A blog covering the health/care ecosystem and people.

Hippocrates is often quoted as saying, “Let food be thy medicine and medicine be thy food.” While some researchers argue that Hippocrates knew the difference between ‘real’ medicine and clinical therapy, there’s no doubt he appreciated the social determinant of health and wellness that food was 1,000 years ago and continues to be today. Taking a page, or prescription note, from the good doctor’s Rx pad, food retailers, healthcare providers, local food banks, and State healthcare programs are working the food-as-medicine connection to bolster public health. One approach to food-as-medicine is promoting the purchase of fresh fruits and vegetables — the

The top health-related activities among U.S. adults include routinely taking vitamins and supplements, and prescription medicines, according to Frost & Sullivan’s report, Are We Engaged Yet? Their response to the titular question lies in in the subtitle: “US consumers appear confused or ambivalent about what it means to be proactive or engaged in their health.” 1 in 2 U.S. adults says they’re “somewhat engaged” in their healthcare, according to Reenita Das’s write-up on the study in Forbes magazine. She notes that: Consumers with higher incomes have more confidence in their access to health care services and quality of care Budget-constrained consumer

Cost ranks first among the factors of selecting health insurance for most Americans across the generations. As a result, most consumers are likely to shop around for both health providers and health plans, learned through a 2016 Xerox survey detailed in New Insights on Value-Based Care, Healthcare Attitudes 2016. The younger the consumer, the more important costs are, Xerox’s poll found, shown in the first chart. Thus, “shopping around” is more pronounced among younger health consumers — although a majority people who belong to Boomer and Greatest Generation cohorts do shop around for both health providers and health insurance plans —

Hospital margins can increase 50% if health providers offer patients a better customer experience, Accenture calculates in the paper, Insight Driven Health – Hospitals see link between patient experience and bottom line. Specifically, hospitals with HCAHPS scores of 9 or 10, the highest recommendations a patient can give in the survey, more likely enjoy higher margins (upwards of 8%). The Hospital Computer Assessment of Healthcare Providers and Systems (HCAHPS) survey is administered by the Centers for Medicare and Medicaid Services (CMS) and measures patients’ exeperiences in hospital post-discharge. The correlation, simply put, is “Happy Patients, Healthy Margins,” Accenture coined in

Faced with the increasing financial responsibility for healthcare payments, and a desire to manage pain and disease via “natural” approaches, more U.S. consumers are seeking and paying for non-conventional or naturopathic therapies — complementary and alternative medicine (CAM). Health and Healing in America, The Harris Poll conducted among U.S. adults, learned that two in three Americans see alternative therapies as safe and effective. 1 in 2 people see alternative therapies as reliable. And most people believe that some of these treatments, like chiropractic and massage therapy, should be reimbursed by health insurance companies. Seven in 10 Americans have used alternative

Where you live in America determines what you might pay for healthcare. In this health economic scenario, as Napoleon is rumored to have said, “geography is destiny.” If you’re searching for low-cost health care, Ohio may just be your state of choice. The map illustrates these health care disparities across the U.S. in 2015, when the price of a single service could vary by more than 200% between one state and another: say, Alaska versus Arizona, or Wisconsin compared to Florida. Even within states, like Ohio, the average price of a pregnancy ultrasound in Cleveland ran nearly three times that received in

The top reason people in America over 50 don’t fill a prescription is the cost of the drug, according to the AARP 2015 Survey on Prescription Drugs. Eight in 10 people 50+ think the cost of prescription drugs is too high, and 4 in 10 are concerned about their ability to afford their medications. Thus, nearly all people over 50 think it’s important for politicians (especially presidential candidates) to control Rx drug costs. Older consumers are connecting dots between the cost of their medications and direct-to-consumer prescription drug advertising: 88% of the 50+ population who have seen or heard drug

In the U.S., spending on prescription medicines reached $425 bn in 2015, a 12% increase over 2014. For context, that Rx spending comprised about 14% of the American healthcare spend (based on roughly $3 trillion reported in the National Health Expenditure Accounts in 2014). We can expect double-digit prescription drug cost growth over the next five years, according to forecasts in Medicines Use and Spending in the U.S. – A Review of 2015 and Outlook to 2020 from IMS Institute of Healthcare Informatics. The biggest cost growth driver is specialty medicines, which accounted for $151 bn of the total Rx spend

Older workers and retirees in the U.S. are most pleased with their healthcare experiences and have the fewest problems accessing  services and benefits. But, “younger workers [are] least comfortable navigating U.S. healthcare system,” which is the title of a press release summarizing results of a survey conducted among 1,536 U.S. adults by the Harris Poll for Accolade in September 2015. Results of this Accolade Consumer Healthcare Experience Index poll were published on April 12, 2016. Accolade, a healthcare concierge company serving employers, insurers and health systems, studied the experiences of people covered by health insurance to learn about the differences across age

Patient engagement is the new imperative in health care, writes Editor-in-chief Alan Weil in his introduction to the April 2016 issue of Health Affairs. It is appropriate and right that Judith Hibbard of the University of Oregon served as the theme adviser for the issue: she’s the innovator of the Patient Activation Measure and has frequently published her research in Health Affairs. Her own bottom-line: that the higher the patient activation, the less health care costs the health plan. (See a recent post on her research here on Health Populi). This issue of Health Affairs is a comprehensive primer on the

There’s an annual $1.5 trillion in revenues for the legacy healthcare system at stake by 2025, at risk of transferring to new entrants keen to please consumers, streamline physician practices, and provide new-new health insurance plans. A team from PwC has characterized this challenge in their strategy+business article, The Coming $1.5 Trillion Shift in Healthcare. Based on their survey of healthcare industry stakeholders and analyzing their economic model, the PwC team developed three scenarios about the 2025 healthcare market in the U.S. These are supply-driven, demand-driven, and equilibrium. The exhibit details each of these possible futures across various industry stakeholder

8 in 10 Americans would like one trusted person to help them figure out their health care, according to the Accolade Consumer Healthcare Experience Index Poll, conducted by The Harris Poll. The study gauged how Americans feel about their healthcare, especially focusing on employer-sponsored health insurance. One-third of people (32%) aren’t comfortable with navigating medical benefits and the healthcare system; a roughly percentage of people aren’t comfortable with their personal knowledge to make financial investments, either (35%). Buying a car, a home, technology and electronics? Consumers are much more comfortable shopping for these things. Consumers say that the most onerous

In the growing era of consumer-driven health, a growing list of options for receiving care are available to consumers. And people are liking new-new sites of care that are more convenient, cheaper, price-transparent, and digitally-enabled. Think of these new-new sites as “new front doors,” according to Oliver Wyman in their report, The New Front Door to Healthcare is Here. The traditional “doors” to primary and urgent care have been the doctor’s office, hospital ambulatory clinics, and the emergency room. Today, the growing locations for retail clinics and urgent care centers are giving consumers more visible and convenient choices for seeking

9 in 10 people in the U.S. use some form of digital technology or electronic tools for health management, Accenture found in the company’s 2016 Consumer Survey on Patient Engagement. Younger people (18-34) tend to favor wearable technology, apps and social media for health. More older people (age 65-74) mine electronic health records (EHRs) for personal health data and more likely use tech for remote consultations with care providers. Overall, the percent of U.S. consumers accessing their EHR data grew by over 50% between 2014 and 2016, from 27% to 45% of people doing so, with older people indexing higher

When I say “Fitbit,” you may think, “digital health.” When I mention “Gatorade,” “Nestle,” and “Dannon,” you might think, “drink,” “chocolate,” and “yogurt.” But soon, the phrase “digital health” will come to mind. That’s because a growing list of food manufacturers is looking to digital technologies to bake (or cook, blend, or mix) health into their value propositions. “Gatorade Taps Into Tech-Thirsty Consumers” is an article published in today’s Wall Street Journal, page B1 in the Business & Tech section of the newspaper. Mike Estrel writes that Gatorade is going high tech, working on a “smart cap” bottle with a microchip

One in 3 consumers is using mobile apps for health, doubling from 16% in 2014 to 33% in 2016, according to a survey from Accenture released during HIMSS 2016 conference. The proportion of people donning a wearable device for health more than doubled, from 9% to 21% between 2014-15. Part of this response is due to more physicians asking their patients — consumers — to adopt a wearable to track a health or fitness metric. One in 5 consumers said their doctor “prescribed” the use of a wearable, and 76% of these people followed the doctor’s recommendation. Most consumers and

What do you get when one of the largest health insurance companies supports the development of a medical-grade activity tracker, enables data to flow through a HIPAA-compliant cloud, and nudges consumers to use the app by baking behavioral economics into the program? You get Motion from UnitedHealthcare, working with Qualcomm Life’s 2net cloud platform, a program announced today during the 2016 HIMSS conference. What’s most salient about this announcement in the context of HIMSS — a technology convention — is that these partners recognize the critical reality that for consumers and their healthcare, it’s not about the technology. It’s about

As consumers’ growing financial skin in the health care game compels them to seek care in lower-cost settings, the pharmacy business recognizes the opportunity to provide healthcare services beyond the core business of filling prescriptions. This month, Drug Store News (DSN) published a special section called which profiles several pharmacy companies’ expanding reach into retail health – in particular, re-defining the concept of the “health fair.” A health fair is “an educational and interactive event designed for outreach to provide basic prevention and medical screening to people in the community,” according to the latest Wikipedia definition. But the health fairs described

All over the world, people define their health and wellness across many dimensions…physical, mental, financial, and appearance. In Florence, Italy, I happened upon a riff on this last component on “look good, feel good” at the Coin Department store located on Via Del Calzaiuoli in central Firenze. Welcome to Coin’s Health&Beauty Store. The two photos tell a story about health, where we live, work, play, and shop, the mantra for public health focused on the social determinants of health beyond healthcare. Here at Coin, adjacent to the holistic brands of Clarins and other luxury labels, is a pharmacy along with

The so-called legacy healthcare system are the incumbents in American health care — hospitals, physician practices, pharma, health plans, and other organizations that have long-served and been reimbursed by traditional volume-based payment. Patients, now morphing in to health consumers, look to these stakeholders to provide new levels of service, accessibility, convenience, transparency and value — the likes of which people find in their daily life in other market sectors. Those consumer demands are pressuring the health system as we know it in many new ways, which I discussed with Unity Stoakes, Co-Founder of Startup Health, at the Health 2.0 Conference in

9 in 10 people in the U.S. believe working with their health clinician as a partner will help them better manage their overall health, according to a survey conducted for The Society for Participatory Medicine. Consumers’ majority call-out for shared decision-making with health care professionals also extends to their self-tracking health data — for example, via activity trackers, digital glucometers for blood sugar, technologies for blood pressure, and food logging apps. 84% of people said that sharing their personal self-tracking health data with clinicians between visits would also help people manage health. That clinician’s involvement is very important to health

Nine in 10 pet owners know when their dog or cat is due for their shots. Eight in 10 women know the frequency with which they get manicures and pedicures. 80% of men know the mileage between old changes. But only 50% of family health care decision makers know their blood pressure, and only 20% know their biometric numbers like cholesterol and BMI. Americans are great at doing preventive care for their pets and automobiles; but not so much for their own bodies and health, finds the report CIGNA Preventive Care Research, a survey of 1,000 U.S. consumers between 25 and

It’s time to get the tea leaves out and mash up trends in my world of health, health care, technology, policy and people for 2016. We’ll start with the central player: people, consumers, patients, caregivers all. Health consumerism on the rise.  People – call us patients, consumers, caregivers – will take on even more financial and clinical decision making risk in 2016. Growing penetration of high-deductible and consumer-driven health plans will push (not just nudge) people into the role of health care consumers, and the emerging businesses and programs serving the transparency market for price and quality will gain traction

Health is where we live, work, play, pray and have fun. And if you’re Penn Jillette, the magician who collaborates with Teller, it took more than sleight of hand or a magic trick to lose 100 pounds — one-third of his body weight. He did it, according to this video, with the help of hard work, and using activity tracking tools from Withings. [youtube https://www.youtube.com/watch?v=EQWCVLvuBzI?rel=0] Unlike many people who quantify themselves for wellness and fitness, Penn did so to avoid having a medical procedure (i.e., the implantation of a stomach sleeve for weight loss) and also to reduce the six

By 2020, according to the World Economic Forum, more than 5 billion people and 30 billion “things” will be connected to the Internet — cars, refrigerators, TVs, washing machines and coffeemakers, among those 5 bn folks’ electronic stuff. But so will medical devices, activity trackers, and a host of sensor-enabled “things” to help people and clinicians optimize health and manage illness. The Internet of Things (IoT) phenomenon, which is already penetrating households with energy management and security applications, is reaching health care. One of the pioneers in this connected health market is Dr. Joseph Kvedar, who leads the Center for

The average price for a specialty drug was $53,384 in 2013; the average household income was $52,250. Thus, even allocating 100% of a family’s annual earnings to pay for a drug wouldn’t stretch far enough to cover it in 2013, nor would it do so today in 2015. This sober health economic artifact comes from the latest Rx Price Watch Report from the AARP, detailing cost trends for prescription drugs across all segments — generics, brands and specialty drugs.  Contrast, as well, the $53K for the average specialty drug with the median 2013 Social Security benefit payout of $15,526 and median Medicare

The phone continues to be the platform technology used in this digital age of health care, according to Better Together: High Tech and High Touch, a survey report sponsored by the Bipartisan Policy Center and the Council of Accountable Physician Practices. Nielsen’s Strategy Health Perspectives project polled 5,014 U.S. adults in June and July 2015 for this study. According to the study sponsors, this is the largest consumer population studied conducted to-date on the topic of digital health use and demand. The first chart illustrates the reality of digital health in the U.S. 2015: that notwithstanding the availability of telehealth,

Reluctantly accepting the Affordable Care Act, health executives and their architects now see opportunities for re-imagining the hospital and health care services, according to Healthcare Industry Trends, a publication that’s part of the 2015 Building & Development Leadership Series provided by Mortenson, a construction services firm that’s active with healthcare organizations. Mortenson conducted a survey at the 2015 ASHE Planning, Design, and Construction Summit, the results of which were published in this report. The over 300 respondents included healthcare executives, facilities managers, and healthcare architects. Thus the lens on the data in this survey is through the eyes of physical

A growing desire for shared decision making with doctors. Increasing trust and consumption of health care information online, in social media, and report cards. Reliance on technology for monitoring health adn wellness, and medical conditions. Together, these three signals converge, illustrating a growing sense of consumer engagement among U.S. patients, found in the 2015 Deloitte Center for Health Solutions Survey of US Health Care Consumers. In Deloitte’s research summary, the title states that “No ‘one-size-fits-all’ approach” will work, given diversity among American health consumers. The sickest health consumers, Deloitte notes, have higher levels of health engagement and index higher on

The fastest-growing category of products and services at Health 2.0 is consumer-facing digital health, and a panel of companies demonstrated various flavors of the New Retail Health. One of the most prominent companies featured in Health 2.0’s conferences from the inception has been MyFitnessPal (MFP), a long-time helpful tool I’ve used to manage my own health-life. Under Armour acquired MFP earlier this year, which I covered here in Health Populi. Under Armour’s original mission was to make all athletes better. With the company’s acquisition of MyFitnessPal, Under Armour continued its morphing from a textile and sports gear company to a

8 in 10 people in the U.S. say that Medicare as well as private health insurance plans should pay for discussions held between patients and doctors about hatlhcare at the end-of-life. The September 2015 Kaiser Family Foundation Health Tracking Poll asks people their opinions about talking end-of-life with their doctors. The vast majority of people support the concept and physicians being paid for holding such conversations in doctor-patient relationship. The question is germane because the Obama Administration has announced plans to pay doctors for office visits to discuss end-of-life (EOL) issues with Medicare patients. There isn’t a huge variation across

Of the over 165,000 mobile health (mHealth) apps available in the Apple iTunes and Google Play (Android) stores, 36 are responsible for one-half of all downloads, based on IMS Institute‘s latest research into Patient Adoption of mHealth: Use, Evidence and Remaining Barriers to Mainstream Adoption published today. This report updates IMS Institute’s 2013 report on mHealth, covered here in Health Populi. For the 2015 research, IMS Institute looked at the state of mHealth apps, number and type, uptake and usage, evidence of the impact apps have on patient care, and consideration of barriers and progress made for apps becoming a

In the growing shared economy, one centerpiece is people-powered health – co-creating, shared decision-making, and a greater appreciation for the impact of social on health. As we approach the mid-point of 2015, there are several signposts pointing to people-powered health/care. FasterCures launched the Science of Patient Input Project, with the objective of getting the patient’s voice into clinical discovery and decision-making. This video describes the intent of the program and its potential for people-powered health and user/patient-centered drug design, beyond the pure clinical efficacy of therapies. Another example of people-powered health comes from The Wall Street Journal dated 29 June 2015, which

Digital health is a fast-growing category of consumer electronics, and many new mobile and wearable health devices were featured at the 2015 CE Week held in New York City. The major themes of the “Fresh Gear” unveiled at the meeting included connected cars, connected home devices, 3-D printing, and a growing array of wristbands, apps, and wearable devices focused on the already-crowded health/wellness segment, and the emerging health/care area. The five I’ll focus on are good examples of digital health tech’s aimed at mainstream consumers shopping at retail at the middle of the market: an area that’s ripe to be served.

Patients in the U.S. are transforming into health care consumers, and in 2015 there are 3 underlying forces shaping that new consumer. This week kicks off the annual BIO conference in Philadelphia, and today Klick Health, the digital communications firm, convenes a group of thought leaders in healthcare to brainstorm markets, financing, and the state of pharmaceutical and life science innovation. An underlying theme throughout this meet-up is patient’s role in health/care. Patients are people, consumers, caregivers, mothers, fathers, sisters, brothers, friends, neighbors, community members, taxpayers, all. We’re old, we’re young, we’re mobile and not-so-much, we’re amputees, we’re migraneurs, we’re cancer

Workplace well-being programs are going beyond physical wellness, incorporating personal stress management and financial management. Nearly one-half of employers offer these programs in 2015. Another one-third will offer stress management in the next one to three years, and another one-fourth will offer financial management to workers, according to Virgin Pulse’s 2015 survey of workplace health priorities, The Busness of Healthy Employees. The survey was published June 1st 2015, kicking off Employee Wellbeing Month, which uses the Twitter hashtag #EWM15. It takes a village to bolster population health and wellness, so Virgin Pulse is collaborating with several partners in this effort

The cost of a PPO for a family of four in America hits $24,671 in 2015, growing 6.3% over 2014’s cost. The growth in health care costs will be driven by high specialty prescription drug costs. The 6.3% growth rate in health costs is a stark increase compared with the twelve month April 2014-March 2015 decline in the Consumer Price Index of -0.1%. Welcome to the 2015 Milliman Medical Index, subtitled “Will the typical American family of four be driving a ‘Cadillac plan’ by 2018?” The MMI gauges the average cost of an employer-sponsored preferred provider organization (PPO) health plan and includes all

The number of people in the U.S. spending over $100,000 a year on prescription drugs tripled in 2014, according to Super Spending: U.S. Trends in High-Cost Medication Use, from The Express Scripts Lab. Express Scripts is a pharmacy benefits management company that manages over one billion prescriptions a year. The company analyzed prescription drug claims for 31.5 million health plan members for this study, in commercially insured, Medicare, and Medicaid plans. The big-dollar story in 2014 was Hepatitis C, with a relatively small patient population but a super-sized drug spend as the first chart shows: a very tall blue bar (Rx

In recent weeks, an enormous amount of money has been raised by organizations using information technology to move health/care to people where they live, work, and play… This prompted one questioner at the recent ANIA annual conference to ask me after my keynote speech on the new health economy, “Is the hospital going the way of the dinosaur?” Before we get to the issue of possible extinction of inpatient care, let’s start with the big picture on digital health investment for the first quarter of 2015. Some $429 mm was raised for digital health in the first quarter of 2015,

The two most trusted health professionals in the eyes of U.S. consumers are nurses and pharmacists, and both of these health workers will be key partners for people wanting to engage in health/care. That was my introductory message kicking off the annual conference of ANIA, the American Nursing Informatics Association, in Philadelphia on April 24, 2015. Meeting in the City of Brotherly Love gave ANIA the opportunity to theme the meeting a “Declaration of Nursing Informatics,” carrying that theme through the exhibition hall with a Benjamin Franklin lookalike walking the floor availing himself of attendees’ requests for selfie-taking with the

Alex Gourley, President of The Walgreen Company, addressed the capacity crowd at HIMSS15 in Chicago on 13th April 2015, saying his company’s goal is to “make good health easier.” Remember that HIMSS is the “Health Information and Management Systems Society” — in short, the mammoth health IT conference that this year has attracted over 41,000 health computerfolk from around the world. So what’s a nice pharmacy like you, Walgreens, doing in a Place like McCormick amidst 1,200+ health/tech vendors?  If you believe that health is a product of lifstyle behaviors at least as much as health “care” services (what our

When you think about life insurance, images of actuaries churning numbers to construct mortality tables may come to mind. Mortality tables show peoples’ life expectancy based on various demographic characteristics. John Hancock is flipping the idea life insurance to shift it a bit in favor of “life” itself. The company is teaming with Vitality, a long-time provider of wellness tools programs, to create insurance products that incorporate discounts for healthy living. The programs also require people to share their data with the companies to quality for the discounts, which the project’s press release says could amount to $25,000 over the

There’s a trifecta of books written by three brilliant doctors that, together, provide a roadmap for the 21st century continuum of health care: The Patient Will See You Now by Eric Topol, MD; The Digital Doctor from Robert Wachter, MD; and, Being Mortal, by Atul Gawande. Each book’s take provides a lens, through the eyes of a hands-on healthcare provider, on healthcare delivery today (the good, the warts and all) and solutions based on their unique points-of-view. This triple-review will move, purposefully, from the digitally, technology optimistic “Gutenberg moment” for democratizing medicine per Dr. Topol, to the end-game importance of

While there’s little evidence that the short-term impact of the Affordable Care Act has limited job growth or driven most employers to drop health insurance plans, the ACA has spawned a “cottage industry” of health companies since 2010, according to PwC. As the ACA turned five years of age, the PwC Health Research Institute led by Ceci Connolly identified at least 90 newcos addressing opportunities inspired by the ACA: Supporting telehealth platforms between patients and providers, such as Vivre Health Educating consumers, such as the transparency provider HealthSparq does Streamlining operations to enhance efficiency, the business of Cureate among others

While shopping is a life sport, and even therapeutic for some, there’s one product that’s not universally attracting shoppers: health insurance. McKinsey’s Center for U.S. Health System Reform studied people who were qualified to go health insurance shopping for plans in 2015, covered by the Affordable Care Act. McKinsey’s consumer research identified six segments of health insurance plan shoppers — and non-shoppers — including 4 cohorts of insured and 2 of uninsured people. The insureds include: Newly-insured people, who didn’t enroll in health plans in 2014 but did so in 2015 Renewers, who purchased health insurance in both 2014 and

“Live long and prosper,” Mr. Spock repeated, like a mantra, throughout his life. We say goodbye, on this dimension anyway, to Leonard Nimoy, who passed away today at the age of 83. Star Trek is a staple entertainment — perhaps even a relaxation therapy — in my home. So Mr. Nimoy’s departure from the Planet is indeed a sad event here. In thinking about Spock’s mantra about living well, I am reminded of an interchange between him and Captain Kirk in the Star Trek movie, The Wrath of Khan. In that film, Spock is severely irradiated while saving the ship, and

Offering wellness programs is universal among U.S. employers, who roughly divide in half regarding their rationale for doing so: about one-half offer wellness initiatives to invest in and increase worker health engagement, and one-half to control or reduce health care costs. Two-thirds of companies offering wellness will increase their budgets, according to the International Foundation of Employee Benefit Plans (IFEBP)  report, Workplace Wellness Trends, 2015 survey results. The IFEBP polled 479 employers in October 2014, covering corporate, public, and multi-employer funds in the U.S. and Canada. The statistics discussed in this post refer solely to U.S. organizations included in the study

1 in 3 U.S. adults used some form of complementary and alternative medicine (CAM) in the U.S. in 2012, led by fish oil in the herbal supplements category, and yoga in the services category. While use of complementary products and services in health has remained unchanged at about 34% of Americans using CAM, the adoption of yoga in American life has doubled among adults in the past decade to about 1 in 10 adults doing some form of yoga. The report, the Use of Complementary Health Approaches in the U.S., a National Health Interview Survey conducted for the National Center for

65 million people know that food journaling works for losing weight, that it’s engaging to do on a well-designed app, and that health is social. MyFitnessPal (MFP) has the distinction of being a top health app used longer by more people and more effectively than probably any other mobile health tool. Under Armour, the athletic goods company, now has MFP under its corporate umbrella, along with Endomondo, another very popular motivating mobile health tool. You may know Under Armour as a company that manufactures and markets functional workout gear. But this deal is so not about the wearable. It’s about