A blog covering the health/care ecosystem and people.

It’s déjà vu all over again for Americans’ well-being: we haven’t felt this low since the advent of the Great Recession that hit our well-well-being hard in December 2008. As COVID-19 diagnoses reached 200,000 in the U.S. in April 2020, Gallup gauged that barely 1 in 2 people felt they were thriving. In the past 12 years, the percent of Americans feeling they were thriving hit a peak in 2018, as the life evaluations line graph illustrates. Gallup polled over 20,000 U.S. adults in late March into early April 2020 to explore Americans’ self-evaluations of their well-being. FYI, Gallup asks consumers

As the coronavirus pandemic’s curve of infected Americans ratchets up in the U.S., people are seeking comfort from listening to Dolly Parton’s bedtime stories, crushing on Dr. Anthony Fauci’s science-wrapped-with-empathy, and streaming the Tiger King on Netflix. These and other self-care tactics are taking hold in the U.S. as most people are “social distancing” or sheltering in place, based on numbers from the early April 2020 Kaiser Family Foundation health tracking poll on the impact of the coronavirus on American life. While the collective practice of #StayHome to #FlattenTheCurve is the best-practice advice from the science leaders at CDC, the NIAID

U.S. consumers were re-shapen by the 2008 Recession in two key ways: people took on more self-service DIY daily life-flows, seeking self-sufficiency and less dependence on institutions; and, consumers became more value-sensitive both in terms of financial value and personal values. As Americans confront the clinical and fiscal realities of the coronavirus in the U.S., the trust people feel with organizations, brands and information sources is shifting, a special report from Edelman explains. In Brand Trust and the Coronavirus Pandemic, Edelman focuses its trust lens on the pandemic and consumers’ shaken confidence in business and government institutions. These findings have

There’s evidence in this week’s JAMA of a dose-response relationship between peoples’ steps and lower mortality. In other words: more steps done daily is statistically significantly associated with death from all causes. Furthermore, step intensity didn’t make a difference in mortality rates, shown in the JAMA-published study, Association of Daily Step Count and Step Intensity With Mortality Among US Adults. The publication of this study is incredibly well-timed given the fact that hundreds of millions of people around the world are in lockdown, #StayHome lifestyles this week, and will be for many weeks to come. Going outside for fresh air

More Democrats would want to get tested for the coronavirus (C19) than would Republicans. And, more women than men believe that a vaccine to address the COVID-19 pandemic believe that treatment would be offered at no-or-low-cost under a Democratic president versus President Trump. These are two key insights gleaned from a look into U.S. adults’ perspectives on the C19 virus in the second week of March 2020. What Are Americans’ Views on the Coronavirus Pandemic? asks and answers an NBC News/Commonwealth Fund Health Care Poll published on 20th March 2020. NBC News and the Commonwealth Fund polled 1,006 people 18

One in two Americans trust the Centers for Disease Control for the facts on the coronavirus pandemic, and 43% trust the World Health Organization. But there’s a huge trust deficit when it comes to trusting President Donald Trump on the facts about COVID-19, a poll from Morning Consult and The Hollywood Reporter found. 2,200 U.S. adults were surveyed between 12 and 15 March 2020 on the coronavirus pandemic and their perspectives on the media and political leaders’ information credibility. For news on the pandemic, only one in five Americans believed the President and 18%, the Vice President, Mike Pence, followed

The hashtag #StayHome was ushered onto Twitter by 15 U.S. national healthcare leaders in a USA Today editorial yesterday. The op-ed co-authors included Dr. Eric Topol, Dr. Leana Wen, Dr. Zeke Emanuel, Dr. Jordan Shlain, Dr. Vivek Murthy, Andy Slavitt, and other key healthcare opinion leaders. Some states and regions have already mandated that people stay home; at midnight last night, counties in the Bay Area in California instituted this, and there are tightening rules in my area of greater Philadelphia. UBS economist Paul Donovan talked about “Lockdown Economics” in his audio commentary today. Paul’s observations resonated with me as

With President Trump’s somber speech from the Oval Office last night, we wake up on 12th March 2020 to a ban on most travel from Europe to the U.S., recommendations for hygiene, and call to come together in America. His remarks focused largely on an immigration and travel policy versus science, triaging, testing and treatment of the virus itself. Here is a link to the President’s full remarks from the White House website, presented at about 9 pm on 11 March 2020. Over the past week, I’ve culled several studies and resources to divine a profile of the U.S. consumer

Anne Case and Angus Deaton were working in a cabin in Montana the summer of 2014. Upon analyzing mortality data from the U.S. Centers for Disease Control, they noticed that death rates were rising among middle-aged white people. “We must have hit a wrong key,” they note in the introduction of their book, Deaths of Despair and the Future of Capitalism. This reversal of life span in America ran counter to a decades-long trend of lower mortality in the U.S., a 20th century accomplishment, Case and Deaton recount. In the 300 pages that follow, the researchers deeply dive into and

Seven in 10 Americans are concerned about the coronavirus outbreak’s impact on the economy, and 6 in 10 people worried about someone they love getting sick from COVID-19. But most Americans also get the politicized nature of the coronavirus and say they’re less likely to vote for President Trump in November based on his handling of the public health threat, according to a just-released survey from Protect Our Care fielded by Public Policy Polling. Some of the data points which demonstrate that Americans are taking the emerging coronavirus pandemic quite seriously are that: 53% disagree that President Trump and his

Four in five U.S. adults say lowering the cost of health care in America should be high priority for the next American president, according to a poll from The Commonwealth Fund and NBC News. Health care costs continue to be a top issue on American voters’ minds in this 2020 Presidential election year, this survey confirms. The first chart illustrates that lowering health care costs is a priority that crosses political parties. This is true for all flavors of health care costs, including health insurance deductibles and premiums, out-of-pocket costs for prescription drugs, and the cost of long-term care. While

The Consumer Technology Association (CTA), collaborating with industry stakeholders, has ushered in a standard for artificial intelligence in health care.   CTA is the membership organization for companies that innovate, manufacture and market consumer-facing tech like big-screen TVs, slick new autos, video games and voice assistants. So what’s an organization like CTA doing with AI and health care? Let me connect the dots. Check out this graphic taken from my book, HealthConsuming: From Health Consumer to Health Citizen. This shows the ten categories of tech I revisit each year at CES, CTA’s annual mega-conference of new-new things in consumer electronics

There’s a gap between the supply of digital health tools that hospitals and health systems offer patients, and what patients-as-consumers need for overall health and wellbeing. This chasm is illustrated in The future of the digital patient experience, the latest report from HIMSS and the Center for Connected Medicine (CCM). The big gap in supply to patients vs. demand by health consumers is highlighted by what the arrow in the chart below points to: managing payments and paying bills. Nowhere in the top 10 most commonly provided digital tools is one for price transparency, cost comparing or cost estimating.  In the

Health care pocketbook issues rank first and second place for Americans in these months leading up to the 2020 Presidential election, according to research from POLITICO and the Harvard Chan School of Public Health published on 19th February 2020. This poll underscores that whether Democrat or Republican, these are the top two domestic priorities among Americans above all other issues polled including immigration, trade agreements, infrastructure and regulations. The point that Robert Blendon, Harvard’s long-time health care pollster, notes is that, “Even among Democrats, the top issues…(are) not the big system reform debates…They’re worried about their own lives, their own

There are 1,844 rural hospitals operating in the U.S. That number is down by 19 in the 2019 calendar year, the worst year of rural hospital closings seen in the past decade. That hockey-stick growth of closures is shown in the first chart, where 34 rural hospitals shut down in the past 2 years. Rural U.S. hospitals are in poor fiscal health. “The accelerated rate at which rural hospitals are closing continues to unsettle the rural healthcare community and demands a more nuanced investigation into rural hospital performance,” threatening the stability of the rural health safety net, according to the

With our HealthConsuming “health is everywhere” ethos, this post updates some of the most impactful recent retail health developments shaping consumers’ health/care touchpoints beyond hospitals, physicians, and health plans. For inspiration and context, I’ll kick off with Roz Chast’s latest New Yorker cartoon from the February 3rd 2020 issue — Strangers in the Night, taking place in a Duane Reade pharmacy. Roz really channels the scene in front of the pharmacy counter, from Q-tips to vitamins and tea. And it’s hummable to the tune of, well, Strangers in the Night. Check out the 24-hour pharmacist under the pick-up sign. Now,

“We need to demand our health citizenship. That means our nation must approach medical treatment and data privacy as civil rights that protect everyone.” This is the start of my column, Americans, let’s claim our health care rights, published by USA Today today. USA Today is publishing a 10-part series called “Hidden Common Ground” addressing key issues where Americans can come together. Thus far, the series has covered climate change, and this month health care. Going forward, we’ll see analyses on jobs, gun rights and violence, and immigration through May’s publishing schedule. In their study conducted in December 2020, USA Today

Americans who have commercial health insurance (say, through an employer or union) are rarely thought to face barriers to receiving health care — in particular, primary care, that front line provider and on-ramp to the health care system. But in a new study published in the Annals of Internal Medicine, commercially-insured adults were found to have visited primary care providers (PCPs) less often, and 1 in 2 had no PCP visits in one year. In Declining Use of Primary Care Among Commercially Insured Adults in the United States, 2008-2016, the researchers analyzed data from a national sample of adult health

Most Americans associate more optimistic words with human genetics research than they do darker implications: “curious,” “hopeful,” “amazed.” and indeed “optimistic” ranked the top four impressions in peoples’ minds, based on a survey form the American Society of Human Genetics (ASHG). Below these perceptions are a few concerning concepts such as “cautious,” “concerned,” “hesitant, and “skeptical,” the poll found. Based on the relatively positive views on genetics research, most Americans support increasing Federal funding for that research: 74% said it was somewhat or very important to do so, compared with 15% saying it was not important. People value genetics research

One in two people over 50 bought a piece of digital technology in the past year. Three in four people over fifty in America now have a smartphone. One-half of 50+ Americans use a tablet, and 17% own wearable tech. The same percentage of people over 50 own a voice assistant, a market penetration rate which more than doubled between 2017 and 2019, AARP noted in the 2020 Tech and the 50+ Survey published in December 2019. For this research, AARP worked with Ipsos to survey (online) 2,607 people ages 50 and over in June and July 2019. Across all

Most people dealing with chronic conditions, and those who care for them, believe that “home is where the health is,” according to a survey about the “21st century house call” from CareMore Health. To gain peoples’ perspectives on health care at home and chronic disease management, CareMore Health and Aspire Health commissioned a survey among 2,009 U.S. adults 23 years of age and over in September and October 2019. The survey sample included people dealing with chronic disease themselves, as well as caregivers attending to people with chronic illnesses. The definition of that “modern house call” is largely based on the

The topline of this year’s annual Gallup Poll into honesty and ethics of professions finds nurses sustaining their reign as the top trusted profession in America. But it’s also important to point out that four of the top five most ethical professions are people working on the front lines of health care: doctors (#3), pharmacists (#4) and dentists (#5). Engineers rank second this year after nurses, edging ahead of doctors and pharmacists who typically have ranked 2nd and 3rd each year in the past decade. One of these years, pharmacists’ reputation fell as the profession was associated with being a

The digital health presence at CES 2020 is the fastest-growing segment of consumer technologies at the Show this year, increasing by 25% over 2019. Heart-focused technologies are a big part of that growth story. In fact, in our search for devices and tools underpinned with clinical proof, evidence is growing for consumer-facing technology for heart-health, demonstrated by this year’s CES. Wrist-worn devices, digital therapeutics, patient engagement platforms, pharma and health plans converged at this year’s CES, with the professional association “blessing” of the American College of Cardiology who granted a continuing medical education credit for physicians attending a one-day “disruptive

The presence of health and medicine is growing at CES, the annual conference of all-things-tech for consumers. At this week’s Show in Las Vegas, we see that the Internet of Healthy Things (a phrase coined by Dr. Joe Kvedar) has taken hold and gone mainstream in remote health monitoring, wearable tech, and heart rate tracking which is now embedded (and expected by health-seeking consumers) in wristbands. An expanding category in the Internet of Healthy Things is oral care. Let’s call this the Internet of Teeth, yet another riff on “IoT.” Of course, oral health goes well beyond teeth and toothbrushes.

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

Across the U.S., the health/care ecosystem warmly embraced social determinants of health as a concept in 2019. A few of the mainstreaming-of-SDoH signposts in 2019 were: Cigna studying and focusing in on loneliness as a health and wellness risk factor Humana’s Bold Goal initiative targeting Medicare Advantage enrollees CVS building out an SDOH platform, collaborating with Unite US for the effort UPMC launching a social impact program focusing on SDoH, among other projects investing in social factors that bolster public health. As I pointed out in my 2020 Health Populi trendcast, the private sector is taking on more public health

As Boomers age, they’re adopting mobile and smart technology platforms that enable people to communicate with loved ones, manage retirement investment portfolios, ask Alexa to play Frank Sinatra’s greatest hits, and manage prescription refills from the local grocery store pharmacy. Last week, the Giant Eagle grocery chain was the first pharmacy retailer to offer a new medication management skill via Alexa. That program has the potential to change our Medicare members manage meds at home to ensure better adherence, supporting better health outcomes and personal feelings of efficacy and control. [As an aside, consumers really value pharmacies embedded in grocery

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

The idea of health care consumerism isn’t just an American discussion, Deloitte points out in its 2019 global survey of healthcare consumers report, A consumer-centered future of health. The driving forces shaping health and health care around the world are re-shaping health care financing and delivery around the world, and especially considering the growing role of patients in self-care — in terms of financing, clinical decision making and care-flows. With that said, Americans tend to be more healthcare-engaged than peer patients in Australia, Canada, Denmark, Germany, the Netherlands, Singapore, and the United Kingdom, Deloitte’s poll found. Some of the key behaviors

Two separate and new OECD reports, updating health and the global economic outlook, raise two issues that are inter-related: that gains in longevity are stalling, with chronic illnesses and mental ill health affecting more people; and, as wealth grows more concentrated among the wealthy, the economic outlook around most of the world is also slowing. First, we’ll mine the Health at a Glance 2019 annual report covering data on population health, health system performance, and medical spending across OECD countries. The first chart arrays the x-y data points of life expectancy versus health spending for each of the OECD countries

Several new studies reveal that more patients are feeling and living out their role as health care payors as medical spending vies with other household line items. This role of patient-as-the-payor crosses consumers’ ages and demographics, and is heating up health care as the top political issue for the 2020 elections at both Federal and State levels. In research from HealthPocket, 2 in 5 Americans said they needed to reduce other household expenses to be able to afford their monthly insurance premiums. Four in ten consumers said their monthly health insurance premiums were increasing. One in four people in the

“Google’s ‘Project Nightingale’ Gathers Personal Health Data on Millions of Americans,” the Wall Street Journal reported in today’s paper and on the WSJ.com website. The story started with the scenario that, “Search giant is amassing health records from Ascension facilities in 21 states; patients not yet informed.” Here’s Ascension’s press release on the collaboration, described in the title as “healthcare transformation.” Note: this release was written after the Wall Street Journal published this story. And, according to the WSJ reporting, “Neither patients nor doctors have been notified. At least 150 Google employees already have access to much of the data

In the U.S., the link between wellness and wealth, money and health, is strong and common across people, young and old. But the impacts of money on health, well-being, and life choices varies across the ages, based on a study from Lively, a company that builds platforms for health savings accounts. The first chart illustrates that health care costs challenge people in many ways: the most obvious health care cost problems prevent people from saving more for retirement or paying down debt. Eight in 10 Americans concur that rising health care costs challenge their ability to save for retirement. Beyond the

Today is 4th November 2019, exactly one year to the day that Americans can express their political will and cast their vote for President of the United States. Health care will be a key issue driving people to their local polling places, so it’s an opportune moment to take the temperature on U.S. voters’ perspectives on healthcare reform. This post looks at three current polls to gauge how Americans are feeling about health care reform 365 days before the 2020 election, and one day before tomorrow’s 2019 municipal and state elections. Today’s Financial Times features a poll that found two-thirds

Patients searching online for health information and health care provider reviews is mainstream in 2019.  Digital health tracking is now adopted by 4 in 10 U.S. consumers. Rock Health’s Digital Health Consumer Adoption Report for 2019 was developed in collaboration with the Stanford Medicine Center for Digital Health. Rock Health’s research has tracked peoples’ use of telemedicine, wearable technology, digital health tracking, and online health information since 2015, and the results this round show relative flattening of adoption across these various tools. Rock Health’s top-line findings were that: Patient-generated health data creates opportunity, and potential challenges Online health information is

Rising health care costs continue to concern most Americans, with one in two people believing they’re one sickness away from getting into financial trouble, according to the 2019 Survey of America’s Patients conducted for The Physicians Foundation. In addition to paying for “my” medical bills, most people in the U.S. also say that income inequality and inadequate social services significantly contribute to high medical spending for every health citizen in the nation. The Physicians Foundation conducts this study into Americans’ views on the U.S. health care system every other year. This year’s poll was conducted in September 2019 and included input

“Bold thinking is great. Bold doing is better,” Dr. Eric Topol introduced his talk yesterday at Medecision’s Liberation 2019 conference. I have the opportunity, for which I’m so grateful, of not only attending this meeting but playing a role as a speaker, a sometimes stage “emcee,” and a keynote speaker. And as an attendee, I learn so much from other speakers, fellow attendees, and Medecision staff all sharing perspectives during breakouts and networking breaks. In mode of attendee (and self-confessed collegial-groupie of Dr. Topol’s), I took in his remarks taking notes as fast as I could thanks to Mom teaching

The market for caregiving is growing and the business community has, finally, begun to pay attention. The Washington Post referred to this market as a “gold rush” to design smart shoes, custom razors and technology for the “over-65 crowd.” Caregiving in the U.S., the seminal report from AARP, estimated that 43,5 million adults in the U.S. had provided unpaid care to an adult or child in the past year, about one in five people being caregivers. Over half of caregivers are women, and are about 49 years of age on average. Caregivers spent over 24 hours a week providing care go

Patients’ experiences with the health care industry fall short of their interactions with other industries — namely online retail, online banking and online travel, a new survey from Cedar, a payments company, learned. Survata conducted the study for Cedar among 1,607 online U.S. consumers age 18 and over in August and September 2019. These study respondents had also visited a doctor or hospital and paid a medical bill in the past year. One-third of these patients had a health care bill go to collections in the past year, according to Cedar’s 2019 U.S. Healthcare Consumer Experience Study. Among those people

As patients have taken on more financial responsibility for first-dollar costs in high-deductible health plans and medical bills, hospitals and health care providers face growing fiscal pressures for late payments and bad debt. Those financial pressures are on both sides of the health care payment transaction, stressing patients-as-payors and health care financial managers alike. I’m speaking to health industry stakeholders on patients-as-payors at Cerner’s Now/Next conference today about the patient-as-payor, a person primed for engagement. That’s as in “Amazon-Primed,” which patients in their consumer lives now use as their retail experience benchmark. But consumers-as-patients don’t feel like health care today

Older people are re-framing their personal images and definitions of aging, from continuing to work past typical retirement age, Skyping and texting with grandchildren, and traveling to destinations well beyond the “snowbird” locales of Florida and Arizona to more active and often charitable/volunteer situations in developing economies. And so, too, are older folks re-imagining how and where their health care services could be delivered and consumed. Most people over 50 years of age are cautious but open to receiving health care virtually via telehealth platforms, according to the National Poll on Healthy Aging from my alma mater, the University of Michigan. U-M’s

That question in the title of this post is begged in the annual 2019 consumer survey released this week from UnitedHealthcare (UHC). UHC gauges peoples’ views on health care, insurance, and costs in its yearly research. This year, transparency and health literacy challenges top the findings. When the three in ten folks do shop, four in ten people used the internet or mobile apps to do so — a dramatic increase from 2012. Shopping is most commonly done among Millennials, one-half of whom shop for health care services. Of people who have used digital tools for health care shopping, 8

Based on the influx of research studies and position papers on social determinants of health flowing into my email box and Google Alerts, I can say we’re past the inflection point where SDoH is embraced by hospitals, professional societies, health plans and even a couple of pioneering pharma companies. PwC published a well-researched global-reaching report this week appropriately titled, Action required: The urgency of addressing social determinants of health. The “wheel of determinants” illustrates potential partners for collaborating in communities to address SDoH factors. The collaborators include governments, health care providers, payors, life science and pharma, tech and telecomms, policy

Four in ten U.S. patients said the state of the economy changes how often they seek health care, according to a new study from TransUnion, the credit agency that operates in the health care finance space. Nearly two-thirds of patients said that knowing their out-of-pocket expenses in advance of receiving health care services influenced the likelihood of their seeking care. Given reports from mass media, business press and regional Federal Reserve press releases, the short-to-midterm economic outlook may be softening, which is the signal that TransUnion is receiving in this health consumer poll. The other side of this personal health

“Digital transformation” is the corporate strategy flavor of the moment across industries, and the health are sector isn’t immune from the trend. As this 13th year of the annual Health 2.0 Conference kicks off this week, I’m focused on finding digital health innovations that engage people — consumers, caregivers, patients, health citizens all. This year’s conference will convene thought leaders across a range of themes, and as is the Health 2.0 modus operandi, live demo’s of new-new things. As Health 2.0 kicks off today in pre-conference sessions, there is useful context described in a new report from the American Hospital

“Every company is a tech company,” Christopher Mimms asserted in the Wall Street Journal in December 2018. Connectivity, artificial intelligence, and automation are now competencies every company must master, Mimms explains. This ethos underpins Humana’s decision to join CTA, the Consumer Technology Association which hosts CES every January in Las Vegas. If you read this blog, you know one of the fastest-growing “aisles” at the annual conference is digital health. Humana joined up with CTA’s Health and Fitness Technology Division this month. Last year, Humana hired Heather Cox in the new post of Chief Digital Health and Analytics Officer, reporting directly

Over the past couple of weeks, Walmart is demonstrating its growing commitment to and leadership in healthcare and public health. The company’s announcement this week of pulling products that can be used in military-style weapons from its Outdoor Sports/Shooting department is a major move for public health that is something of a watershed that will impact well beyond the company’s inventory and stock price. This announcement will continue a trend among some thoughtful business leaders, like CEO Edward Stack of Dick’s Sporting Goods, banning gun sales from the retailer’s 125 stores in March 2019, who have begun to listen to

Two new data points converge that beg the question in the title of this post. These two surveys are: The Morning Consult’s poll published today finding growing support among Democratic voters for Medicare for All as the centerpiece for health reform in America; and, A recent study from Eligibility.com on “Medicare Myths Explained,” with the tagline, “How much do you know about Medicare?” Not so very much, Eligibility.com found out. Let’s start with the Morning Consult poll results, which compare support for Medicare for All from January 2019 and August 2019. The headline number from this poll is seen in

Issue No. 4 of StartUp Health Magazine is dedicated to 8 Health Moonshot Principles. StartUp Health sees these moonshots taken together as, “a blueprint for achieving the impossible.” There’s an aspect of U.S. health care that currently feels impossible to achieve, and that’s consensus on what would constitute a sound approach to covering all Americans for health care as a civil right and whether the nation can “afford” doing so. On pages 22-23 of the digital magazine, you’ll find my essay, “From Health Consumers to Health Citizens.” This write-up summarizes the plotline of my book titled HealthConsuming, which features that