information served up. Therefore, most consumers a very satisfied with the healthcare information they receive from nurses, eye doctors, pharmacists, dentists, nurse practitioners, doctors, and dietitians. But social media influencers. patient organizations, online patient forums, and pharmaceutical companies? Not so much. Only one-half of U.S. consumers believe that health-related information on the internet is as reliable as information from medical professionals. Welcome to The Great American Search for

Food deserts aren’t just a U.S. phenomenon. They’re found all around the world. This week as I explore social determinants of health and technology solutions in several parts of Europe, I’ve learned more about food access challenges in the UK. These are discussed in a report published this month by the Social Market Foundation asking, What are the barriers to eating healthily in the UK?  The research was supported by Kellogg’s, the food manufacturer. The first table comes from the report, and the topline shows that about 4 in 10 Britons shopped at a cheaper food store in response to high

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

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

The impact of health and wellness is on most consumers’ minds, Nielsen’s consumer research has found. Sarah Schmansky, Nielsen’s strategy leader for health, wellness and “fresh,” moderated a panel at the GMDC Health-Beauty-Wellness Conference in Orlando today that brainstormed how consumers are shopping for health. Underneath that “how” is more than the next-best-me-too-product for allergy or acne. It’s about efficacy of the product at the core, but bundled with social responsibility and sustainability, informative packaging, transparency of ingredients, and education that empowers the individual. “Self-care is the driver of growth,” Sarah began the discussion. But these needs under the self-care umbrella

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

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

It will cost about $275,000 for a couple retiring in the U.S. this year to cover their healthcare costs for the rest of their life in retirement, Fidelity estimated. But Americans are notoriously pretty undisciplined about saving money, compared with peers living in other developed countries. How to address this challenge? Show people what improving their personal health can do to boost their 401(k) plans. This tactic is discussed in Health & Retirement Savings: Leveraging Healthcare Costs to Drive 401(k) Contributions & Improve Health, from HealthyCapital, a joint venture of Mercy health systems and HealthView Services.   The chart illustrates three

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

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

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

“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

Over four in 10 U.S. workers were enrolled in a high-deductible health plan in the first 9 months of 2017, according to the latest research published by the National Center for Health Statistics, part of the Centers for Disease Control in the U.S. Department of Health and Human Services. The report details Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January-September 2017. About 28 million people were uninsured in the U.S. in 2017, about the same proportion as in 2016 — but nearly 20 million fewer than in 2010, as the line chart illustrates. The

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

It’s February 1st, which marks the first of 28 days of American Heart  Month – a time to get real, embrace, learn about, and engage with heart health. Heart disease kills 610,000 people in the U.S. every year, equal to 1 in 4 deaths in America. It’s the leading cause of death for both men and women in the U.S. Knowing your blood pressure is an important step for managing the risks of heart disease. That hasn’t yet been available to those of us who quantify our steps, weight, sleep, food intake, and other health metrics. In 2017, Hugh Langley

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

Nurses working in the U.S. are number one when it comes to ethics and honesty, the Gallup Poll found for the sixteenth year in a row. After nurses, military officers, grade school teachers, medical doctors and pharmacists rank second through fifth in ethical-line behind top-rated nursing. It’s important to note that consumers have ranked pharmacists and doctors in second and third place in this annual survey for many years. This year, both professions fall below the military and teachers. Nurses have been #1 in this study every year since Gallup launched the survey in 1999, except for 2001 when firefighters topped

As 2018 approaches, consumers will gather healthy New Year’s Resolutions together. Entering the New Year, most Americans are also dealing with concerns about healthcare costs, cybersecurity, and caring – for physical health, mental stress, and the nation. Healthcare costs continue to be top-of-mind for consumer pocketbook issues. Entrenched frugality is the new consumer ethos. While the economy might be statistically improving, American consumers’ haven’t regained confidence. In 2018, frugality will impact how people look at healthcare costs. 88% of US consumers are likely to consider cost when selecting a healthcare provider, a Conduent survey found. Physicians know this: 81% of

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

More consumers are seeking health-making opportunities everywhere, both within and outside of traditional healthcare touch-points. That includes peoples’ consumption of beer. We learned from the Edelman Health Engagement Barometer that consumers seek to engage for health beyond healthcare organizations – namely, hospitals, providers, over-the-counter medicines, pharma and insurance. What was perhaps the most surprising industry segment consumers called on for personal health engagement was brewing and alcohol. Fully 8 in 10 consumers expect brewing and spirits companies to engage in health. The bar chart shows this finding, arraying beer and liquor producers on par with retail and consumer technology, along

Talk about the last mile in healthcare. CVS Pharmacy will deliver prescription drugs to patients’ homes, the company announced this week. “Same-day prescription delivery gives customers the easy option of having the pharmacy they trust deliver right to their front door at no cost,” Helen Foulkes, President of CVS Pharmacy, said in the press release. Rx home delivery may not be “the” last mile to conquer all healthcare access challenges, but it’s nonetheless a signal that healthcare industry suppliers are focusing on helping patients streamline their health-consumer lives. In this case, it’s also CVS morphing towards Amazon’s Prime delivery model. Amazon

THINK: money and love. To find health, working-aged people seek financial stability and good relationships, according to the Consumer Health POV Report from Welltok, meQuilibrium, and Zipongo, featured in their webinar broadcast today. The online consumer survey was conducted among 2,000 full-time working U.S. adults in August 2017, segmented roughly into thirds by Boomers (37%), Gen Xers (32%), and Millennials (31%). Much lower down the priority list for healthy living are managing food, sleep, and stress based on the poll. Feeling stress is universal across most consumers in each of the three generational cohorts, especially related to work and finance.

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