A blog covering the health/care ecosystem and people.

For health care, there are many uncertainties as we reflect, one week after the 2024 U.S. elections, on probably policy and market impacts that we can expect in 2025 and beyond. In today’s Health Populi post, I’ll reflect on the first of several certainties we-know-we-know about U.S. health citizens and key factors shaping the American health ecosystem. In this first of several posts on “What Stays True for U.S. Health Care Post #Election2024,” I’ll focus on U.S. consumer dissatisfaction with drug prices — across political party identification.          Let’s set the context with data from a recently-published

Health literacy and, indeed, literacy across the many layers relevant for health (digital, medical, financial), is a challenge for people of all ages. The Institute for Healthcare Policy Innovation’s National Poll on Healthy Aging at the University of Michigan focused on people 50 and over in their latest study published this month: Health Literacy – How Well Can Older Adults Find, Understand, and Use Health Information. On the upside, 4 in 5 older people (50+) feel confident in being able to spot health mis-information, the chart from the Poll report clearly tells us. 20% of older U.S. health citizens are

In a super-divided electorate like the U.S. with about 60 days leading up to the 2024 Elections, we might assume there are no “purple” areas of agreement between the Red (Republicans) and the Blue (Democrats) thinking in PANTONE color politics. Surprisingly, there are many health policies on which Democrats and Republicans concur, as found in a series of YouGov polls conducted in May 2024.                         YouGov fielded the health policies poll in five waves online, each among roughly 1,100 U.S. adults in May 2004. This bar chart summarizes health

“Voter registration in hospitals is the new frontier in health care.” That’s the headline in a WBUR story last week detailing the efforts of health care professionals in “amplifying” their patients’ voices inside and outside of the hospital walls by advocating for their health citizenship — through voter registration and public health policy advocacy.                  I’m a long-time evangelist for health citizenship and the role that a person’s engagement in the civic commons plays in one’s own health, the health of their communities and of the nation as a whole. I’m not alone

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

Over one-half of people 50 years of age and older in the U.S. have felt financial strain in the past year, resulting in 1 in 2 folks cutting back on everyday expenses like groceries and gas. We learn that nearly one-half of people 50 and over say they’ve been impacted by inflation “a great deal” in Making Ends Meet: Financial Strain and Well-Being Among Older Adults, the latest report from the Institute for Healthcare Policy and Innovation’s National Poll on Healthy Aging based at the University of Michigan (my alma mater). The poll was conducted by NORC at the University

You would assume that most people over 50 would be worried about the financial future of Medicare to cover health care as those middle-aged Americans age. But a surprising two-thirds of young Americans between 18 and 29, and 7 in 10 between 30 and 39 years of age, are concerned that Medicare’s solvency will worsen leading to their not being able to receive Medicare when eligible to receive it, discovered in the 2024 Healthcare in America Report from West Health and Gallup. This year’s research focused on aging in America, exploring areas of U.S. health care system successes as well

Welcome to post #2 of 3, publishing the results of three dialogue sessions between Richard Kaufmann, CISO of Amedisys, and me. The timing of our conversations, tracking both Richard’s and the company’s evolving approach to cybersecurity in health care, has coincided with the Change Healthcare breach and ransom that emerged in February 2024. This second blog of the three is being edited just days after Andrew Witty’s testimony to the U.S. Senate Finance Committee which convened a hearing on May 1st themed, “Hacking America’s Health Care: Assessing the Change Healthcare Cyber Attack and What’s Next.” UnitedHealth Group acquired Change Healthcare

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.           

With the urgent need to identify more efficient and lower-cost health care delivery models, we look to growing evidence for digital health technologies that support the Hospital at Home (HaH) model, considered in a new review article published in late February in npj Digital Medicine, The hospital at home in the USA: current status and future prospects. Clinicians from Scripps Research and Johns Hopkins School of Medicine collaborated on this work, calling out the relatively fast adoption of HaH programs during the peak of the COVID-19 pandemic. In some parts of the world, such as Australia and Norway, “in-person at-home

The cost of living ranks top in U.S. voters’ minds among many issues Americans are feeling and following in late 2023. A close second in line is affordability of health care, as consumers’ household budgets must make room for paying medical bills — with prescription drug costs also very important as a discussion topic for 2024 Presidential candidates, we learn from the latest KFF Health Tracking Poll published 1 December. The monthly study focused on U.S. voters’ top issues and perspectives on the health system and care approaching the new year of 2024. KFF fielded the study among 1,301 U.S.

A majority of the U.S. public does not want politicians to “up-end” government-funded health programs, according to the Kaiser Family Foundation’s March 2023 Health Tracking Poll.           Social Security, Medicare, and Medicaid all garner most partisans’ support whether identifying as Democrat, Independent, or Republican, KFF found in their monthly poll of U.S. voters ages 18 and over. The survey was conducted online and by telephone among 1,271 U.S. adults between March 14-23, 2023.               Among all the important findings in this well-timed poll, I’ll point to the issue of public

Today we review the various viewpoints on Amazon’s announced acquisition of One Medical (ONEM, aka 1life Healthcare) which has been a huge story in both health care trade publications, business news, and mainstream media outlets. Welcome to Day 2 of The Retail Health Battle Royale in the U.S., my week-long update of the American retail health/care ecosystem weaving the latest updates from the market and implications and import for health care consumers.       The deal was announced on 21 July, with Amazon striking the price at about $3.9 billion. Goldman Sachs and Morgan Stanley put the deal together,

The good news about prescription drugs, in the context of medical spending in the U.S., is that 9 in 10 medicines prescribed are generics. They comprise only 3% of all U.S. healthcare spending.           But there’s bad news about prescription drugs in the context of medical spending in America. U.S. Consumers Overpay for Generic Drugs, a new paper from the Leonard Schaeffer Center for Health Policy & Economics asserts, with recommendations to address the intermediaries who benefit from the way Americans currently pay for medicines. Generics are “an American success story,” the authors call out, bringing

A couple retiring in 2022 should budget $315,000 to cover their health care costs in retirement, based on the 21st annual Retiree Health Care Cost Estimate from Fidelity Investments. For context, note that the median sales price of a home in the U.S. in April 2022 was $391,200.             It’s important to understand what the $315,000 for “health care costs” in retirement does not cover, explained in Fidelity’s footnoted methodology: the assumption is that the hypothetical opposite-sex couple is enrolled in Original Medicare (not Medicare Advantage), and the cost estimate does not include other health-related expenses

If you made your living in commercial real estate — and especially, working with hospitals’ and health systems’ office space — would the concept of telehealth be freaking you out right now? If you heed the words of JLL’s 2022 Patient Consumer Survey, you’d chill (at least a bit). The tagline on this paper is, “Convenience and choice drive patient decisions as new digital options take hold.” I was particularly keen to dig into this study based on its sponsoring organization: JLL is a real estate services company serving over a dozen vertical markets — including health care, life sciences,

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,

Most U.S. adults across political parties favor allowing the Federal government authority to negotiate for drug prices — even after hearing the arguments against the health policy. Drug price negotiation, say by the Medicare program, is a unifying public policy in the current era of political schisms in America, based on the findings in a special Kaiser Family Foundation (KFF) Health Tracking Poll conducted in late September-early October 2021. Overall, 4 in 5 Americans favor allowing the Federal government negotiating power for prescription drug prices, shown in the first chart from the KFF report. By party, nearly all Democrats agree

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

“What if…healthcare happened where we live, work, play, pray and shop, delivering the highest levels of retail experience?” I asked and answered in my book HealthConsuming: From Health Consumer to Health Citizen. The chapter called “The new retail health” began with that “what if,” and much of the book responded with the explanation of patients evolving toward health consumers and, ultimately, health citizens empowered and owning their health and care. This week, Dollar General announced the hiring of its first Chief Medical Officer, Dr. Albert Wu. With that announcement, America’s largest dollar-store chain makes clear its ambitions to join a

Two studies published in May 2021 illustrate the value and importance of telehealth to patients in 2020, and a disconnect among many C-level executives working in hospitals, academic medical centers, and other care provider organizations. Together, the two reports from J.D. Power and BDO illustrate some mis-alignment between the demand and supply side of telehealth. On the consumer demand side, patients’ growing use of telehealth in the COVID-19 pandemic along with more frequent digital contacts with health plans bolstered member satisfaction, discovered by the J.D. Power 2021 U.S. Commercial Member Health Plan Study. J.D. Power has conducted the U.S. Commercial

The COVID-19 pandemic accelerated a whole lot of digital transformation for people staying home. For digital natives, that wasn’t such an exogenous shock. For older people who are digital immigrants, they will remember their initial Zoom get-together’s with much-missed family, ordering groceries online in the first ecommerce purchase, and using telemedicine for the first time as a digital health front-door. Laurie Orlov,  tech industry veteran, writer, speaker and elder care advocate, is the founder of the encyclopedic Aging and Health Technology Watch website. She takes this propitious moment to assess The Future of Wearables and Older Adult in a new report.

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

COVID-19 ushered in the era of our homes as safe havens for work, shopping, education, fitness-awaking, bread-baking, and health-making. In my latest essay written for Medecision, I weave together new and important data and evidence supporting the basic social determinant of health — shelter, housing, home — and some innovations supporting housing-as-medicine from CVS Health, UnitedHealth Group, AHIP, Brookings Institution, the Urban Land Institute, and other stakeholders learning how housing underpins our health — physical, mental, financial. Read about a wonderful development from Communidad Partners, working with the Veritas Impact Partners group, channeling telehealth to housing programs serving residents with

At the start of CES 2021, I had the opportunity to catch up with Karsten Russell-Wood, Portfolio Marketing Leader, Post Acute & Home, Connected Care at Philips. We brainstormed just as CES 2021 was going to “open,” virtually, for the consumer electronics conference’s first all-virtual meeting. Philips, a longtime major exhibitor at CES, created an entirely new online experience for the CES attendees – a sort of virtual gallery of different exhibits that are accessed from a single point in a “room” with various entry points. One of the company’s key messages for CES 2021 was health care delivered outside

By April 2020, over one million Medicare members were receiving health care via telemedicine. The graph here shows you the hockey-stick growth for virtual care use by older Americans into the second month of the coronavirus pandemic. The COVID-19 public health crisis up-ended all aspects of daily living in America for people of all ages. For older Americans, avoiding the risk of contracting the tricky virus in public, and especially, in health care settings, became Job 1. The pandemic thus nudged older people toward adopting digital lifestyles for daily life, for shopping, for praying, and indeed, for health care. Laurie

The median charge for hospitalizing a patient with COVID-19 ranged from $34,662 for people 23 to 30, and $45,683 for people between 51 and 60 years of age, according to FAIR Health’s research brief, Key Characteristics of COVID-19 Patients published July 14th, 2020. FAIR Health based these numbers on private insurance claims associated with COVID-19 diagnoses, evaluating patient demographics (age, gender, geography), hospital charges and estimated allowed amounts, and patient comorbidities. They used two ICD-10-CM diagnostic codes for this research: U07.1, 2019-nCoV acute respiratory disease; and, B97.29, other coronavirus as the cause of disease classified elsewhere which was the original code

Nine in ten Americans is concerned about the price of prescription drugs in the wake of the coronavirus pandemic, Gallup and West Health found in their survey on the cost of healthcare, published today. A majority of people across political party share this concern: overall, 88% of U.S. adults are concerned about rising drug prices in response to COVID19, split across party ID with: 94% of Democrats, 86% of Independents, and 84% of Republicans. By demographics, more women than men are concerned about rising costs for the three health care spending categories the survey studied: drug prices, insurance premiums, and

Patients in the U.S. are self-rationing care in the era of COVID-19 by cutting spending on health care visits and prescription drugs. The coronavirus pandemic’s impact on health consumers’ spending varies depending on whether the household is generally a healthy family unit, healthy “enthusiasts,” dealing with a simple or more complex chronic conditions, or managing mental health issues. PwC explored how COVID-19 is influencing consumers’ health care behaviors in survey research conducted in early April by the Health Research Institute. The findings were published in a May 2020 report, detailing study findings among 2,533 U.S. adults polled in early April

Health care continues to be the top-ranked voting issue in the U.S. looking to the November 2020 Presidential and Congressional elections. The Kaiser Family Foundation conducts the monthly poll which gauges U.S. adults’ perspectives on health care, and this month’s January 2020 Kaiser Health Tracking Poll explores Americans’ views on broad healthcare reform plans and specific medical policy issues. Overall, Americans point to prescription drug costs and the preservation of the Affordable Care Act’s protections for people with pre-existing conditions, the first chart tells us. Third and fourth on voters’ minds are protecting patients from surprise medical bills and better

My cousin Arlene got married in Detroit at the classic Book Cadillac Hotel on July 23, 1967, a Sunday afternoon wedding. When Daddy drove us back out to our suburban home about 30 minutes from the fancy hotel, the car radio was tuned to WWJ Newsradio 950, all news all the time. As soon as Daddy switched on the radio, we were shocked by the news of a riot breaking out in the city, fires and looting and gunshots and chaos in the Motor City. Two days later, my father, who did business with Mom-and-Pop retail store owners in 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’ 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

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

There are over 60 million enrollees in Medicare in 2019, and fully one-third are in Medicare Advantage plans. Medicare is adding 10,000 new beneficiaries every day in the U.S. Medicare Advantage enrollment is fast-growing, shown in the first chart where over 22 million people were in MA plans in January 2019. Better understanding this group of people will be critical to helping manage a fast-growing health care bill, and growing burden of chronic disease, for America. To that end, HealthMine conducted a survey among 800 people enrolled in Medicare Advantage plans ag 65 and over with at least one diagnosed

The health/care ecosystem continues to morph as the stakeholder groups themselves are blurring across and outside of their core businesses. Today’s example of this is Clover Health, which launched Clover Therapeutics this week. This research organization will develop medicines targeting older adults — which makes sense because Clover Health’s target consumer market is Medicare Advantage beneficiaries. “Clover Therapeutics was created to address the significant unmet needs in chronic progressive diseases in the Medicare population,” Cheng Zhang, Head of Clover Therapeutics, is quoted in the press release. The company will first collaborate with Genentech (Roche) to research and develop therapies based

Twenty Democratic Presidential candidates each have a handful of minutes to make their case for scoring the 2020 nomination, “debating” last night and tonight on major issues facing the United States. I watched every minute, iPad at the ready, taking detailed notes during the 120 minutes of political discourse conducted at breakneck speed. Lester Holt, Savannah Guthrie, and Jose Diaz-Balart asked the ten candidates questions covering guns, butter (the economy), immigration, climate change, and of course, health care — what I’m focusing on in this post, the first of two-debate-days-in-a-row. The first ten of twenty candidates in this debate were,

At least one in three people who have tried out virtual health care have done so because they use technology in all aspects of life and want to do the same with their healthcare. This data point has informed my vision for self-care and the home as our health hub, bolstered in part through the research of Accenture from which this first graphic comes. A common theme at health care meetings these days is how and when health care will meet its Amazon, Apple, or Uber moment? Lately, one of my speaking topics is the “Amazon Prime-ing” of health consumers,

Calls for universal health care, some under the banner of Medicare for All,” are growing among some policy makers and presidential candidates looking to run in 2020. As a response, the Chairman of the House Budget Committee in the U.S. Congress, Rep. John Yarmuth (D-Ky.), asked the Congressional Budget Office (CBO) to develop a report outlining definitions and concepts for a single-payer health care system in the U.S.         The result of this ask is the report, Key Design Components and Considerations for Establishing a Single-Payer Health Care System, published on 1st May by the CBO. The report provides

“ATA” is the new three-letter acronym for the American Telemedicine Association, meeting today through Tuesday at the Convention Center in New Orleans.  Ann Mond Johnson assumed the helm of CEO of ATA in 2018, and she’s issued a call-to-action across the health/care ecosystem for a delivery system upgrade. Her interview here in HealthLeaders speaks to her vision, recognizing, “It’s just stunning that there’s such a lag between what is possible in telehealth and what is actually happening.” I’m so keen on telehealth, I’m personally participating in three sessions at #ATA19. On Monday 15th April (US Tax Day, which is relevant

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

Self-care is the new health care as patients, now consumers at greater financial risk for medical spending, are learning. At #CES2019, I’m on the lookout for digital technologies that can help people adopt and sustain healthy behaviors that can help consumers save money on medical care and enhance quality of life-years. This week’s heart-and-food tech announcements at #CES2019 coincide with an FDA recall on a popular drug prescribed to treat hypertension (high blood pressure). Using food and tech as medicine can help people avoid going on medications like statins and others for heart health. An important example of this self-care

As Tip O’Neill’s mantra goes, “All politics is local.” In the U.S. 2018 midterm elections, healthcare voting seems to have translated as a local issue, falling into O’Neill’s axiom. In this election, healthcare was the most important voting issue for consumers, PwC found, ranking above the economy, national security, and education. On this morning after 2018 midterm election results are (mostly) out, it looks like healthcare was a local and state issue for U.S. 2018 midterm voters. The Democrats flipped more than 23 seats in the U.S. House of Representatives to gain control of that chamber. The Senate is up

The U.S. Department of Commerce Bureau of Economic Analysis (BEA) released, for the first time, data that quantifies Americans’ spending to treat 261 medical conditions, from “A” diseases like acute myocardial infarction, acute renal failure, ADHD, allergic reactions, anxiety disorders, appendicitis and asthma, to dozens of other conditions from the rest of the alphabet. High Spending Growth Rates For Key Diseases In 2000-14 Were Driven By Technology And Demographic Factors, a June 2018 Health Affairs article, analyzed this data. This granular information comes from the BEA’s satellite account, using data from the Medical Expenditure Panel Survey which nationally examines expenditures by disease;

Health care in America is such a scary experience that more people are afraid of paying for care than the actually getting sick part of the scenario. The patient is the payor, and she is afraid…more afraid of the paying than of the illness, according to a survey conducted among U.S. health consumers from WestHealth Institute and NORC, Americans’ Views of Healthcare Costs, Coverage, and Policy from WestHealth and NORC.     See the orange bar on the left: 40% of Americans are “extremely or very afraid” about paying for care if they get seriously ill, and 33% are that afraid

The biggest healthcare spenders in the United States are households and the Federal government, each responsible for paying 28% of the $3.3 trillion spent in 2016. Private business — that is, employers covering healthcare insurance — paid for 20% of healthcare costs in 2016, based on calculations from the CMS Office of the Actuary’s report on 2016 National Health Expenditures. The positive spin on this report is that overall national health spending grew at a slower rate in 2016, at 4.3% after 5.8% growth in 2015. This was due to a decline in the growth rates for the use of

Old-age inequality among current retirees in the U.S. is already greater than in ever OECD country except Chile and Mexico, revealed in Preventing Ageing Unequally from the OECD. Key findings from the report are that: Inequalities in education, health, employment and income start building up from early ages At all ages, people in bad health work less and earn less. Over a career, bad health reduces lifetime earnings of low-educated men by 33%, while the loss is only 17% for highly-educated men Gender inequality in old age, however, is likely to remain substantial: annual pension payments to the over-65s today are

Healthcare tops the list of Americans’ concerns, tied with a dissatisfaction for government, this month (May 2017). According to a Gallup poll published 12 May, poor government leadership and healthcare are together the most important problem currently facing the U.S. Immigration, the economy, jobs, and race relations are distance 3rd places in this survey, which was conducted during the first week of May 2017 among 1,011 U.S. adults 18 years and older. The highest percent of Americans citing healthcare as America’s most important problem was 26%, found in August/September 2008 when town hall meetings round the country were protesting healthcare

Americans are more than five times more likely to skip medication doses or not fill prescriptions due to cost than peers in the United Kingdom or Switzerland. U.S. patients are twice as likely as Canadians to avoid medicines due to cost. And, compared with health citizens in France, U.S. consumers are ten-times more likely to be non-adherent to prescription medications due to cost. It’s very clear that more consumers tend to avoid filling and taking prescription drugs, due to cost barriers, when faced with higher direct charges for medicines. This evidence is presented in the research article, Cost-related non-adherence to prescribed