A blog covering the health/care ecosystem and people.

“It’s the economy stupid,” Jennifer Tescher, CEO of the Financial Health Network, titles her latest column in Forbes. Published two weeks after the 2024 U.S. elections, Jennifer’s assertion sums up what, ex post facto, we know about what most inspired American voters at the polls in November 2024: the economy, economics, inflation, the costs of daily living….pick your noun, but it’s all about those Benjamins right now for mainstream American consumers across many demographic cuts. With that realization, we must remind ourselves as we enter a new year under a second-term President Trump that health care spending for everyday 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

The average person in the U.S. retiring in 2024 will need to bank $165,000 to pay for health care costs in retirement — a sum that does not include long-term care, Fidelity Investments advises us in the 23rd annual look at this always-impactful (and sobering) forecast. I’ve covered this study every year since 2011 here in Health Populi, continuing to add to this bar chart; in the interest of space and legibility, I started this year’s version of the chart at 2014, when the cost for a couple was gauged at $220K.             Fidelity began

On June 11, Rohit Chopra, the Director of the Consumer Financial Protection Bureau (CFPB) announced the agency’s vision to ban Americans’ medical debt from credit reports. He called out that, “In recent years, however, medical bills became the most common collection item on credit reports. Research from the Consumer Financial Protection Bureau in 2022 showed that medical collections tradelines appeared on 43 million credit reports, and that 58 percent of bills that were in collections and on people’s credit records were medical bills.” Chopra further explained that medical debt on a consumer credit report was quite different than other kinds

Health insurance plans make mainstream media news every week, whether coverage deals with the cost of a plan, the cost of out-of-network care, prior authorizations, or cybersecurity and ransomware attacks, among other front-page issues. This week, AHIP (the acronym for the industry association of America’s Health Insurance Plans) is convening in Las Vegas for its largest annual 2024 meeting. We expect at least 2,400 attendees registered for the meeting, and they’ll not just be representing the health insurance industry itself; folks will attend #AHIP2024 from other industry segments including pharmaceuticals, technology, hospitals and health systems, and the investment and financial services

In the past year, the growth of prescription drug utilization and spending has much to do with the use of GLP-1 agonists to treat diabetes and obesity, along with immunology therapy, and lipid meds, along with specialty medicines now accounting for over half of spending — up from 49% in 2018. This update comes from The Use of Medicines in the U.S. 2024 from the IQVIA Institute for Human Data Science. The annual report details trends in health services utilization, the use of prescription drugs, patient financing of those costs, the drivers underpinning the medicines spending, and an outlook to 2028.

Among Americans 50 years of age and over, the top health-related concerns are Cost, Cost, and Cost — for medical services, for long-term and home care, and for prescription medications. Quality of care ranks lower as a concern versus the financial aspects of health care in America among people 50 years of age and older, as we learn what’s On Their Minds: Older Adults’ Top Health-Related Concerns from the University of Michigan Institute for Healthcare Policy and Innovation. AARP sponsors this study, which is published nearly every month of the year on the Michigan Medicine portal.           

This post follows up Part 1 of a two-part series I’ve prepared in advance of the AHIP 2024 conference where I’ll be brainstorming these scenarios with a panel of folks who know their stuff in technology, health care and hospital systems, retail health, and pharmacy, among other key issues. Now, let’s dive into the four alternative futures built off of our two driving forces we discussed in Part 1.             The stories: 4 future health care worlds for 2030 My goal for this post and for the AHIP panel is to brainstorm what the person’s

As we start the month of April 2024 in the U.S., it’s tax season in America with Federal (and other) income taxes due on the 15th of the month. This is also the time my research clock alarm goes off for an important annual report that describes the latest profile of the patient-as-payer in the U.S. ‘Tis the season for J.P. Morgan’s InstaMed team to analyze health care payments data, describing the experiences of consumers, providers and payers in the Trends in Healthcare Payments Fourteenth Annual Report.                   The overall takeaway for

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

You’ve heard of food-as-medicine and exercise-as-medicine. Now we see the emergence of telecomms-as-medicine — or more specifically, a driver of health, access, and empowerment. Elevance Health, the health plan organization serving 117 million members, launched a program to channel mobile phones and data plans into the hands of some Medicaid plan enrollees, explained in the organization’s press release on the program. To implement this program and get connectivity into consumers’ hands and homes, Elevance Health is collaborating with several telecomms companies including Verizon, AT&T, Samsung, and T-Mobile. Funding is supported by the FCC’s Affordable Connectivity Program.        

Two-thirds of U.S. consumers say they can’t afford to pay their medical bills on-time, based on the 2023 Consumer Survey from Access One, a financial services company focused on healthcare payments.               The report’s title page asks the question, “What options do consumers really want for paying healthcare expenses?” The survey report responds to that question, finding out that nearly one-half of patients have taken some kind of action to reduce their medical expenses. Furthermore, one-third of consumers are not confident they could pay a medical bill of $500 or more. Access One fielded

“Simplicity is the ultimate sophistication,” Leonardo DaVinci wrote through his lens on innovation. Simplicity can be a transformational cornerstone of health/care innovation, we learn from Siegel+Gale’s report on the World’s Simplest Brands Tenth Edition (WSBX). Siegel+Gale found the most consumers are willing to pay more for simpler brand experiences and are more likely to recommend a brand for those simpler experiences, as well.             Across the 15,000 consumers the firm polled globally (across nine countries), five key factors underpin peoples’ experiences with the enchantingly “simple” companies: they are, Easy to understand Transparent and honest Caring for

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.

With consumer and prescriber interest in GLP-1 receptor agonist drugs “soaring,” health plan managers have a new source of financial stress and clinical questions on their to-do list. A team of Virta Health leaders held a webinar on 13th July 2023 to explain the results of a study the company just completed assessing health plan execs’ current views on Ozempic and other GLP-1 medicines with a view on both clinical outcomes and cost implications for this growing category of drugs that address diabetes and obesity.             Indeed, diabetes and obesity are top health concerns among the

If you live in Massachusetts, Hawaii, and New Hampshire, you win a kind of state lottery for public health and well-being, based on this year’s read of the 2023 Scorecard on State Health System Performance from The Commonwealth Fund.           Here’s a picture of the annual study’s top-line findings, a roster of the fifty U.S. states ranked by a mash-up of health system indicators. As Annie Burkey of FierceHealthcare succinctly summed it up, the “Commonwealth Fund gives healthcare in southeastern states failing grades across the board.” I’ll give you more details about the Top and Bottom

“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).            

Reviewing the annual 2023 report from the IQVIA Institute for Human Data Science discussing The Use of Medicines in the U.S. is always a detailed, deep, and insightful dive into the state of prescription drugs. It’s a volume speaking volumes on the current picture of prescribed meds, spending and revenues, health care utilization trends, and a forecast looking out to 2027. In my read of this year’s review, I see a flashing light for U.S. health care: “Wake up, public health!” I’ve pulled out a few of the data points that speak to me about population health, prevention and early

People are sick of being sick, the New York Times tells us. “Which virus is it?” the title of the article updating the winter 2022-23 sick-season asked. Entering 2023, U.S. health citizens face physical, financial, and mental health challenges of a syndemic, inflation, and stress – all of which will shape peoples’ demand side for health care and digital technology, and a supply side of providers challenged by tech-enabled organizations with design and data chops. Start with pandemic ennui The universal state of well-being among us mere humans is pandemic ennui: call it languishing (as opposed to flourishing), burnout, or

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 odds are against hospitals collecting patient balances greater than $7,500,” the report analyzing Hospital collection rates for self-pay patient accounts from Crowe concludes.       Crowe benchmarked data from 1,600 hospitals and over 100,00 physicians in the U.S. to reveal trends on health care providers’ ability to collect patient service revenue. And bad debt — write-offs that come out of uncollected patient bill balances after “significant collection efforts” by hospitals and doctors — is challenging their already-thin or negative financial margins.           The first chart quantifies that bad debt attributable to patients’ self-pay payments

Some patients dealing with cancer at Mercy Health’s Lourdes Hospital have been supplied with gas cards. This gesture is enabling families to get to medical appointments around Paducah, Kentucky where, this week, car drivers faced regular gas priced at an average of $4.16 a gallon compared with $2.92 one year ago.           Here’s the Hospital’s Facebook page featuring their gratitude to FiveStar Food Mart, the American Cancer Society, and the Mercy Health Foundation. “By providing cancer patients with gas cards, the cancer care team at Mercy Health Lourdes Hospital in Paducah hopes to mitigate financial challenges

Declines in preventive care services like cancer screenings and blood glucose testing concern employers, whose continued to cover health insurance for employees during the pandemic.                       “As we enter the third year of the COVID-19 pandemic, employers continue to battle escalating clinical issues, including delayed care for chronic conditions, postponed preventive screenings, and the exponential increase in demand for behavioral health services,” the Chief Medical Officer for Castlight Health notes in an analysis of medical claims titled Millions of People Deferred Crucial Care During the Pandemic, published in June. The

Year 3 into the COVID-19 pandemic, health citizens are dealing with coronavirus variants in convergence with other challenges in daily life: price inflation, civil and social stress, anxiety and depression, global security concerns, and the safety of their families. Add on top of these significant stressors the need to deal with medical bills, which is another source of stress for millions of patients in America. I appreciated the opportunity to share my perspectives on “The Patient As the Payer: How the Pandemic, Inflation, and Anxiety are Reshaping Consumers” in a webinar hosted by CarePayment on 25 May 2022. In this

Inflation and rising prices are the biggest problem facing America, most people told the Kaiser Family Foundation March 2022 Health Tracking Poll. Underpinning that household budget concern are gas and health care costs. Overall, 55% of people in the U.S. pointed to inflation as the top challenge the nation faces (ranging from 46% of Democrats to 70% of Republicans). Second most challenging problem facing the U.S. was Russia’s invasion into Ukraine, noted by 18% of people — from 14% of Republicans up to 23% of Democrats. The COVID-19 pandemic has fallen far down Americans’ concerns list tied third place with

There’s a trifecta cost challenge hitting U.S. household budgets in February 2022, highlighted in a poll from Morning Consult: inflationary spikes for housing, food, and energy, and the COVID-19 Omicron variant forcing health care costs up for some consumers driving medical debt up. This further underscores the reality that medical spending in the U.S. is taking shape as a consumer service or good, competing with — potentially crowding out — other household line items like food and increasingly costly petrol to fill gas tanks. Or taken the other way, gas and food crowding out health care spending, leading to either

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,

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’

In the U.S., “Health care is complicated because complexity is profitable.” So explain Bob Kocher, MD, and Anuraag Chigurupati, in a viewpoint on Economic Incentives for Administrative Simplification, published this week in JAMA. Dr. Kocher, a physician who is a venture capitalist, and Chigurupati, head of member experience at Devoted Health, explain the misaligned incentives that impede progress in reducing administrative spending. This essay joins two others in the October 20, 2021 issue of JAMA which highlight administrative spending in American health care: Administrative Simplification and the Potential for Saving a Quarter-Trillion Dollars in Health Care by Nikhil Sahni, Brandon

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

The COVID-19 pandemic exacerbated food insecurity in the U.S., a situation that was already challenging for millions of American families before the public health crisis emerged. While several Congressional and administrative actions were implemented in 2020 and the first half of 2021, the issue of food insecurity — defined as being unable to acquire enough food due to insufficient money or resources — remains a tragic aspect of daily living for many Americans — and especially for children who live in households where jobs have been lost and incomes reduced. Nutrition security has also been a health risk where people

A majority of Democrats, Independents, and Republicans agree that nurses are underpaid. Most Americans across political parties also believe that hospital executives are overpaid, according to a poll from The Associated Press-NORC Center for Public Affairs Research. The survey analysis is aptly titled, Most Americans Agree That Nurses and Aides Are Underpaid, While Few Support Using Federal Dollars to Increase Pay for Doctors, . Insurance executives are also overpaid, according to 73% of Americans — an even higher percent of people than the 68% saying hospital execs make too much money. In addition to nurses being underpaid, 6 in 10

In the U.S., patients have assumed the role of health care payors with growing co-payments, coinsurance amounts, and deductibles pushing peoples’ out-of-pocket costs up. This has raised the importance of price transparency, which is based on the hypothesis that if patients had access to personally-relevant price/cost information from doctors and hospitals for medical services, and pharmacies and PBMs for prescription drugs, the patient would behave as a consumer and shop around. That hypothesis has not been well proven-out: even though more health care “sellers” on the supply side have begun to post price information for services, patients still haven’t donned

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

To pay for health care expenses, the average nest-egg required for a couple retiring in the U.S. in 2021 will be $300,000 according to the 20th annual Fidelity Investments Retiree Health Care Cost Estimate. I’ve tracked this survey for over a decade here on Health Populi, and updated the annual chart shown here to reflect a $40,000 increase in retiree costs since 2016. While the rate of increase year-on-year since then has slowed, the $300,000 price-tag for retiree health care costs is a huge number few Americans have saved for. That $300K splits up unequally for an opposite-gender couple (in

Our feet have become an important health focus during the pandemic, as the importance of exercise-as-medicine and mental health helper has looked to walking, running, and biking as good-for-us physical activities. The Mayo Clinic published an informative piece on Feet and the COVID-19 Pandemic, and the Cleveland Clinic posted advice on exercising during the pandemic earlier this month with the strong recommendation of walking. So it makes sense that the apparel category whose brand equity grew most between 2020 and 2021 was footwear, announced in the Brand Finance Apparel 50. Each year, Brand Finance evaluates the value of “brands,” as

More Americans are happier in March 2021 than they’ve been for a year, based on consumer research from Civic Science polling U.S. adults in early March 2021. For the first time, a larger percent of Americans said they were better off financially since the start of the pandemic. This week, Civic Science shared their latest data on what they’re seeing beyond the coronavirus quarantine era to forecast trends that will shape a post-COVID America. Buoying peoples’ growing optimism was the expectation of the passage of the American Cares Act, which President Biden signed into effect yesterday. The HPA-CS Economic Sentiment Index

The COVID-19 pandemic forced consumers to define what were basic or essential needs to them; for most people, those items have been hygiene products, food, and connectivity to the Internet. There’s another good that’s essential to people who are patients: prescription drugs. A new report from CoverMyMeds details the current state of medication access weaving together key health care industry and consumer data. The reality even before the coronavirus crisis emerged in early 2020 was that U.S. patients were already making painful trade-offs, some of which are illustrated in the first chart from the report. These include self-rationing prescription drug

In the U.S., the COVID-19 pandemic has revealed disparities in housing, food, and job security, and the role that one’s ZIP code and social determinants play in health outcomes. Overall, America has done poorly in light of being 4% of the world’s population but having one-fifth of the planet’s deaths due to the coronavirus. But these have disproportionately hit non-white people, who are nearly three times as likely to die from COVID-19 than white Americans. I’ve been head-down reviewing the first two days of President Biden’s signing Executive Orders, reading the National Strategy for COVID-19 Response, and inventorying line items

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

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

The coronavirus pandemic has revealed deep cracks and inequities in U.S. health care in terms of exposure to COVID-19 and subsequent outcomes, with access to medical care and mortality rates negatively impacting people of color to a greater extent than White Americans. The pandemic has also led to economic decline that, seven weeks before the 2020 elections in America, is top-of-mind for health citizens with the virus-crisis itself receding to second place, according to the Kaiser Family Foundation September 2020 Health Tracking Poll. KFF polled 1,199 U.S. adults 18 years of age and older between August 28 and September 3,

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,

Along with the life-threatening impact of the coronavirus on physical health, and the accompanying mental health distress activated by self-distancing comes a third unintended consequence with the pandemic: a hard hit on women’s personal economies. The recession of the pandemic is considered by many economists as a “She-Cession,” a downturn in the economy that’s negatively impacting women more acutely than men. This is markedly different than the Great Recession of 2008, the last major financial crisis: that financial decline was coined a “ManCession,” taking a more significant toll out of more typically men’s jobs like construction and manufacturing where fewer

One in two people in the U.S. say their financial health has been negatively impacted by the COVID-19 pandemic, through job loss, income disruption, or reduced work hours. The 2020 Financial Wellness Census, from Prudential found that one-half of U.S. adults are anxious about their financial future as of May 2020, an increase from 38% in late 2019. Prudential surveyed 3,000 U.S. adults across three generational cohorts: Millennials, Gen X, and Baby Boomers. The economic hit from the pandemic has disproportionately impacted people of color, younger people, women, small business owners, gig workers, and people working in retailer harder than

The coronavirus pandemic has further opened the kimono of the U.S. healthcare system to Americans: four months into the COVID-19 outbreak, most consumers (62%) of people in the U.S. are more concerned about other people not having access to high quality health care versus themselves. This is a 16 point increase in concern in May 2020 compared with the response to the same question asked in February in a poll conducted by the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research (the AP-NORC Center). The AP-NORC Poll found more of this