A blog covering the health/care ecosystem and people.

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

Nations throughout the world are challenged by the cost of health care: from Brazil to China, India to the Philippines, and especially in the U.S., people are morphing into health care consumers. Three categories of health spending in the bulls-eye of countries’ Departments of Health are prescription drugs, and the costs of care in hospitals and doctors’ offices. In the U.S., one tactic for cost containment in health is “switching” certain prescription drugs to over-the-counter products – those deemed to be efficacious and safe for patients to take without seeking treatment from a doctor. Over-the-counter drugs (OTCs) are available every

Patients are concerned about private risks of personal health data, resulting in some patients not disclosing certain information to health providers to protect their perceived EHR privacy and security risks. Peoples’ mixed feelings about sharing personal health information with their providers and EHRs is explored in The double-edged sword of electronic health records: implications for patient disclosure, published in the July 2014 issue of JAMIA, the Journal of the American Medical Informatics Association (AMIA). “The perception of the [EHR] technology may elicit non-disclosure as a privacy-protecting behavior,” the authors warn. Celeste Campos-Castillo and Denise Anthony, the paper’s researchers who work in

Make-over your medicine cabinet. That’s a key headline for International Self-Care Day (ISD) on July 24, 2014, an initiative promoting the opportunity for people to take a greater role in their own health care and wellness. Sponsored by the Consumer Healthcare Products Association (CHPA), consumer products companies, health advocacy organizations, and legislators including John Barrow (D-GA), a co-sponsor of H.R. 2835 (aka the Restoring Access to Medications Act), the Day talked about the $102 billion savings opportunity generated through people in the U.S. taking on more self-care through using over-the-counter medicines. After the 2008 Recession hit the U.S. economy, industry analysts

“Reality is the leading cause of stress among those in touch with it,” Lily Tomlin once quipped. Perhaps in 2014, America is the land of stress because we’re all so in touch with reality. THINK: reality TV, social networks as the new confessional, news channeling 24×7, and a world of too much TMI. So no surprise, then, that one-half of the people in the U.S. have had a major stressful event or experience in the last year. And health tops the list of stressful events in This American Life in the forms of illness and disease (among 27% of people)

Consumers around the world are feeling more knowledgeable, self-confident and realistic, enabled by mobile platforms, the democratic power of social “choruses,” and a more sharing economy featuring collaborative consumption. As peoples’ phones get smarter and smarter, they carry more powerful multichannel information devices in their hands which empower Homo Informaticus – the new global digital consumer, described in EY’s report, How to copilot the multichannel journal. EY polled 29,943 consumers in the Consumers on Board survey living in 34 countries: across the Americas, Asia-Pacific, the Middle East, India and Africa. Homo informaticus is the rational consumer smartly using technology to filter information.

There’s a growing number of wearable digital health devices on the market, and more will appear at the 2015 Consumer Electronics Show in Las Vegas. Four new such products competed live today at CE Week’s Battle of the Bands, an event launched by Living in Digital Times. The competitors included GoQii, Healbe, Skulpt, and Wellograph, Wellograph calls itself “the world’s first wellness watch.” Made of sapphire crystal, the watch has a sleek design, targeting a working professional audience who wants a view on health throughout the day. The watch has an Integrated heart rate sensor, taking readings from the wrist for pulse,

Most people (54%) want their mobile phones to enable health care interactions, according to Mobile Thought Leadership, a paper from FICO that summarizes data from a survey conducted with health citizens around the world. FICO conducted research among 2,239 adult smartphone users in the UK, Australia, Brazil, China, France, Germany, India, Italy, Japan, Korea, Mexico, Russia, Turkey and the United States. The data discussed here in Health Populi refer to a subset covering just U.S. consumers. Among the one-half of consumers interested in doing more health care interactions via mobile in the future, the most popular options are: receiving reminders of appointments,

A vast majority of people shopping for a health plan on a Health Insurance Exchange for coverage in 2014 obtained information online via websites. One-half of these shoppers used only online information, and 29% combined both websites and other sources like direct assistance, informal assistance, and via (offline) media. In the Health Reform Monitoring Survey from the Urban Institute Health Policy Center, a research team, funded by the Robert Wood Johnson Foundation and the Ford Foundation, looked into data collected from the Health Reform Monitoring Survey in March 2014 at the end of the 2014 open enrollment period for the

Tomorrow is World No Tobacco Day. The use of tobacco is one of the most preventable public health issues on the planet. And the global tobacco epidemic contributed to 100 million deaths around the world in the 20th century. 6 million people die every year due to tobacco use — including 600,000 deaths due to exposure to secondhand smoke. About 500 million people living today will be dead from the use of tobacco products if current smoking habits continue, the World Health Organization (WHO) expects. WHO sponsors the World No Tobacco Day every year on May 31. For this year’s

During my conversation with a prominent pharma industry analyst yesterday, he observed, “As a consumer, you are self-insured until you get sick.” My brain then flashed back to a graph from the 2013 Employer Health Benefits Survey conducted annually by the Kaiser Family Foundation (KFF). The chart is shown here. It illustrates the upward line indicating that in 2013, 4 in 5 workers were enrolled in a health plan that included an annual deductible. That’s the “self-insurance” part of the observation my astute conversationalist noted. Simply put, when you are enrolled in a high-deductible health plan, You, The Consumer, are responsible for

“The surge in HDHP enrollment is causing patients to become consumers of healthcare,” begins a report documenting the rise of patients making more payments to health providers. Patients’ payments to providers have increased 72% since 2011. And, 78% of providers mail paper statements to patients to collect what they’re owed. “HDHPs” are high-deductible health plans, the growing thing in health insurance for consumers now faced with paying for health care first out-of-pocket before their health plan coverage kicks in. And those health consumers’ expectations for convenience in payment methods is causing dissatisfaction, negatively affecting these individuals and their health providers’

Yesterday kicked off this week in Health Populi, focusing on the growing role of transparency in health care in America. Today’s post discusses the results from Change Healthcare’s latest Healthcare Transparency Index report, based on data from the fourth quarter of 2013, published in May 2014. Charges for health services — dental, medical and pharmacy – varied by more than 300% in Q42013 — even within a single health network. Change Healthcare found this, based on their national data on 7 million health-covered lives. The company analyzed over 180 million medical claims. The company built the Healthcare Transparency Index (HCTI)

People managing chronic diseases are more likely to have accessed information in their electronic medical records — and are also less likely to worry about the privacy risks of their personal electronic health information compared with people who are healthy. Over 2,000 people, both those who say they’re healthy and those with chronic conditions, were surveyed by Accenture in February-March 2014, and their responses are summarized in the report, Consumers with Chronic Conditions Believe the Ability to Access Electronic Medical Records Outweighs Concern of Privacy Invasion. Slight more consumers are concerned about privacy risks related to online banking, online shopping,

  9 in 10 U.S. adults would be willing to share their personal health information  to help researchers better understand a disease or improve care and treatment options — with varying desires to control the anonymity of their data, according to  the fourth Makovsky Health/Kelton Survey published April 24, 2014. This study gauged peoples’ perspectives on personal data privacy based on 1,001 responses from Americans ages 18 and older and was fielded in March 2014. The chart shows four variations on the theme of consumers’ interest in sharing their personal health data with researchers, finding that: – 40% of people

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

People are spending more out of their own pockets on health care, and particularly for medications. There are two sides to the medicine-spending coin: there’s the low-end which are generic drugs, most of which carry a co-pay of $10 or less. Then there’s the high end of specialty pharmaceuticals, a fast-growing category of very expensive products for which many consumers dearly pay — if and when they choose to take their doctors’ recommendations. In Medicine use and shifting costs of healthcare, IMS Institute for Healthcare Informatics reports that while (inexpensive) generic drugs comprise 86% of prescriptions in the U.S., it’s high

I have seen the future of food and it is in Italy at a grocery chain called Conad, which launched a locavore-focused brand called Sapori & Dintorni. Here in Florence, Italy, where I’m spending a week’s holiday with my family, we stay in an apartment in the Oltrarno – just south of the Arno River, up a short hill from the southern tip of the Ponte Vecchio, the old bridge known for its gold and silver jewelry. But the real gem in this neighborhood is that grocery store, whose Sapori & Dintorni label represents food sourced from Italy’s great food

There’s a new member in the C-suite in health care, and her name is the Chief Patient Officer (CPO). That new role in health-town is filled by Dr. Anne Beal, appointed by Sanofi, the global biopharma company, to fill this new job description. Here she is, shaking hands with Colin Powell in one of the many awards ceremonies where Dr. Beal’s work in public health has been lauded. But what is a CPO? Because it’s a new job, Dr. Beal can create the role, at least within the environment and mission of Sanofi and the larger life sciences world. Some

A consumer who is faced with greater financial skin-in-the-healthcare game, cost-sharing, is expected to become a smart shopper for lower-priced health products and services. When it comes to patients given prescriptions for medicines, the theory is that patients will choose less expensive generic drugs over brand names it people think the cheaper meds are good substitutes. This is referred to as the generic-drug dispensing rate (GDR). But the theory doesn’t consistently hold true in real life, a study from the Employee Benefit Research Institute (EBRI), Brand-Name and Generic Prescription Drug Use After Adoption of a Full-Replacement, Consumer-Directed Health Plan With a

I had the pleasure of spending quality time brainstorming with Mikki Nasch, co-founder of AchieveMint, yesterday. Mikki worked on the early days of building the FICO score with Fair Isaac, so has been involved in Big Data well before it became the well-#hashtagged buzzword it is today. In our conversation, we talked about the history of FICO and how it took about a decade for consumers to understand it, accept it, and use it as a tool for bettering their credit ratings. When a FICO score was below an acceptable threshold to a lender – say, for a new car

In 2014, we are digital omnivores. Most people “consume” information and entertainment on more than one screen: 7 hours’ worth over a 5-hour period. You read that right: most people who watch TV, use a laptop or PC, smartphone or tablet are multitasking use of these devices in parallel. And above all, people are using smartphones as their primary screen. The AdReaction: Marketing in a multiscreen world report from Millward Brown paints a picture of global consumers who are cobbling together multiscreen experiences. The smartphone has become the “do it all” device if you don’t carry a laptop or tablet around, especially favored

In the not-too-distant future, will our health care be universally available to all, standardized with limited choices? Or, will we be in self-care mode, able to “buy up” if we can afford it like luxury goods? Will health care delivery be totally tech- and information-driven? Or, will care be driven by insurers’ health plans with artful designs that (almost) predetermine our choices? Welcome to four futures of health care, brought to us by PA Consulting whose report, How Can We Stop Healthcare From Bankrupting Our Children? speaks to scenarios based on 2 uncertainties, whether: Health care will be a personal

Health data is everywhere, but not much useful to drink. Is #bigdata in health care at the top of the Hype Cycle? And how do we humanize it, make it relevant and useful for our everyday life? In other words, can this data help us hack our lives and health for the better? That question has been on my mind for the past couple of years since the convergence of big data and data analytics and health has emerged. Yesterday at the 2014 South-by-Southwest happening, I attended a panel discussion called Hacking Your Life For Better Health (#hacklife on Twitter).

With health costs increase increasing at 4.4% in 2014, a slightly higher rate of growth than the 4.1% seen in 2013. While this is lower than the double-digit increases U.S. employers faced in 2001-2004, it’s still twice the rate of general consumer price inflation. That’s what the first graph shows, based on the The 19th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care.  Employers generally want to continue to provide health insurance…for the time being. 92% of companies expect to make changes in health plan provisions in 2014, with 1 in 2 anticipating “significant

Returning to terra firma following last week’s convening of the 2014 annual HIMSS conference…taking some time off for family, a funeral, the Oscars, and dealing with yet another snowstorm…I now take a fresh look back at #HIMSS14 at key messages. In random order, the syntheses are: Healthcare in America has entered an era of doing more, with less...and health information technology is a strategic investment for doing so. The operational beacon going forward is moving toward The Triple Aim: building population health, enhancing the patient’s experience, and lowering costs per patient. The CEO of Aetna, Mark Bertolini, spoke of the

Thinking about personal health information technology – the wearable devices, remote health monitors, digital weight scales, and Bluetooth-enabled medical equipment scaled for the home – there are two glasses. One is half-full and the other, half-empty. The half-full glass is the proliferation of consumer-facing devices like Fitbit, Jawbone and Nike, which comprise the lion’s market share in the health wearables segment; the mass adoption of mobile phones and tablets; consumers’ multi-screen media behavior (as tracked by Nielsen); and consumers’ growing share of medical spending, now about 40% of annual spending (or something north of $8,000 for a family of four

Even before stepping into the Orlando Convention Center on Sunday 23 February 2014, my clairvoyant powers know the forecast of the Best in Show: the growing role of patients in health care, reflected in both the education session at the annual 2014 meeting of HIMSS as well as the product/service mix being proffered on the convention show floor. As a member of HIMSS Connected Patient Committee, I know first-hand the conscious effort and energy that the organization has committed to getting real about patients’-peoples’-caregivers’ central role in health care. The organization was built on providers and technology. When I first

Most people face constraints in following a healthier lifestyle, according to new research from Bain & Company. Stress, time constraints, difficulty changing habits, getting enough sleep, and financial issues all militate against people project managing their health on a daily basis. Enter The Health Axioms, 32 mantras for simplifying healthcare DIY to empower and engage people in self-health. Conceived by health/tech designer Juhan Sonin, who teaches at MIT and is part of the team at Involution Studios, Health Axioms are 32 messages each designed on a 2×3 inch card and packaged as a deck to inspire and support health outside

IBM’s data analytics engine Watson, having cut its teeth on complex health care conditions like cancer, is now entering an even more challenging space: wellness. Why is wellness more challenging? Because understanding a person’s wellness goes beyond mining data from health care claims silos in hospitals, pharmacies, and physicians’ electronic health records. Wellness happens where we live, work, play and pray. Wellness is nurtured through choices made every day at home, in the workplace, and at moments-of-truth in the grocery store and restaurant where slick marketing messages planted in our subconscious compete with our more rational minds that tell us to

While the prescription drug bill makes up about 10% of U.S. national health spending, the fastest-growing component of pharmacy spending is specialty medications. These are categorized as “specialty” drugs because they rarely have generic equivalents, and treat serious or life-threatening diseases (such as cancer, MS, and rheumatoid arthritis). They are also “special” because specialty pharmaceuticals average $3,000 per patient per month and can surpass $100,000 a year for certain products. As a result, the top two goals for managing specialty medications among employers are #1, to reduce inappropriate utilization, and #2, to reduce drug acquisition costs, based on a survey

Bravo! to CVS/pharmacy who today announced it would pull tobacco products from store shelves by October 2014. “The sale of tobacco products is inconsistent with our purpose,” the company’s press release asserts. The move will cost CVS $1.5 billion in revenue annually, as the company seeks to consolidate its position as a health company. CVS/pharmacy is part of CVS Caremark, which includes the retail pharmacy chain (the second-largest in the U.S.), a pharmacy benefit management company (Caremark), and retail health clinics (Minute Clinics). CVS Caremark also participates in a healthy communities program issuing grants for projects that focus on health

  A growing proportion of American families are facing money problems related to health care, according to the report, Financial Burden of Medical Care: A Family Perspective, No. 142 in the NCHS Data Brief series from the CDC, published January 2014 and based on 2012 data. 1 in 4 families are dealing with some financial burden due to medical care. “Financial burdens” in health include problems paying medical bills in the past 12 months, shared by 16.5% of families; and medical bills being paid over time, faced by 21.4% of families. 1 in 10 families (9%) have medical bills they are

If your wallets are lighter at the end of the month, you’re likely to have less access to quality food, and more likely to be admitted to the hospital if you have diabetes. The hypothesis that people with low incomes whose household budgets are spent before the end of the month have greater health inequities was tested in the article, Exhaustion of Food Budgets At Month’s End And Hospital Admissions For Hypoglycemia, published in the January 2014 issue of Health Affairs. Researchers from the University of California – San Francisco found that, indeed, the health in households with low-income suffer from

Three-quarters of us are concerned about health care, a fraction fewer than those of us worried about the economy. Underneath stress about healthcare, people are worried about costs and the impact of the Affordable Care Act (ACA). Say hello to the Healthcare Worry Scale, developed by Chase Communications, a firm focused on marketing and media, largely in the health industry. Chase found that: – 93% believe that their health care costs will continue to increase – 49% say the ACA’s impact is a “major” worry – 43% say getting a disease, medical condition, or injury that health insurance doesn’t fully

There’s truly good news for public health about smoking: January 11th marked the 50th anniversary of the U.S. Surgeon General’s Report on Smoking and Health. That’s five decades’ worth of progress raising peoples’ awareness about the toxic impact of nicotine and chemicals embodied in cigarettes, and deleterious impacts on health and the economy. As a result, smoking rates have been cut in half since 1964, as the downward-sloping graph illustrates. With that happy news in my subconscious, I took a long walk, tracked by my digital device, through the Venetian Hotel in Las Vegas last week, bound for the 2014 Consumer Electronics

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

Wearable technology is the new fashion accessory, Accenture observes in its 2014 survey report, Racing Toward a Complete Digital Lifestyle: Digital Consumers Crave More. In parallel with the supply-side growth of wearable technology that is seen this week at the 2014 Consumer Electronics Show, Accenture brings a sanguine story to the supply side of the equation, finding consumers “craving more” than one function from a digital device. Over one-half of consumers surveyed in six countries favored vehicle navigation, home safety/security monitors, health monitor, home comfort and control, fitness monitors, and personal safety monitors. Nearly one half (46%) liked smartwatches, and

The rise of digital health at the 2014 Consumer Electronics Show signals the hockey-stick growth of consumer-facing health devices for fitness and, increasingly, more medical applications in the hands of people, patients, and caregivers. This year at #CES2014, while the 40% growth of the CES digital health footprint will get the headlines, the underlying story will go beyond wristbands and step-tracking generating data from an N of 1 to tools that generate data to bolster shared-decision making between people and the health system, and eventually support population health. For example: – Aetna is partnering with J&J to deploy their Care4Today

7 in 10 people in the U.S. see a doctor for their health care, and prefer seeing a doctor over a nurse practitioner, based on a poll Ipsos conducted on behalf of the American Academy of Family Physicians. What do people seek in a doctor? Knowledge, state-of-the-art treatments, experience and trustworthiness are the top traits people seek in health providers overall. Ipsos probed further into various traits for clinicians (including doctors, nurses and NPs), asking which of these factors were embodied in the health professional people want to receive care from. The most important attributes for doctors were: Who I want

Who do you trust? If you’re a member of the middle of the U.S. normal bell curve, you’re thinking “nurses.” 8 in 10 Americans put nurses at the top of the ethics list, a question that Gallup has frequently surveyed since 1976. Nurses have ranked highest in honesty and ethics in America since Gallup began included the profession in the poll in 1999 (except for 2001, when firefighters were #1 post 9/11). Tied for second place this year are pharmacists and grade school teachers (with 70% of U.S. adults ranking them with high ethical standards), closely followed by doctors and

Gird your wallets, U.S. consumers: watch the dollars flow out-of-pocket for prescription drugs in 2014, as predicted by the 2013-2014 Prescription Drug Benefit Cost and Plan Design Report published by the Pharmacy Benefit Management Institute (PBMI) this week. Constraints covering most plan members are: Step therapy Prior authorization (to get approvals to fill high-cost drugs, notably growth hormones, injectables, controlled substances, Retin-A, and medications for sleep disorders, and Compulsory 90 day refills at retail (90-day dispensing for chronic meds). This Report, sponsored by Takeda, is the gold standard of drug benefit trends, having been published since 1995. Average 30-day copayments

At the Venture+ Forum at the 2013 Mobile Health Summit yesterday, Lisa Suennen, Managing Director of Psilos Ventures was asked what she and her venture capital fund look for in choosing new investments for their health care portfolio. She succinctly said, “technologies that lower costs.” With nearly $1 in $5 of the U.S. economy attributable to health spending, Lisa’s got a point. Technology in U.S. health care has been mostly additive and expense-inducing, not reducing: fax machines and printers, for example, continue to proliferate in health care settings as part of “networking,” and once you add a new clinical technology

This Thanksgiving, we’re once again participating in the annual Engage With Grace blog rally, encouraging those who haven’t considered their end-of-life preferences to start thinking about them, and asking those who have done it to consider how their decisions may have changed over time. It’s good food for thought. Wishing you all a happy, healthy holiday season.  Most of us find ourselves pretty fascinating… flipping through photos and slowing down for the ones where we’re included, tweeting our favorite tidbits of information, Facebook-ing progress on this or that… We find other people captivating as well.  In fact, there’s a meme going around

23andme received word from the Food & Drug Administration (FDA) on November 22, 2013, that they must cease and desist selling the company’s Saliva Collection Kit and Personal Genome Service (PGS). FDA explained in their Warning Letter, “Most of the intended uses for PGS listed on your website, a list that has grown over time, are medical device uses under section 201(h) of the FD&C Act. Most of these uses have not been classified and thus require premarket approval or de novo classification, as FDA has explained to you on numerous occasions. “Some of the uses for which PGS is intended are

Ordering up and financing health care in the U.S. looks like the proverbial Chinese food menu, picking and paying for “one from column A, and one from column C.” But that’s no way to operate a well-oiled machine for delivering quality health care, according to Healthcare Shifts from á la Carte to Prix Fixe from Strategy&, an analysis of the fragmented, high-cost and only fair quality American health system. One solution to this challenge is bundled payment. “No one has an overarching view of the entire process,” the report opines, “with an eye toward improving customer service, quality, or costs.” Further exacerbating the sub-optimal

This week in America, the concept of “health care consumer” is in a tug-of-war, and those of us trying to behave as such feel bloodied in the skirmish. One side of the tug-of-war is the obvious, post October 1st reality of the sad state of the Health Insurance Exchanges. This has been well covered in mass media, right, left and center. And Americans polled by Gallup last week express their knowledge of that fact — even if they didn’t know what Healthcare.gov was on the 1st of October. The first chart shows that health care is now a front-burner issue

Games are part of peoples’ lives in the 20-teens. Gamification has been used in military and business training and now is a growing method to help change peoples’ behavior across a variety of issues — health, among them. But it’s not all “fun and games” when it comes to succeeding in applying gaming methods in health, according to Gaming to Engage the Healthcare Consumer, a report from ICF International. ICF’s roots are in the defense industry, and the team that wrote this paper together have decades of experience in military applications. These learnings can be quite useful when translated into the

People who received health care in the U.S. between the second quarters of 2012 and 2013 faced 38% higher out-of-pocket costs, growing from $1,862 to $2,568 in just one year. These were payments for common procedures like joint replacements, Caesarean sections, and normal births. At the same time, consumers’ access to revolving credit lines fell by $1,000 over the twelve months. (Credit lines here include bank-issued credit cards, store credit cards, and home equity loans). The TransUnion Healthcare Report from TransUnion, the credit information company, paints a picture of tightening money for all consumers in the face of rising household