A blog covering the health/care ecosystem and people.

Today marks eight days before #Election2024 in the U.S. While many political pundits assert that “health care is not on the ballot,” I contend it is on voters’ minds in many ways — related to the economy (the top issue in America), social equity, and even immigration (in terms of the health care workforce). In today’s Health Populi blog, I’m digging into  Access Denied: patients speak out on insurance barriers and the need for policy change, a study conducted by Ipsos on behalf of PhRMA, the Pharmaceutical Research and Manufacturers of America — the pharma industry’s advocacy organization (i.e., lobby

“If the U.S. were sensible, weight management would be treated as a public health issue,” David Cutler writes in the JAMA Health Forum dated August 15, 2024. Dr. Cutler, distinguished economics professor at Harvard, talks about “the pathology of U.S. health care” citing the example of weight loss medications — in short, the uptake of GLP-1 drugs to address Type 2 diabetes first, and subsequently obesity.          Dr. Cutler notes that the price of these drugs in the U.S. “far exceeds” that of other countries: specifically, 9 times that of the prices in Germany and the Netherlands

With 70 different clinical trials for GLP-1 drugs in process with the FDA, payers — and other stakeholders in the health care ecosystem — have the semaglutide-SENSE top of mind, based on my ongoing updating of this fast-moving market space.               For overall market context on pace-of-growth in adoption, check out this chart from a JAMA Health Forum research letter on Prescription Fills for Semaglutide Products by Payment Method, published August 2nd. The study was based on the IQVIA National Prescription Audit PayerTrak data which captures 92% of Rx’s filled at retail pharmacies in

Health care costs for an “average” person covered by an employer-sponsored PPO in the U.S. rose 6.7% between 2023 and 2024, according to the 2024 Milliman Medical Index. Milliman also calculated that the largest driver of cost increase in health care, accounting for nearly one-half of medical cost increases, was pharmacy, the cost of prescription drugs, which grew 13% in the year.             The big number this year is $32,066, which is the cost of that employer-sponsored PPO for a family of 4 in 2024. I’ve curated the chart of the MMI statistic for many

The Wall Street Journal reported yesterday that surging hospital prices are helping to keep inflation high.                 Hospital costs rose 7.7% last month, the highest increase in 13 years. This chart from WSJ’s reporting illustrates the >2x change in the CPI for hospitals vs the overall rate of price increases. Hospitals are not alone in price cliffs, with health insurance premiums spiking last year at the fastest rate in a decade, the Labor Statistics data showed. “For patients and their employers, the increases have meant higher health-insurance premiums, as well as limiting wage

Since the introduction of GLP-1 drugs on the market, their use has split into two categories: for obesity and “recreationally,” according to the Chief Economist with UBS (formerly known as Union Bank of Switzerland). Paul Donovan, said economist, discusses The economics of getting thin in his regularly published comment blog.                   “These different uses have different economic consequences,” Donovan explains: Obese patients who use GLP-1s should become more productive employees, Donovan expects — less subject to prejudice, and less likely to be absent from work. While so-called recreational GLP-1 consumers may experience these

Let’s put “health” back into the U.S. health care system. That’s the mantra coming out of this week’s annual Capitol Conference convened by the National Association of Benefits and Insurance Professionals (NABIP). (FYI you might know of NABIP by its former acronym, NAHU, the National Association of Health Underwriters).         NABIP, whose members represent professionals in the health insurance benefits industry, drafted and adopted a new American Healthcare Consumer Bill of Rights launched at the meeting. While the digital health stakeholder community is convening this week at VIVE in Los Angeles to share innovations in health tech, NABIP

One-third of U.S. consumers feel in worse financial shape now than in 2022, with inflation a top concern, discovered in the 2024 New Year’s Financial Resolutions Study from Fidelity Investments.          In this 15th annual update of Fidelity’s research into Americans’ New Year’s resolutions for financial health, we learn the mantra that 2024 will be the year of living practically, opening new chapters for saving and paying down debt. Fidelity conducted an online poll among 3,002 U.S. adults 18 and over in October 2023 to gauge peoples’ perspectives on personal finances, and well-being currently and into 2024. This

Due to their delayed return to medical services and diagnostic testing in the COVID-19 pandemic era, U.S. employees are expected to sustain serious health impacts that will drive employers’ health care costs, envisioned in the 2024 Large Employer Health Care Strategy Survey from the Business Group on Health (BGH).               Dealing with mental health issues is the top health and well-being impact workers in large companies are addressing in 2023. Looking forward, large employers foresee their workers will be seeking care for chronic conditions and later-stage cancers that are diagnosed due to delayed screenings.

“Healthcare costs came roaring back in 2021” after falling in 2020. In 2023, that roaring growth in health care costs continues with expected growth of 5.6%.             For 2023, you could take your $31K+ and buy a Toyota Corolla Cross Hybrid auto, fund a year at the Gnomon School in Hollywood toward a degree in animation or game design, or buy healthcare for your family of 4. Welcome to this year’s annual look at health care costs for a “typical” U.S. family explained in the 2023 Milliman Medical Index (MMI).            

“Can employers afford not to care?” MetLife’s 21st annual U.S. Employee Benefit Trends Study asks and answers that question, with a resounding and evidence-based “NO.”                 I’m in Salt Lake City today discussing the drivers of health, “yesterday, today, and tomorrow” at the Virgin Pulse Thrive Summit, celebrating the ten-year anniversary of the company. As you would expect from an organization that is part of Richard Branson’s business ecosystem, the meeting will be energetically produced, delivering insights wrapped in info-taining ways. One of those features will be my being invited to create a

Consumers’ wellness life-flows and demands in 2023 will go well beyond exercise resolutions, eating more greens, and intermittent fasting as a foodstyle. It’s time for us to get the annual update on health consumers from the multi-faceted team who curated the Global Wellness Summit’s annual report on The Future of Wellness 2023 Trends.                   In this year’s look into wellness for the next few years, we see that health-oriented consumers are seeking solutions for dealing with loneliness and mental health, weight and hydration, travel-as-medicine as health destinations, and — not surprisingly —

Due to gender pay gaps, time away from the workforce for raising children and caring for loved ones, women in the U.S. face a risky retirement outlook according to Emerging from the COVID-19 Pandemic: Women’s Health, Money, and Retirement Preparations from the Transamerica Center for Retirement Studies (TCRS).               As Transamerica TCRS sums up the top-line, “Societal headwinds are undermining women’s retirement security.” Simply said, by the time a woman is looking to retire, she has saved less than one-half of the money her male counterpart has put away for aging after work-life. The

Employers covering health insurance for workers’ families will face insurance premiums reaching, on average, $22,463. That is roughly what a year at an independent college in Connecticut would cost, or a round of pay for a ref in the Stanley Cup playoffs. With that sticker-shock level of health plan costs, welcome to the 2022 Employer Health Benefits Survey from Kaiser Family Foundation, KFF’s annual study of employer-sponsored health care.                 Each year, KFF assembles data we use all year long for strategic and tactical planning in U.S. health care. This mega-study looks at

The concept that all companies are “health care companies” takes on greater import in the wake of the pandemic. The 2023 Large Employers’ Health Care Strategy and Plan Design Survey from the Business Group on Health (BGH) found that two in three large employers see their health and well-being strategy as an integral part of their overall workforce strategy. This is our annual go-to study guiding us on the private sector’s big thinking about health care plans and investments on workers’ behalf.           The first line chart illustrates how this phenomenon shot up in importance for

Supply chain challenges, inflation, and plummeting consumer economic sentiment are setting the stage for a decline in consumer electronics revenues for 2022. However, there will be some bright spots of growth for consumer tech spending, for 5G smartphones, smart home applications, gaming, and health technologies, noted in the Consumer Technology Association’s CTA U.S. Consumer Technology One-Year Industry Forecast, 2018-2023.             Underneath the overall industry spend of $503 billion, a 0.2% drop from 2021, CTA expects software, gaming, video and audio streaming spending will grow by 3.5% and hardware to fall by 1.4% this year. With

As more than 1 in 3 U.S. workers were unemployed during the pandemic and another 38% had reductions in hours and pay, Americans’ personal forecasts and expectations for retirement have been disrupted and dislocated.                 In its look at The Road Ahead: Addressing Pandemic-Related Setbacks and Strengthening the U.S. Retirement System from the Tramsamerica Center for Retirement Studies (TCRS), we learn about the changing views of U.S. workers on their future work, income, savings, dreams and fears. Since 1988, TCRS has assessed workers’ perspectives on their futures, this year segmented the 10,003 adults

When high-deductible health plans became part of health insurance design in America, they were lauded as giving patients “more skin in the game” of health care payments. The theory behind consumer-directed care was that patients-as-consumers would shop around for care, morph into rational consumers of medical services just as they would do purchasing autos or washing machines, and shift the cost-curve of American health care ever downward. That skin-in-the-game has been a risk factor for .some patients to postpone care as well as take on medical debt — the strongest predictor of which is dealing with multiple chronic conditions. “The

“Until now, focus on….the social determinants of health has been for government and civil society. The private sector has not been involved in the discussion or, worse, has been seen as part of the problem. It is time this changed,” asserts the report, The Business of Health Equity: The Marmot Review for Industry, sponsored by Legal & General in collaboration with University College London (UCL) Institute of Health Equity, led by Sir Michael Marmot.               Sir Michael has been researching and writing about social determinants of health and health equity for decades, culminating publications

There’s more evidence that doctors and patients, both, want to use telehealth after the COVID-19 pandemic fades. Doximity’s second report on telemedicine explores both physicians’ and patients’ views on virtual care, finding most doctors and health consumers on the same page of virtual care adoption. For the physicians’ profile, Doximity examined 180,000 doctors’ who billed Medicare for telemedicine claims between January 2020 and June 2021. Telemedicine use did not vary much across physician age groups. Doctors in specialties that manage chronic illnesses were more likely to use telehealth: endocrinology (think: diabetes), gastroenterology, rheumatology, urology, nephrology, cardiology, ENT, neurology, allergy, and

In the U.S., being covered by health insurance is one of the social determinants of health. Without a health plan, an uninsured person in America is far more likely to file for bankruptcy due to medical costs, and lack access to needed health care (and especially primary care). But even with health insurance coverage, most health-insured people are concerned about medical costs in America, found in a MITRE-Harris Poll on U.S. consumers’ health insurance perspectives published today. “Even those fortunate to have insurance struggle with bills that result from misunderstanding or underestimating costs of treatments and procedures,” Juliette Espinosa of

Even with growing inflation in the U.S. and post-pandemic job growth in 2021, the cost of health insurance premiums rose faster than either the price of goods or wages. That family health plan premium reached $22,221, an increase of 22% since 2016, we learn in the annual report from Kaiser Family Foundation, 2021 Employer Health Benefits Survey. This report is our go-to encyclopedia of statistics on health insurance year-after-year, surveying companies’ annual health insurance strategies for coverage and tactics for managing spending and workers’ health outcomes. This 2021 update takes into account the impacts and influence of COVID-19 on workers’

COVID-19 exacted a toll on health citizens’ mental health, worsening a public health challenge that was already acute before the pandemic. It’s World Mental Health Day, an event marked by global and local stakeholders across the mental health ecosystem. On the global front, the World Health Organization (WHO) describes the universal phenomenon and burden of mental health on the Earth’s people… Nearly 1 billion people have a mental disorder Depression is a leading cause of disability worldwide, impacting about 5% of the world’s population People with severe mental disorders like schizophrenia tend to die as much as 20 years earlier

One in two people in the U.S. receive health insurance through employers. As large employers tend to be on the vanguard of benefit plan design, it’s useful to understand how these companies are thinking ahead on behalf of their employees. With that objective, it’s always instructive to explore the annual study from the Business Group on Health, the 2022 Large Employers’ Health Care Strategy and Plan Design Survey. As a result of the COVID-19 pandemic, large employees have many concerns about worker and dependents’ health. The biggest firms in America providing health insurance for workers are expecting an increase in

There is one health care public policy issue that unites U.S. voters across political party: that is the consumer-facing costs of prescription drugs. With the price of medicines in politicians’ and health citizens’ cross-hairs, the pharmaceutical and biotech industries have responded in many ways to the Rx pricing critiques from consumers (via, for example, Consumer Reports/Consumers Union and AARP), hospitals (through the American Hospital Association), and insurance companies (from AHIP, America’s Health Insurance Plans). The latest poll from the University of Chicago/Harris Public Policy and the Associate Press-NORC Center for Public Affairs Research quantifies the issue cross-party, finding that 74%

In the COVID-19 pandemic, health care spending in the U.S. increased by a relatively low 6.0% in 2020. This year, medical cost trend will rise by 7.0%, expected to decline a bit in 2022 according to the annual study from PwC Health Research Institute, Medical Cost Trend: Behind the Numbers 2022. What’s “behind these numbers” are factors that will increase medical spending (the “inflators” in PwC speak) and the “deflators” that lower costs. Looking around the future corner, the inflators are expected to be: A COVID-19 “hangover,” leading to increased health care services utilization Preparations for the next pandemic, and

In the COVID-19 pandemic, as peoples’ daily lives shifted closer and closer to home, and for some weeks and months home-all-the-time, health care, too, moved beyond brick-and-mortar hospitals and doctors’ offices. The public health crisis accelerated “what’s next” for health care delivery, detailed in A New Era of Virtual Health, a report published by TripleTree. TripleTree is an investment bank that has advised health care transactions since 1997. As such, the team has been involved in digital health financing and innovation for 24 years, well before the kind of platforms, APIs, and cloud computing now enabling telehealth and care, everywhere. The

In 2020, investments in digital health reached $14.1 bn, much of which went into niche applications like lab testing, medication adherence, and on-demand triage for urgent care. These companies targeting primary care components represent the “unbundling of the family doctor,” as CB Insights recently coined the market trend. Fragmentation is a hallmark of the U.S. health care system, or more aptly “non-system” as my old friend J.D. Kleinke noted in his book titled Oxymorons….published in 2001. Twenty years later, we confront primary care as a dichotomy: as unbundled pieces of (we hope) innovation, and in organizations re-imagining a new continuity

For a worker in the U.S. who benefits from health insurance at the workplace, the annual family premium will average $21,342 this year, according to the 2020 Employer Health Benefits Survey from the Kaiser Family Foundation. The first chart illustrates the growth of the premium shares split by employer and employee contributions. Over ten years, the premium dollars grew from $13,770 in 2010 to $21K in 2020. The worker’s contribution share was 29% in 2010, and 26% in 2020. Single coverage reached $7,470 in 2020 and was $5,049 in 2010. Roughly the same proportion of companies offered health benefits to

In the U.S., symptoms of depression were three-times greater in April 2020 in the COVID-19 pandemic than in 2017-2018. And rates for depression were even higher among women versus men, along with people earning lower incomes, losing jobs, and having fewer “social resources” — that is, at greater risk of isolation and loneliness. America’s health system should be prepared to deal with a “probable increase” in mental illness after the pandemic, researchers recommend in Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic in JAMA Network Open. A multidisciplinary team knowledgeable in medicine, epidemiology, public health,

In the midst of the coronavirus pandemic, two certainties emerge in the lives of physicians: they are generating less revenue, and they have adopted more virtual care in practices. The Physicians Foundation surveyed 3,513 physicians in July 2020 on their perspectives on COVID-19 and how the pandemic has impacted practices and patients. This study is part one of three conducted by the Foundation this year, subtitled the “COVID-19 Impact Edition” of the 2020 Survey of America’s Physicians which the Foundation conducts each year. Merritt Hawkins conducted the study on behalf of the Foundation, shifting the focus to the pandemic. This

Most U.S. employers worry about workers’ mental health and substance use as employees begin returning to work in the summer of 2020. About 4 in 5 U.S. companies are “very concerned” or “concerned” about employees’ chronic illnesses, acute illnesses, and injuries along with behavioral health issue, based on McKinsey’s annual employer survey which coincided this year with the COVID-19 pandemic. Challenges of opioid use in the workforce remain a concern for two-thirds of U.S. companies, as well. Some 9 in 10 U.S. companies say behavioral health has a negative impact on workforce productivity. In response, 7 in 10 employers are

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

In the midst of growing inpatient admissions and test results for COVID-19, Congress is working as I write this post to finalize a round of legislation to help Americans with the costs-of-living and (hopefully) health care in a national, mandated, clarifying way. Right now in the real world, real patients are already being treated for COVID-19 in American hospitals. Patients are facing health care costs that may result in multi-thousand dollar bills at discharge (or death) that will decimate households’ financial health, particularly among people who don’t have health insurance coverage, covered by skinny or under-benefited plans, and/or lack banked

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

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

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

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

This year, an employer-sponsored PPO for a family of four in the U.S. will cost $28,386, a 3.6% increase over 2018, according to the 2019 Milliman Medical Index (MMI). Based on my annual read of this year’s Index, the PPO costs roughly the same as a new Dodge Charger or a year attending the engineering school at Alfred University. The Milliman MMI team has updated the methodology for the Index; the chart shown here is my own, recognizing that the calculations and assumptions beneath the 2019 data point differ from previous years. The key points of the report are that:

With lower expectations of and satisfaction with health care, Millennials in America seek three things: available, accessible, and affordable services, research from the Transamerica Center for Health Studies has found. Far and away the top reason for not obtaining health insurance in 2018 was that it was simply too expensive, cited by 60% of Millennials. Following that, 26% of Millennials noted that paying the tax penalty plus personal medical expenses were, together, less expensive than available health options. While Millennials were least likely to visit a doctor’s office in the past year, they had the most likelihood of making a

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

National health spending in the U.S. is expected to grow by 5.7% every year from 2020 to 2027, the actuaries at the Centers for Medicare and Medicaid Services forecast in their report, National Health Expenditure Projections, 2018-2927: Economic And Demographic Trends Drive Spending And Enrollment Growth, published yesterday by Health Affairs. For context, note that general price inflation in the U.S. was 1.6% for the 12 months ending January 2019 according to the U.S. Bureau of Labor Statistics. This growth rate for health care costs exceeds every period measured since the high of 7.2% recorded in 1990-2007. The bar chart illustrates the

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

Today is Boxing Day and St. Stephens Day for people who celebrate Christmas, so I share this post as a holiday gift with well-wishes for you and those you love. The tea leaves have been brewing here at THINK-Health as we prepared our 2019 forecast at the convergence of consumers, health, and technology. Here’s our trend-weaving of 4 C’s for 2019: costs, consumerism, cyber and care, everywhere… Health care costs will continue to be a mainstream pocketbook issue for patients and caregivers, with consequences for payors, suppliers and ultimately, policymakers. Legislators inside the DC Beltway will be challenged by the

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

The complexity of the U.S. healthcare system erodes Americans’ health literacy, Accenture asserts in their report, The Hidden Cost of Healthcare System Complexity.                             And that complexity costs, Accenture calculated, to the tune of nearly $5 billion in administrative cost burden to payors. Accenture developed a healthcare system literacy index to quantify the relationship between peoples’ understanding of how health insurance works and what a lack of understanding can cost the system. The index looks at consumer comprehension of health insurance terms like premium, deductible, copayment, coinsurance, out-of-pocket

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

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

Design-thinking has come to health/care, finally, and Amy Cueva has been beating this drum for a very long time. I’m delighted to be in her collegial circle, speaking at the conference about the evolving healthcare consumer who’s financially strapped, stressed-out, and Amazon Primed for customer service. I’m blogging live while attending HXD 2018 in Cambridge, MA, the health/care design conference convened by Mad*Pow, 26th and 27th June 2018. Today was Day 1 and I want to recap my learnings and share with you. Amy, Founder and Chief Experience Office of Mad*Pow, kicked off the conference with context-setting and inspiration. Design