A blog covering the health/care ecosystem and people.

Some 6 in 10 people in the U.S. have been financially impacted by COVID-19. Those most negatively affected by the pandemic tend to be younger, Gen Z age group and African-American, 63% of whom felt financial pressure directly due from the virus and the national economic lockdown. By late May 2020, 34% of black Americans had lost their jobs compared with 21% in late April, compared with 18% of white consumers, reported in The COVID-19 Pandemic’s Financial Impact on U.S. Consumers, survey research from TransUnion. This post describes data from TransUnion’s Wave 9 report, which polled 2,086 U.S. adults 18

Imagine this: you find yourself with $6,553 in your pocket and you can pick one of the following: A new 2020 Breitling Navitimer watch; A year’s in-state tuition at Valdosta State University; or, A PPO for an average individual. Welcome to the annual Milliman Medical Index (MMI), which gauges the yearly price of an employer-sponsored preferred-provider organization (PPO) health insurance plan for a hypothetical American family and an N of 1 employee. That is a 4.1% increase from the 2019 estimate, about twice the rate of U.S. gross domestic product growth, Milliman points out in its report.   Milliman bases

Will the coronavirus inspire greater adoption of telehealth in the U.S.? Let’s travel to Shanghai, China where, “the covid-19 epidemic has brought millions of new patients online. They are likely to stay there,” asserts “The smartphone will see you now,” an article in the March 7th 2020 issue of The Economist. The article returns to the advent of the SARS epidemic in China in 2003, which ushered in a series of events: people stayed home, and Chinese social media and e-commerce proliferated. The coronavirus spawned another kind of gift to China and the nation’s health citizens: telemedicine, the essay explains. A

Outpatient revenue is crossing the curve of inpatient income. This is the new reality for U.S. hospitals and why I’ve titled this post, “outpatient is the new inpatient,” a future paradigm for U.S. hospitals This realization is informed by data in a new report from Deloitte, Where have the many hospital inpatient gone? The line chart illustrates Deloitte’s top and bottom line: “The shift toward outpatient is happening and will likely have a tremendous impact on operations, business models, staffing, and capital. Health systems should prepare for the future today and start thinking not only about how to manage their

In CTA’s 2020 Consumer Tech Forecast launched yesterday at Media Day 1 at CES, Steve Koenig VP of Research, said that, “digital health is an ecosystem of ecosystems.” Health, medical and wellness trends featured large in the forecast, which brought together key trends for 5G, robotics, voice tech, AR/VR/XR, and the next iteration of IoT — which Steve said will still be called “IoT,” but in this phase will morph into the “Intelligence of Things.” That speaks to Steve’s phrase, “ecosystem of ecosystems,” because that’s not just “digital” health — that’s now the true nature of health/care, and what is

The three winners of the 2019 Nobel Prize for Economics — Banerjee and Duflo (both of MIT) and Kremer (working at Harvard) — were recognized for their work on alleviating global poverty.” “Over 700 million people still subsist on extremely low incomes. Every year, five million children still die before their fifth birthday, often from diseases that could be prevented or cured with relatively cheap and simple treatments,” The Nobel Prize website notes. To respond to this audaciously huge challenge, Banerjee, Duflo and Kremer asked quite specific, granular questions that have since shaped the field of development economics — now

One in three Americans does not have a broadband connection, according to a new report from the NPD Group. This means that about 100 million people in the U.S. can’t benefit from telehealth and other digital health connections that can bolster self-care, home care, and lower cost care. Most of these folks in the broadband-digital divide live in rural America/ “The so-called digital divide, between those that can or cannot make the best use of the Internet, can be clearly felt in rural markets where the lack of broadband impacts everything from entertainment to the educational system,” Eddie Hold, President

There are many forms of magic inspired by Disney, the company. There’s the obvious attraction, the Magic Kingdom, that was Walt’s original destination vision, “imagineered” in 1932. Then there are other kinds of magic. The one I’m deep into in the moment is inspiration, ideation, and “reimagineering” my own thinking about work, legacy, and social justice. I’m grateful to have had the opportunity to spend much of this week at the inaugural Disney Institute Women’s Leadership Summit. The Institute convened about 300 women (and a handful of brave “He-for-She” men keen on diversity) in Orlando to learn about and brainstorm

We are all Homo informaticus these days, multi-channel, multi-platform beings using digital platforms. “Computing is not about computers anymore. It is about living,” Nicholas Negroponte wrote in Being Digital. He said that in 1995. In that quarter-century since Negroponte made that prescient observation, we come to better understand that being a Digital Society has its upsides and downfalls, alike. We need a “new needs model” for the digital age, asserts a new report, Human Needs in a Digital World, the 2019 Digital Society Index report from the Dentsu Aegis network. Taking Maslow’s Hierarchy of Needs as a basic construct, the Index

CVS + Aetna have merged to evolve a new business model for health and medical care. Walgreen’s continues to add new services beyond the core pharmacy business, and Walmart is expanding telehealth and healthier food aisles in the grocery. More grocery stores  added dietitians to their operations in 2018, as well. As people take on more self-care for health care, they are looking to access products and services in retail bricks-and-mortar and ecommerce channels in the same places they buy food and other products. ACSI’s latest customer satisfaction benchmark study into retailers provides insights into the trusted channels for retail health

Ten years ago, two brothers, physicians both, started up a telemedicine company called American Well. They launched their service first in Hawaii, where long distances and remote island living challenged the supply and demand sides of health care providers and patients alike. A decade later, I sat down for a “what’s new?” chat with Roy Schoenberg, American Well President and CEO. In full  transparency,  I enjoy and appreciate the opportunity to meet with Roy (or very occasionally Ido, the co-founding brother-other-half) every year at HIMSS and sometimes at CES. In our face-to-face brainstorm this week, we covered a wide range

In the health care world, it is now commonly accepted that genes contribute less than half of the influence on peoples’ health status. Other issues play starring roles in overall well-being, including environmental factors, health care services, and social determinants of health (SDOH). These inputs include education, personal economics (like job security and financial stability), physical built environments (think: transportation access, safe and healthy housing), food and nutrition, and access to health care. At HIMSS17, I gave a talk in a big room about how technology can scale SDOH; we had standing room only, which is not a brag —

In the U.S., the highest levels of unemployment are in places that often have the lowest access to broadband connectivity. And, “without a proper broadband connection, these communities can’t start or run a modern business, access telemedicine, take an online class, digitally transform their farm, or research a school project online,” Microsoft President Brad Smith said yesterday as the company announced their continued commitment to expanding broadband in rural America. Microsoft is expanding a program the company launched last year to address the rural broadband gap in the U.S. The Airband Initiative is working from Northwest Georgia to South Africa to bolster

There’s a shortage of medical providers in the United Kingdom, a nation where healthcare is guaranteed to all Britons via the most beloved institution in the nation: The National Health Service. The NHS celebrated its 70th anniversary in July this year. The NHS “supply shortage” is a result of financial cuts to both social care and public health. These have negatively impacted older people and care for people at home in Great Britain. This article in the BMJ published earlier this year called for increasing these investments to ensure further erosion of population and public health outcomes, and to prevent

    CVS Health’s acquisition of Aetna was approved this week by U.S. Federal regulators after months of scrutinizing the antitrust-size-market control implications of the deal. I wrote this post on the deal as an inflection point in American healthcare on 3rd December 2017 when CVS and Aetna announced their marriage intentions. This post updates my initial thoughts on the deal, given the morphing US healthcare market on both the traditional health services front and fast-evolving retail health environment. The nation’s largest retail pharmacy chain signed a deal to combine with one of the top three health insurance companies. The deal

Obesity, diabesity, food deserts and food swamps co-exist across America, factors that cost the U.S. economy over $327 billion a year just in the costs of diagnosed diabetes. In addition, America’s overweight and obesity epidemic results in lost worker productivity, mental health and sleep challenges, and lower quality of life for millions of Americans. Food — healthy, accessible, fairly-priced — is a key social determinant of individual health, wellness, and a public’s ability to pursue happiness. There’s a lot the U.S. can learn from the food culture, policy and economy of Italy when it comes to health. This week, I have the

Patients are the new healthcare payors, and as such, taking on the role of health consumers. In fact, health and wellness consumers have existed since a person purchased the first toothpaste, aspirin, heating pad, and moisturizing cream at retail. Or consulted with their neighborhood herbalista, homeopathic practitioner, therapeutic masseuse, or skin aesthetician. Today, the health and wellness consumer can DIY all of these things at home through a huge array of products available in pharmacies, supermarkets, Big Box stores, cosmetic superstores, convenience and dollar stores, and other retail channels – increasingly, online (THINK, of course, of Amazon — more on

Googling the words “disruption” and “healthcare” today yielded 33.8 million responses, starting with “Riding the Disruption Wave in Healthcare” from Bain in Forbes, Accenture’s essay on “Big Bang Disruption in Healthcare,” and, “A Cry for Encouraging Disruption” in the New England Journal of Medicine Catalyst. This last article responded to the question, “Can we successfully deliver better quality care for patients at a lower cost?” asked by François de Brantes, Executive Director of the Health Care Incentives Improvement Institute. “Disruption” as a noun and an elephant in our room has been with us in healthcare since the September/October 2000 issue of

          The U.S. gets relatively low ROI for its relatively exorbitant spending on healthcare, noted once again in the latest Health at a Glance, the annual OECD report on member nations’ healthcare systems. The report includes U.S. country data asking, “How does the United States compare?” with its sister OECD countries. The answer is, “not well across most population health, access, and mortality measures.” For the Cliff’s Notes/Where’s Waldo top-line of the research, find the two long bars in this chart heading “south” of the OECD average, and one long blue bar going “north.” The northern climbing bar

Yesterday at 1 pm, we learned that the incidence of suicide is up in America in a report from the Centers for Disease Control (CDC), an agency in the U.S. Department of Health and Human Services. This morning, we awake to news that Anthony Bourdain, the witty and prolific travel and food expert, took his own life. Earlier this week, Kate Spade, fashion designer and creative force, took her own life. The loss of these two bright lights, gone from our lives to suicide within a few days of each other, gives me the sad compulsion to say something, again, about

This is what happened to pharma stock prices on Friday after President Trump and Secretary of Health and Human Services Alex Azar outlined their new policies focusing on prescription drug prices. The graph is the Nasdaq U.S. Smart Pharmaceuticals Index (NQSSPH) from May 11, 2018, the date when POTUS and Secretary Azar made their announcement. What this upward driving curve indicates, from the start of stock trading in the morning until the ring of the closing bell, is that the pharma industry players, both manufacturers and PBMs, were quite delighted with what they heard. The blueprint for restructuring the prescription drug industry,

Two weeks in a row, The Economist, the news magazine headquartered in London, included two special reports stapled into the middle of the magazines. Universal health care was covered in a section on 28 April 2018, and coverage on financial inclusion was bundled into the 5th May edition. While The Economist’s editors may not have intended for these two reports to reinforce each other, my lens on health and healthcare immediately, and appreciatively, connected the dots between healthcare coverage and financial wellness. The Economist, not known for left-leaning political tendencies whatsoever, lays its bias down on the cover of the section here: universal healthcare

In the US, when it comes to life and death, it’s good to live in Hawaii, Utah, Minnesota, North Dakota, and Iowa — the top five states with the greatest life expectancy and healthy life expectancy at birth in 2016. For health and longevity, sorry to see the lowest five ranked states are Washington DC which ranks last, along with Mississippi, Louisiana, South Carolina, and Alabama. This sober geography-is-health-destiny update was published this week in JAMA, The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States. The first chart illustrates states down the left

We are only just past the dawn of the second machine age, where digitization is enabling artificial intelligence. “Our new tools are destroying both trust and truth, creating a hunger for community and authenticity. We crave actual physical connection to neighbours, colleagues, and fellow townspeople, even if digitally facilitated.”  Anne-Marie Slaughter wrote this in a column I read this morning in the Financial Times titled, “Our struggle with technology to protect trust and truth.” Trust and truth underpin health engagement, we learned in the first Edelman Health Engagement Barometer launched ten years ago. Those were the early days of the formation

New research points out that real people live real lives, and our assumptions about social determinants of health (SDOH) may need to be better informed by those real lives. I read three reports in the past week sobering up my bullish #SDOH ethos dealing with food deserts, transportation, and health service access — three key social determinants of health. To remind you about the social determinants, here’s a graphic from Kaiser Family Foundation that summarizes the key pillars of SDOH. Assumption 1: Food deserts in and of themselves diminish peoples’ healthy nutrition lifestyles. Low-income households who are exposed to the same food-buying

Nurses working in the U.S. are number one when it comes to ethics and honesty, the Gallup Poll found for the sixteenth year in a row. After nurses, military officers, grade school teachers, medical doctors and pharmacists rank second through fifth in ethical-line behind top-rated nursing. It’s important to note that consumers have ranked pharmacists and doctors in second and third place in this annual survey for many years. This year, both professions fall below the military and teachers. Nurses have been #1 in this study every year since Gallup launched the survey in 1999, except for 2001 when firefighters topped

In 2016, most consultations between patients and Kaiser-Permanente Health Plan were virtual — that is, between consumers and clinicians who were not in the same room when the exam or conversation took place. Virtual healthcare may be the new black for healthcare providers. Mercy Health System in St. Louis launched a virtual hospital in 2016, covered here in the Health Populi post, “Love, Mercy, and Virtual Healthcare.” Intermountain Healthcare announced plans to build a virtual hospital in 2018. And, earlier this month, UPMC’s CEO, Jeffrey Romoff, made healthcare headlines saying, “UPMC desires to be the Amazon of healthcare.” UPMC, aka University of Pittsburgh

Talk about the last mile in healthcare. CVS Pharmacy will deliver prescription drugs to patients’ homes, the company announced this week. “Same-day prescription delivery gives customers the easy option of having the pharmacy they trust deliver right to their front door at no cost,” Helen Foulkes, President of CVS Pharmacy, said in the press release. Rx home delivery may not be “the” last mile to conquer all healthcare access challenges, but it’s nonetheless a signal that healthcare industry suppliers are focusing on helping patients streamline their health-consumer lives. In this case, it’s also CVS morphing towards Amazon’s Prime delivery model. Amazon

U.S. consumers feel positive about the roles of technology and social determinants in improving healthcare, but are concerned about costs, according to the 2017 Patient Survey Report conducted for The Physicians Foundation. The survey gauged patients’ perspectives across four issues: the physician-patient relationship, the cost of healthcare, social determinants of health, and lifestyle choices. Two key threads in the research explain how Americans feel about healthcare in the U.S. at this moment: the role of technology and the cost of health care. First, the vast majority of consumers view technology, broadly defined, as important for their health care. 85% of people

  In 2015, poor and low-income people in America had worse health care than high-income households; care for nearly half of the middle-class was also worse than for wealthier families.   Welcome to the 2016 National Healthcare Quality and Disparities Report from the Agency for Healthcare Research and Quality (AHRQ). The report assesses many measures quantifying peoples’ access to health care, such as uninsurance rates (which improved between 2010 and 2016), and quality of health care — including person-centered care, patient safety, healthy living, effective treatment, care coordination, and care affordability. While some disparities lessened between 2000 and 2015, disparities

The Netherlands, France and Germany are the best places to be a patient, based on the Global Access to Healthcare Index, developed by the Economist Intelligence Unit (EIU). Throughout the world, nations wrestle with how to provide healthcare to health citizens, in the context of stretched government budgets and demand for innovative and accessible services. The Global Access to Healthcare Index gauges countries’ healthcare systems in light of peoples’ ability to access services, detailed in Global Access to Healthcare: Building Sustainable Health Systems. The United States comes up 10th in line (tied with Spain) in this analysis. Countries that score the

The top healthiest eating communities tend to circle the perimeter of the map of the lower 48 U.S. states. In these towns, more than 72% of health citizens report healthy eating. These areas are located in California, Florida, and Massachusetts, among others. Areas with the lowest rates of healthy eating are concentrated generally south of the Mason-Dixon Line, in places like Arkansas, Kentucky, and Mississippi, and other states. In these places, fewer than 57% of people eat healthy. Eating healthy foods in moderation is a mighty contributor to personal and public health, discussed in the report, State of American Well-Being

Healthcare was based on three pillars in 16th century Florence, Italy: diet, surgery, and pharmacy. Five centuries later, not much has changed in Italy or the U.S. But how healthcare gets funded and delivered in the context of these pillars significantly varies between the two countries, and impacts each nation’s health. To put this in context, visiting the Biblioteca Medicea Laurenziana (the Medici’s Laurentian Library) today in Florence was a trip through medical-surgical history, starting in the second half of the 16th century. The design of this magnificent library’s foyer and reading room was initially conceived by Michelangelo. The reading room