A blog covering the health/care ecosystem and people.

HIMSS convenes its annual conference this week in Orlando, kicking off with an Executive Summit that featured John Mackey, the CEO and Co-Founder of Whole Foods, in conversation with Cris Ross, CIO of the Mayo Clinic. Mackey said in support of his long-held belief that food is the”best solution” to address Americans’ health. As for health care? Not so much, at least as it’s delivered in the United States. ”Why don’t we have clinics that help people change their diets and lifestyles so that they can reverse the disease or prevent it?” Mackey asked, rhetorically. ”It’s astounding. There’s a huge entrepreneurial

As we enter COVID-19’s “junior year,” one unifying experience shared by most humans are feelings of pandemic fatigue: anxiety, grief, burnout, which together diminish our mental health. There are many signposts pointing to the various flavors of mental and behavioral health challenges, from younger peoples’ greater risk of depression and suicide ideation to increased deaths of despair due to overdose among middle-aged people. And about one-in-three Americans has made a 2022 New Year’s resolution involving some aspect of mental health, the American Psychiatric Association noted approaching the 2021 winter holiday season. Underneath this overall statistic are important differences across various

I cannot recall a season when so many health consumer studies have been launched into my email inbox. While I have believed consumers’ health engagement has been The New Black for the bulk of my career span, the current Zeitgeist for health care consumerism reflects that futurist mantra: “”We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run,” coined by Roy Amara, past president of Institute for the Future. That well-used and timely observation is known as Amara’s Law. This feels especially apt right “now” as we enter 2022,

In 2020, Genentech launched its first study into health inequities. The company spelled out their rationale to undertake this research very clearly: “Through our work pursuing groundbreaking science and developing medicines for people with life-threatening diseases, we consistently witness an underrepresentation of non-white patients in clinical research. We have understood inequities and disproportionate enrollment in clinical trials existed, but nowhere could we find if patients of color had been directly asked: ‘why?’ So, we undertook a landmark study to elevate the perspectives of these medically disenfranchised individuals and reveal how this long-standing inequity impacts their relationships with the healthcare system

We’ve long know that “the patient” has been an under-utilized resource in the U.S. healthcare system since Dr. Charles Safran testified with that statement to Congress way back in 2004…an era where bipartisanship for health IT was a real thing. Today, with the insights of Alexandra Drane (Founder of ARCHANGELS) and Dr. Nirav Shah (of Stanford University), we know that caregivers are among the most over-utilized resources in the U.S. healthcare system — overused, over-stressed, under-paid, detailed n How Health Systems Can Care for Caregivers, published in the NEJM Catalyst July 2021 issue. In this study, Drane and Shah analyze

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

In a matter of several weeks, people living in the U.S. have endured massive personal social, emotional, physical and fiscal disruption due to the COVID-19 pandemic. State mandates to shelter at home, the adoption of wearing face masks and covers in public, and re-making dining tables and dens into home-working spaces for kids in school or parents telecommuting, American homes have morphed into petri dishes of people undergoing dramatic changes in a very short time. A new report from PwC looks at peoples’ changes in health behaviors in the first two months of the pandemic, asking whether these changes will

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

“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

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

One in three working-age people in the U.S. have seen a doctor about something stress-related. Stress is a way of American life, based on the findings in The United States of Stress, a survey from Everyday Health. Everyday Health polled 6,700 U.S. adults between 18 and 64 years of age about their perspectives on stress, anxiety, panic, and mental and behavioral health. Among all sources of stress, personal finances rank as the top stressor in the U.S. Over one-half of consumers say financial issues regularly stress them out. Finances, followed by jobs and work issues, worries about the future, and relationships cause

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

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

Trust in the United States has declined to its lowest level since the Edelman Trust Barometer has conducted its annual survey among U.S. adults. Welcome to America in Crisis, as Edelman brands Brand USA in 2018. In the 2018 Edelman Trust Barometer, across the 28 nations polled, trust among the “informed public” in the U.S. “plunged,” as Edelman describes it, by 23 points to 45. The Trust Index in America is now #28 of 28 countries surveyed (that is, rock bottom), dropping below Russia and South Africa. “The public’s confidence in the traditional structures of American leadership is now fully

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.

As we look for signs of stability in U.S. health care, there’s one stakeholder that’s holding firm: employers providing healthcare benefits. Two studies out this week demonstrate companies’ commitment to sponsoring health insurance benefits….with continued tweaks to benefit design that nudges workers toward healthier behaviors, lower cost-settings, and greater cost-sharing. As Julie Stone, senior benefits consultant with Willis Towers Watson (WLTW), noted, “The extent of uncertainty in Washington has made people reluctant to make changes to their benefit programs without knowing what’s happening. They’re taking a wait-and-see attitude.” First, the Willis Towers Watson 22nd annual Best Practices in Health Care Employer

Large employers are taking more control over health care costs and quality by pressuring changes to how care is actually delivered, based on the results from the 2017 Health Plan Design Survey sponsored by the National Business Group on Health (NBGH). Health care cost increases will average 5% in 2017 based on planned design changes, according to the top-line of the study. The major cost drivers, illustrated in the wordle, will be specialty pharmacy (discussed in yesterday’s Health Populi), high cost patient claims, specific conditions (such as musculoskeletal/back pain), medical inflation, and inpatient care. To temper these medical trend increases,

Virtually all employers who offer health coverage to workers extend health benefits to all full-time employees. 94% offer health care coverage to opposite-sex spouses, and 83% to same-sex spouses. One-half off health benefits to both opposite-sex and same-sex domestic partners (unmarried). Dental insurance, prescription drug coverage, vision insurance, mail order prescription programs, and mental health coverage are also offered by a vast majority (85% and over) of employers. Welcome to the detailed profile of workplace benefits for the year, published in 2016 Employee Benefits, Looking Back at 20 Years of Employee Benefits Offerings in the U.S., from the Society for Human

Nearly 1 in 2 people own at least one wearable device, up from 21% in 2014; one-third of people own more than one such device that tracks some aspect of everyday life, according to PwC’s latest research on the topic, The Wearable Life 2.0 – Connected living in a wearable world, from PwC. Wearable technology in this report is defined as accessories and clothing incorporating computer and advanced electronic technologies, such as fitness trackers, smart glasses (e.g., Google Glass), smartwatches, and smart clothing. Specifically, 45% of people own a fitness band, such as a Fitbit, the most popular device in this

American workers are feeling financial stress and uncertainty, struggling with health care costs, and seeking support for managing finances. 75% of employees feel financially insecure, with 60% feeling stressed about their financial situation, according to the 2016 Workplace Benefits Report, based on consumer research conducted by Bank of America Merrill Lynch. The overall feeling of financial wellness fell between 2013 and 2015. 75% of U.S. workers don’t feel secure (34% “not very secure” and 41% “not at all secure”), with the proportion of workers identifying as “not at all secure” growing from 31% to 41%. Financial wellness was defined for this

What do you get when one of the largest health insurance companies supports the development of a medical-grade activity tracker, enables data to flow through a HIPAA-compliant cloud, and nudges consumers to use the app by baking behavioral economics into the program? You get Motion from UnitedHealthcare, working with Qualcomm Life’s 2net cloud platform, a program announced today during the 2016 HIMSS conference. What’s most salient about this announcement in the context of HIMSS — a technology convention — is that these partners recognize the critical reality that for consumers and their healthcare, it’s not about the technology. It’s about

This is the dawning of the Age of Consumer-Driven Health, the tipping point of which has been passed. The data point for this assertion comes from the National Business Group on Health‘s annual 2016 Large Employers’ Health Plan Design Survey. The tagline, “reducing costs while looking to the future,” suggests some of the underlying tactics employers will use to manage their financial burden of providing health insurance to workers. That burden will continue to shift to employees and their dependents in the form of greater cost-sharing: for premiums, co-pays and co-insurance, and the hallmark of consumer-driven health plans (CDHPs): high(er) deductibles.

From elite soccer and football fields to youth athletes in public school gyms, wearable technology has come to sports bringing two big benefits of gathering data at the point of exercise: to gauge performance and coach back to the athlete in real time, and to prevent injury. I discussed the advent of the Internet of Things in sports on the Scoop and Score podcast with Andrew Kahn, sports journalist and writer, and Stephen Kahn, sports enthusiast and business analyst. [In full disclosure these two Kahn’s are also my brilliant nephews.] We recorded the podcast on July 14, 2015, the day

People in the U.S. spend over five-and-a-half hours a day with digital media in 2015, with time on mobile devices exceeding use of laptop and desktop computers. The growth of mobile means people are using and seeking more just-in-time services in daily living, and this has big implications for health/care, based on the annual mega-report on Internet Trends from Mary Meeker, KPCB’s internet analyst. “People” in health/care are patients, consumers and caregivers; people in health/care are also health plan administrators, employer benefits managers, doctors, nurses, allied health professionals, financial managers in hospitals, pharmacists, and the entire range of humans who

Alex Gourley, President of The Walgreen Company, addressed the capacity crowd at HIMSS15 in Chicago on 13th April 2015, saying his company’s goal is to “make good health easier.” Remember that HIMSS is the “Health Information and Management Systems Society” — in short, the mammoth health IT conference that this year has attracted over 41,000 health computerfolk from around the world. So what’s a nice pharmacy like you, Walgreens, doing in a Place like McCormick amidst 1,200+ health/tech vendors?  If you believe that health is a product of lifstyle behaviors at least as much as health “care” services (what our

Offering wellness programs is universal among U.S. employers, who roughly divide in half regarding their rationale for doing so: about one-half offer wellness initiatives to invest in and increase worker health engagement, and one-half to control or reduce health care costs. Two-thirds of companies offering wellness will increase their budgets, according to the International Foundation of Employee Benefit Plans (IFEBP)  report, Workplace Wellness Trends, 2015 survey results. The IFEBP polled 479 employers in October 2014, covering corporate, public, and multi-employer funds in the U.S. and Canada. The statistics discussed in this post refer solely to U.S. organizations included in the study

Long an advocate for consumer-directed health in his company, John Mackey, co-CEO and co-Founder of Whole Foods Market, is talking about expanding the food chain’s footprint in retail health. “Americans are sick of being sick,” Mackey is quoted in “Whole Foods, Half Off,” a story published in Bloomberg on January 29, 2015. Mackey talks about being inspired by Harris Rosen, a CEO in Florida, who has developed a workplace clinic for employees’ health care that drives high quality, good outcomes, and lower costs. Mackey imagines how Whole Foods could do the same, beginning in its hometown in Austin, TX. He

People with more financial skin in the health care game are more likely to act more cost-consciously, according to the latest Employee Benefits Research Institute (EBRI) poll on health engagement, Findings from the 2014 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey published in December 2014. Health benefit consultants introduced consumer-directed health plans, assuming that health plan members would instantly morph in to health care consumers, seeking out information about health services and self-advocating for right-priced and right-sized health services. However, this wasn’t the case in the early era of CDHPs. Information about the cost and quality of health care services was scant,

Are you Feelin’ Groovy about wearables? Well slow down, you move too fast… …at least, according to Accenture’s latest survey into consumers’ perspectives on new technologies, published this week in conjunction with the 2015 Consumer Electronics Show in Las Vegas, the largest annual convention in the U.S. featuring technology for people. At #CES2015, we’re seeing a rich trove of blinged-out, multi-sensor, shiny new wearable things at the 2015 Consumer Electronics Show. Swarovski crystals are paired with Misfit Wearables, called the Swarovski Shine, shown here as a shiny new thing, indeed. Withings launched its Activite fitness tracking watch in new colors.

“A wearable future is around the corner,” PwC says. So it’s appropriate the consulting firm’s new report is indeed titled The Wearable Future. Wearable technologies — smartwatches, sensor-laden workout gear, activity tracking wristbands, and Google Glass, among them — are more than individual tracking and information devices. They’re part of a larger ecosystem called The Internet of Things (IoT), which is made of lots of stuff, each ‘thing’ incorporating a sensor that measures something. Those measurements can track virtually everything that someone does throughout the day: beyond the obvious steps taken, hours slept, and GPS coordinates, sensors can sense movement

Expecting health care cost increases of 5% in 2015, employers in the U.S. will focus on several tactics to control costs: greater offerings of consumer-directed health plans, increasing employee cost-sharing, narrowing provider networks, and serving up wellness and disease management programs. The National Business Group on Health’s Large Employers’ 2015 Health Plan Design Survey finds employers committed to health engagement in 2015 as a key strategy for health benefits. More granularly, addressing weight management, smoking cessation, physical activity, and stress reduction, will be top priorities, shown in the first chart. An underpinning of engagement is health care consumerism — which

Employer wellness programs are growing in the U.S., bundled with consumer-directed plans and health savings accounts. A wellness company’s work with employee groups is demonstrating that workers who adopt mobile health technologies — especially “wearables” coupled with smartphone apps — helps change behavior and drive health outcomes. Results of one such program are summarized in Wearables at Work, a technical brief from Vitality, a joint venture of Humana and Discovery Ltd., published April 23, 2014. Vitality has been working in workplace wellness since 2005, first using pedometers to track workers’ workouts. In 2008, Vitality adopted the Polar heart rate monitor for

The CEO of a family-owned grocery store chain wrote a letter to New York State lawmakers to support $65 million worth of spending on a computer system for health information in the state. That grocer is Danny Wegman, and that project is the Statewide Health Information Network, aka SHIN-NY. In his letter beginning, “Dear New York Legislator,” Wegman identifies several benefits he expects would flow out of the health IT project: 1. Improve health care for all New Yorkers 2. Lower health care costs, through reducing hospital readmission rates and reducing duplicate testing. 3. Lead to health data “liquidity” (my

Employers continue to invest in wellness programs aimed at improving employees’ health. In 2014, 3 in 4 employers plan to offer incentives to employees who participate in health improvement programs compared = and the financial value of these incentives has grown to $500, up from $338 in 2010. In its fifth year, the National Business Group on Health (NBGH)/Fidelity Investments have conducted their benefit consulting survey, culminating in the report, Employer Investments in Improving Employee Health. In the past 5 years, employers have increased their investments in wellness: the chart illustrates the growth of programs addressing physical activity/weight management and health eating,

3 in 4 people in America will buy health care at retail with a subsidy within just a few years, according to Mark Bertolini, CEO of Aetna. Bertolini was the first keynote speaker this week at the 2014 HIMSS conference convened in Orlando. Bertolini’s message was grounded in health economics 101 (about which frequent readers of Health Populi are accustomed to hearing). A healthy community drives a healthy local economy, and healthier people are more economically satisfied, Bertolini explained. The message: health care can move from being a cost driver to being an economic engine. But getting to a healthy

This post appeared in my Huffington Post column on January 16, 2013. In the afterglow of the 2014 Consumer Electronics Show (CES), away from the neon lights of Las Vegas, 4D curved TV screens, and uber-hip Google Glass wearers, a big question remains: Do we, the people, really want to tech our way to self-health? The number of digital health companies exhibiting at CES grew by 40 percent, exceeding 300 based on the count of the International Consumer Electronics Association, sponsor of the event. The hockey-stick growth of “wearable technology” seen at the 2014 Consumer Electronics Show begs the question: Are there

When the head of the Consumer Electronics Association gives a shout-out to the growth of health products in his annual mega-show, attention must be paid. The #2014CES featured over 300 companies devoted to “digital health” as the CEA defines the term. But if you believe that health is where we live, work, play, and pray, then you can see health is almost everywhere at the CES, from connected home tech and smart refrigerators to autos that sense ‘sick’ air and headphones that amplify phone messages for people with hearing aids, along with pet activity tracking devices like the Petbit. If

We who are charged with forecasting the future of health and health care live in a world of scenario planning, placing bets on certainties (what we know we know), uncertainties (what we know we don’t know), and wild cards — those phenomena that, if they happen in the real world, blow our forecasts to smithereens, forcing a tabula rasa for a new-and-improved forecast. There are many more uncertainties than certainties challenging the tea leaves for the new year, including the changing role of health insurance companies and how they will respond to the Affordable Care Act implementation and changing mandates

Coast-to-coast, stress is the modus vivendi for most Americans: 55% of people feel stressed in every day life, according to a study from Televox. A Stressful Nation: Americans Search for a Healthy Balance paints a picture of a nation of physically inactive people working too hard and playing too little. And far more women feel the stress than men do. 64% of people say they’re stressed during a typical workday. 52% of people see stress negatively impacting their lives. And nearly one-half of people believe they could better manage their stress. As a result, physicians say that Americans are experiencing negative

In health care, when money is tight, labor inputs like nurses and doctors stretched, and patients wanting to be treated like beloved Amazon consumers, what do you do? Why, innovate and thrive. This audacious Holy Grail was the topic for a panel II moderated today at the Connected Health Symposium, sponsored by Partners Heathcare, the Boston health system that includes Harvard’s hospitals and other blue chip health providers around the region. My panelists were 3 health ecosystem players who were not your typical discussants at this sort of meeting: none wore bow ties, and all were very entrepreneurial: Jeremy Delinsky

The “O” word drives health costs in America ever-upward. Without bending the obesity curve downward toward healthy BMIs, America won’t be able to bend that stubborn cost curve, either. The Economic Impacts of Obesity report from Alere Wellbeing accounts for the costs of chronic diseases and how high obesity rates play out in the forms of absenteeism, presenteeism, and direct health care costs to employers, workers and society-at-large. Among the 10 costliest physical health conditions, the top 3 are angina, hypertension and diabetes — all related to obesity and amenable to lifestyle behavior change. The top-line numbers set the context:

By 2022, $1 in every $5 worth of spending in the U.S. will go to health care in some way, amounting to nearly $15,000 for each and every person in America. From biggest line item on down, health spending will go to payments to: Hospitals, representing about 32% of all spending Physicians and clinical costs, 20% of spending Prescription drugs, 9% of spending Nursing, continuing care, and home health care, together accounting for over 8% of health spending (added together for purposes of this analysis) Among other categories like personal care, durable medical equipment, and the cost of health insurance.

Most Americans don’t understand what a health savings account (HSA) is – including people who are enrolled in the plans. While health literacy is generally acknowledged to be a public health challenge in America, health insurance literacy is not well recognized. Yet in the emerging consumer-directed health plan era of U.S. health care, peoples’ lack of understanding of health financial accounts will get in the way of people who really need care seeking care at the right time. This leads to greater health spending later when the consumer-patient can develop a health condition that could have been prevented (say, pre-diabetes

3 in 4 Americans say that out-of-pocket costs are the main reason they decide whether or not to seek preventive care, in A Call for Change: How Adopting a Preventive Lifestyle Can Ensure a Healthy Future for More Americans from TeleVox, the communications company, published in June 2013. TeleVox surveyed over 1,015 U.S. adults 18 and over. That’s the snapshot on seeking care externally: but U.S. health consumers aren’t that self-motivated to undertake preventive self-care separate from the health system, either, based on TeleVox’s finding that 49% of people say they routinely exercise, and 52% say they’ve attempted to improve eating habits.

Employers who provide health insurance are getting much more aggressive in 2013 and beyond in terms of increasing employees’ responsibilities for staying well and taking our meds, shopping for services based on cost and value, and paying doctors based on their success with patients’ health outcomes and quality of care. Furthermore, nearly one-half expect that technologies like telemedicine, mobile health apps, and health kiosks in the back of grocery stores and pharmacies are expected to change the way people regularly receive health care. What’s behind this? Increasing health care costs, to be sure, explains the 18th annual survey from the National

While there is big uncertainty about how health reform will roll out in 2014, and who will opt into the new (and improved?) system, health cost growth will slow to 6.5% signalling a trend of moderating medical costs in America. Even though more newly-insured people may seek care in 2014, the costs per “unit” (visit, pill, therapy encounter) should stay fairly level – at some of the lowest levels since the U.S. started to gauge national health spending in 1960. That’s due to “the imperative to do more with less has paved the way for a true transformation of the

The notion of consumers’ greater skin in the game of U.S. health care — and the underlying theory of rational economic men and women that would drive people to greater self-care — permeated the agenda of the 2nd annual Consumer Health & Wellness Innovation Summit, chaired by Lisa Suennen of Psilos Ventures. Lisa kicked off the meeting providing a wellness market landscape, describing the opportunity that is the ‘real’ consumer-driven health care: people getting and staying well, and increasing participation in self-management of chronic conditions. The U.S. health system is transforming, she explained, with payors beginning to look like computer

Health, happiness and engagement among employees are closely-linked and drive productivity in the workplace. But there’s a gap between the kind of wellness services employers offer workers to bolster health, and the programs that people actually want. The current state of employer wellness programs is described in a survey conducted by Virgin HealthMiles and Workforce, The Business of Healthy Employees: A Survey of Workplace Health Priorities, published in June 2013. There’s a gap between what workers want for wellness and what employers are offering. Most-demanded by workers are health on-site food choices desired by 79% of employees; but, only 33%

U.S. employers have been implementing various flavors of consumer-directed health plans for the better part of a decade. But consumers feel neither “directed” nor especially competent in managing their way through these plans. It appears that employers also have their own sort of health plan illiteracy when it comes to understanding health reform — the Affordable Care Act — according to the 2013 Aflac WorkForces Report (AWR) based on a survey of 1,900 benefits managers and over 5,200 U.S. workers conducted in January 2013. While you might know the Aflac Duck, you may not be aware that Aflac is the