A blog covering the health/care ecosystem and people.

“It’s the economy stupid,” Jennifer Tescher, CEO of the Financial Health Network, titles her latest column in Forbes. Published two weeks after the 2024 U.S. elections, Jennifer’s assertion sums up what, ex post facto, we know about what most inspired American voters at the polls in November 2024: the economy, economics, inflation, the costs of daily living….pick your noun, but it’s all about those Benjamins right now for mainstream American consumers across many demographic cuts. With that realization, we must remind ourselves as we enter a new year under a second-term President Trump that health care spending for everyday 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

The premium for employer-sponsored health plans grew by 6-7% between 2023 and 2024, according to the report on Employer Health Benefits 2024 Annual Survey from the Kaiser Family Foundation, KFF’s 26th annual study into U.S. companies’ spending on workers’ health care.                 In 2024 the average annual health insurance premium for family coverage is $25,572, split by 75% covered by the employer (just over $19,000) and 25% borne by the employee ($6,296), shown in the first chart from the report. The nearly $26K family premium is the average across all plan types in the

“If the U.S. were sensible, weight management would be treated as a public health issue,” David Cutler writes in the JAMA Health Forum dated August 15, 2024. Dr. Cutler, distinguished economics professor at Harvard, talks about “the pathology of U.S. health care” citing the example of weight loss medications — in short, the uptake of GLP-1 drugs to address Type 2 diabetes first, and subsequently obesity.          Dr. Cutler notes that the price of these drugs in the U.S. “far exceeds” that of other countries: specifically, 9 times that of the prices in Germany and the Netherlands

“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

People have been undergoing their own human kind of digital transformations, turbocharged during the pandemic for many who never used Zoom or Amazon Prime or Uber. That consumer-borne digital transformation has shaped people as health consumers, many having used telehealth and appointment-scheduling online. And peoples’ relationships with pharmacies are also changing, with more health consumers finding greater satisfaction with their mail order pharmacy experiences than with moat retail brick and mortar chain drug stores, the latest J.D. Power 2024 U.S. Pharmacy Study found.                       It’s clear that mail order is

The U.S. Bureau of Labor Statistics had good news for American consumers long-facing inflation for household spending over the past couple of years, announcing on July 11, 2024, that the general consumer price index (CPI) fell, lowering real prices for people buying airline tickets, used cars and trucks, communication, and petrol to fill auto tanks.               That positive economic news did not extend to medical care and personal care, the BLS reported, whose costs increased by 3.3% and 3.2%, respectively. (Motor vehicle insurance costs grew a whopping 19.5% in the report, FYI). Following the

Most Americans follow some kind of eating regime, seeking energy, more protein, and healthy aging, according to the annual 2024 Food & Health Survey published this week by the International Food Information Council (IFIC). But a person’s household finances play a direct role in their ability to balance healthful food purchases and healthy eating, IFIC learned.              In this 19th annual fielding of this research, IFIC explored 3,000 U.S. consumers’ perspectives on diet and nutrition, trusted sources for food information, and new insights into peoples’ views on the GLP-1 weight-loss drugs and the growing sense

Health care costs for an “average” person covered by an employer-sponsored PPO in the U.S. rose 6.7% between 2023 and 2024, according to the 2024 Milliman Medical Index. Milliman also calculated that the largest driver of cost increase in health care, accounting for nearly one-half of medical cost increases, was pharmacy, the cost of prescription drugs, which grew 13% in the year.             The big number this year is $32,066, which is the cost of that employer-sponsored PPO for a family of 4 in 2024. I’ve curated the chart of the MMI statistic for many

In the past year, the growth of prescription drug utilization and spending has much to do with the use of GLP-1 agonists to treat diabetes and obesity, along with immunology therapy, and lipid meds, along with specialty medicines now accounting for over half of spending — up from 49% in 2018. This update comes from The Use of Medicines in the U.S. 2024 from the IQVIA Institute for Human Data Science. The annual report details trends in health services utilization, the use of prescription drugs, patient financing of those costs, the drivers underpinning the medicines spending, and an outlook to 2028.

In the past few years, what event or innovation has had the metaphorical impact of hitting you upside the head and disrupted your best-laid plans in health care? A few such forces for me have been the COVID-19 pandemic, the emergence of Chat-GPT, and Russia’s invasion of Ukraine. That’s just three, and to be sure, there are several others that have compelled me to shift my mind-set about what I thought I knew-I-knew for my work with organizations spanning the health care ecosystem. I’m a long-time practitioner of scenario planning, thanks to the early education at the side of Ian

Three major milestones marked March 2024 which compel us to note the growing role of patients-as-consumers — especially for self-prescribing medicines and medical devices. This wave of self-prescribed healthcare is characterized by three innovations: the Opill, GLP-1 receptor agonists, and Dexcom’s Continuous Glucose Monitoring (CGM) system that’s now available without a prescription. Together, these products reflect a shift in health care empowerment toward patients as consumers with greater autonomy over their health care when the products and services are accessible, affordable, and designed with the end-user central to the value proposition and care flows. Let’s take a look at each

In the U.S., national news media, Federal statistics, dozens of business leaders  and the Federal Reserve Bank have been talking about an historically positive American economy on a macro level. But among individual residents of the U.S., there is still a negative feeling about the economy in a personal context, revealed in the Kaiser Family Foundation Health Tracking Poll for February 2024.                I’ve selected three figures of data from the KFF’s Poll which make the point that in peoples’ negative feelings about the national economy, their personal feelings about medical costs rank high

Nurses rank highest among various factors in the U.S. health system in the latest Gallup poll — earning a grade of “excellent” or “good” by American adults surveyed in November 2023.               Further substantiation for nurses’ topping this poll of excellent care is that Gallup found historic low confidence in the U.S. health system among Americans  earlier this year in a July study. Note that 8 in 10 consumers rate nurses excellent/good compared with  7 in 10 people ranking physicians this way, 6 in 10 for hospitals, 5 in 10 for telemedicine/virtual visits, and

Two-thirds of U.S. consumers say they can’t afford to pay their medical bills on-time, based on the 2023 Consumer Survey from Access One, a financial services company focused on healthcare payments.               The report’s title page asks the question, “What options do consumers really want for paying healthcare expenses?” The survey report responds to that question, finding out that nearly one-half of patients have taken some kind of action to reduce their medical expenses. Furthermore, one-third of consumers are not confident they could pay a medical bill of $500 or more. Access One fielded

“We definitely do see a slight change compared to the total population, we do see a slight pullback in overall basket,” the CEO of Walmart US is quoted in Bloomberg. “Just less units, slightly less calories.”                   With patients’ use  GLP-1 drugs such as Ozempic, Wegovy, and Mounjaro fast-rising in the pharmacy market, so are the concerns of companies that stock the-middle-of-the-grocery-store aisles for processed foods like sweet and salty snacks. As the prospects for the drug companies who manufacture prescription drugs made for patients managing diabetes and obesity are on the

Oh, how quickly people forget…and slow to forgive. U.S. consumers’ positive views for healthcare, pharma and retail have significantly fallen in just one year, the latest annual Gallup poll of industry rankings in America found as of August 2023. This stat for the pharma industry was the lowest Gallup ever recorded for the sector since 2001.                     I can’t help hearing Paul Simon’s lyrics to Slip Slidin’ Away….”you know the nearer your destination, the more you’re slip slidin’ away” when it comes to health citizens’ perceptions of pharma and the healthcare

An aging U.S. population with a preference for growing older at home — and a fiscally challenging health care financing outlook — are setting the demographic and financial table for the shift of medical care to peoples’ homes discussed in The State of Health at Home Models: Key Considerations and Opportunities, published by the American Medical Association (AMA).             Note that this framework has been developed by the AMA, the largest professional organization of doctors. While moving health care to the home will involve quite different workflows and disruptions to current general medical practice, it

Patients’ perceptions of health care quality and experience have fallen in the three years since 2020, based on a July 2023 update from The Beryl Institute – Ipsos Px Pulse study.         Start with health care quality, which 58% of U.S. adult patients ranked as “very good or good” in June 2020. The percent of health consumers evaluating their healthcare quality as very good or good fell to 41% of people in June 2023, an erosion of 17 percentage points, shown in the first chart.         Next, consider patients’ ratings on their care experience,

With consumer and prescriber interest in GLP-1 receptor agonist drugs “soaring,” health plan managers have a new source of financial stress and clinical questions on their to-do list. A team of Virta Health leaders held a webinar on 13th July 2023 to explain the results of a study the company just completed assessing health plan execs’ current views on Ozempic and other GLP-1 medicines with a view on both clinical outcomes and cost implications for this growing category of drugs that address diabetes and obesity.             Indeed, diabetes and obesity are top health concerns among the

Health care cost trend will spike up another percentage point to 7.0% in 2024, according to the annual report from the PwC Health Research Institute, Medical cost trend: Behind the numbers 2024.                 Every year, the PwC HRI team goes behind those numbers to assess cost inflators and deflators which underpin annual medical inflation. As the first line chart illustrates, the peak of medical trend in the last 18 years was in 2007 when the U.S. saw double-digit cost growth of nearly 12%. Here’s a link to PwC’s 2007 study looking behind the

In health care, one of the “gifts” inspired by the coronavirus pandemic was the industry’s fast-pivot and adoption of digital health tools — especially telehealth and more generally the so-called “digital front doors” enabling patients to access medical services and personal work-flows for their care. Two years later, Experian provides a look into The State of Patient Access: 2023.                     You may know the name Experian as one of the largest credit rating agencies for consumer finance in the U.S. You may not know that the company has a significant footprint

As most Americans confess to feeling stressed over the past six months, peoples’ food and beverage choices have been intimately connected with their mental and emotional well-being, we learn from the 2023 Food & Health Survey from the International Food Information Council (IFIC). For this year’s study, IFIC commissioned Greenwald Research to conduct 1,022 interviews with adults between 18 and 80 years of age in April 2023. The research explored consumers’ perspectives on healthy food, the cost of food, approaches to self-care through food consumption, the growing role of social media in the food system, and the influence of sustainability

We continue to track to evolving, expanding landscape of retail health — which we see as the expanding ecosystem of health/care accessible to people-as-health consumers. This week, three intriguing examples are resonating with us: The ever-evolving weight-loss industry FDA favors OTC use for Perrigo’s Opill daily oral contraceptive birth control pill The convergence of fashion and health — specifically, how an over-the-counter medicine converges with clothing that helps us feel better.                   Let’s start with weight-loss, as several aspects of health/care come together in the consumer’s retail health sandbox. Dr. Eric Topol

Many health citizens in the U.S. would likely skip receiving preventive health care services if the Affordable Care Act’s (ACA) coverage for them goes away, a Morning Consult survey found.                   The first chart illustrates the top-line of this research: that most U.S. adults would not pay out of pocket for several preventive services including tobacco cessation, drug use screening, weight loss measures to prevent obesity-related illnesses, as well as screening for depression or HIV. One of the key benefits embedded in the ACA was “free” without co-pay shares for  preventive care. These

Two announcements this week add important initiatives to patients’ growing choices that speak to their consumer-sides’ sense of value and personal healthcare cost-containment: Amazon launched RxPass, a generic medicines subscription service; and, Dollar General promoted its mobile health service powered by DocGo on demand for health visits, “right outside the store.”             These two programs come from outside of the legacy health care system of so-called incumbents — hospitals, health systems, health insurance — leveraging two brand-names beloved to many consumers for convenience, price transparency, and sheer cost. First, check out Amazon Pharmacy’s RxPass. Amazon

Rising costs are the #1 reason U.S. health consumers are avoiding or delaying health care, replacing concerns about COVID-19, based on survey research from Qualtrics.         The company’s Healthcare Cost of Living survey research learned that 48% of U.S. adults chose to defer health care in 2022, split by 31% of consumers skipping care due to cost concerns, and, 17% of people delaying care who had concerns about the coronavirus. Note the types of care delayed or skipped: Over 27% of people delayed care related to nutrition 26% delayed routine or preventive care, such as screenings or

Employers covering health insurance for workers’ families will face insurance premiums reaching, on average, $22,463. That is roughly what a year at an independent college in Connecticut would cost, or a round of pay for a ref in the Stanley Cup playoffs. With that sticker-shock level of health plan costs, welcome to the 2022 Employer Health Benefits Survey from Kaiser Family Foundation, KFF’s annual study of employer-sponsored health care.                 Each year, KFF assembles data we use all year long for strategic and tactical planning in U.S. health care. This mega-study looks at

What happens to a health care ecosystem when the volume of patients and revenues they generate decline? Add to that scenario a growing consensus for a likely recession in 2023. How would that further impact the micro-economy of health care?                   A report from Trilliant on the 2022 Trends Shaping the Health Economy helps to inform our response to that question. Start with Sanjula Jain’s bottom-line: that every health care stakeholder will be impacted by reduced yield. That’s the fewer patients, less revenue prediction, based on Trilliant’s 13 trends re-shaping the U.S. health

Patients have more financial skin-in-their-healthcare-games facing high-deductibles and direct out-of-pocket costs for medical bills…including prescription drugs. I collaborated with GoodRx on a “yellow paper” discussing The Health Consumers as Payer, with implications and calls-to-action for pharma and life science companies. You can download the paper at this link.               The report is intended to be a playbook for understanding patients’ growing role as consumers and health care payers, providing insights into peoples’ home economic mindsets and how these impact a patient’s adherence to medication based on cost and perceived value. With inflation facing household

Thinking about the social determinants of prescription drugs, how people take medicines in real life in my latest post in Medecision’s Liberate Health blog.           I had one of those special lightbulb moments when listening to Mauricio Gonzalez-Arias, M.D. of NYC Health + Hospitals and Suvida Healthcare discussing medication adherence and what prevents us from taking our meds as prescribed. His discussion on social determinants’ role in shaping our relationship with prescriptions was powerful, and the jumping off point for this essay.           Medication adherence is a challenge that fiscally costs the

In a busy week of news in the health care and digital health world, it would be easy to miss a press release published on 23rd August on the food-as-medicine front. But don’t blink this snippet away. It is another strong signal about the growing blur between grocery stores, food, digital tech, and population health.       The digital health platform LLENA (AI) announced its collaboration with Walmart to support people managing diabetes with personalized nutrition support from data tracking pulling through to healthy food delivery. Note LLENA (AI)’s tagline: “where AI meets GI for better health.” “LLENA” is

Nearly 100 million people in the U.S. cut back on healthcare due to costs in the first half of 2022, according to the latest poll on health care costs form Gallup and West Health, gauging Americans’ financial health in June 2022. That’s the month when inflation in the U.S. reached 9.1%, a 40-year high.             Among Americans’ cuts to household spending was the most common medical self-rationing behavior, delaying or avoiding  care or purchasing prescription drugs, the survey found. Nearly 4 in 5 people in the U.S. had delayed care or prescription meds between January

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,

Some patients dealing with cancer at Mercy Health’s Lourdes Hospital have been supplied with gas cards. This gesture is enabling families to get to medical appointments around Paducah, Kentucky where, this week, car drivers faced regular gas priced at an average of $4.16 a gallon compared with $2.92 one year ago.           Here’s the Hospital’s Facebook page featuring their gratitude to FiveStar Food Mart, the American Cancer Society, and the Mercy Health Foundation. “By providing cancer patients with gas cards, the cancer care team at Mercy Health Lourdes Hospital in Paducah hopes to mitigate financial challenges

“Inflation is the big story,” the economics team at Morning Consult told us yesterday in a call on “How to Think Like An Economist.” While I already thought I did that, Team @MorningConsult updated us on the current state of consumers and what’s weighing most heavily on their minds…inflation being #1. An hour after the Morning Consult session, I brainstormed the topic of consumers-as-payers of medical bills and prescription drugs with GoodRx strategy leaders. In my data wonkiness, inflation certainly played a starring role in setting the stage for Mind, Body and Wallet — the title of one of the sources

We are stuck on Band-Aids and hooked on hygiene and self-care according to the Most Trusted Brands 2022 study from Morning Consult.             In 2022, the most trusted brands in the United States were Band-Aid Lysol Clorox UPS CVS Health (pharmacy) VISA Cheerios The Weather Channel Colgate, and Home Depot. These products and companies sustain trends I tracked in Years 1 and 2 of the COVID-19 pandemic when several of these were most-trusted, bolstering peoples’ lives living in, working from, and making health at home.             Four key trends underscore

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

The COVID-19 pandemic has impacted patients who were already deeply engaged with their own health care before the coronavirus emerged. Compared with a year ago, more patients and their advocates are seeking quality therapies, innovation, engagement, and integrity from pharmaceutical companies, based on research published today from PatientView. PatientView, based in the UK, has collaborated with over 40,000 patient advocacy organizations globally marking over 10 years doing this research. The eleventh annual report on the Corporate Reputation of Pharma was conducted among 2,150 patient groups between November 2021 and February 2022, covering health citizens in Europe (with 1,229 organizations), North

Inflation and rising prices are the biggest problem facing America, most people told the Kaiser Family Foundation March 2022 Health Tracking Poll. Underpinning that household budget concern are gas and health care costs. Overall, 55% of people in the U.S. pointed to inflation as the top challenge the nation faces (ranging from 46% of Democrats to 70% of Republicans). Second most challenging problem facing the U.S. was Russia’s invasion into Ukraine, noted by 18% of people — from 14% of Republicans up to 23% of Democrats. The COVID-19 pandemic has fallen far down Americans’ concerns list tied third place with

The financial toxicity of health care costs in the U.S. takes center stage in Health Populi this week as several events converge to highlight medical debt as a unique feature in American health care. “Medical debt is the most common collection tradeline reported on consumer credit records,” the Consumer Financial Protection Bureau called out in a report published March 1, 2022. CFPB published the report marking two years into the pandemic, discussing concerns about medical debt collections and reporting that grew during the COVID-19 crisis. Let’s connect the dots on: A joint announcement this week from three major credit agencies,

In October 2021, the Consumer Technology Association (CTA) announced that Robert Ford, CEO and President of Abbott, would give a keynote speech at CES 2022, the world’s largest annual convention of the technology industry. “This marks the first time in CES history that a healthcare company will take the mainstage for a keynote at the show,” CTA’s press release stated. I covered this announcement in the Health Populi blog at the time, and today want to double-down on the significance of Ford’s leading presence at #CES2022. When announced, the news was a signal that health care and the larger tech-enabled

Even with growing inflation in the U.S. and post-pandemic job growth in 2021, the cost of health insurance premiums rose faster than either the price of goods or wages. That family health plan premium reached $22,221, an increase of 22% since 2016, we learn in the annual report from Kaiser Family Foundation, 2021 Employer Health Benefits Survey. This report is our go-to encyclopedia of statistics on health insurance year-after-year, surveying companies’ annual health insurance strategies for coverage and tactics for managing spending and workers’ health outcomes. This 2021 update takes into account the impacts and influence of COVID-19 on workers’

COVID-19 exacted a toll on health citizens’ mental health, worsening a public health challenge that was already acute before the pandemic. It’s World Mental Health Day, an event marked by global and local stakeholders across the mental health ecosystem. On the global front, the World Health Organization (WHO) describes the universal phenomenon and burden of mental health on the Earth’s people… Nearly 1 billion people have a mental disorder Depression is a leading cause of disability worldwide, impacting about 5% of the world’s population People with severe mental disorders like schizophrenia tend to die as much as 20 years earlier

In April 2020, telemedicine morphed into mainstream medical care as hospitals and physicians risk-managed exposure to infection by meeting with patients, virtually, when possible. By March 2020, telehealth channels were replacing visits to doctors and emergency departments as shown in the first chart from the CDC’s report on the early pandemic period. By the spring of 2021, telehealth use stabilized, but health systems had built the processes and policies to deliver on the promise of omni-channel health care — from the patient’s home and hands (via smartphones) into community sites closer-to-home, and returning to brick-and-mortar medical buildings. Welcome to Telehealth

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%

In the U.S., patients have assumed the role of health care payors with growing co-payments, coinsurance amounts, and deductibles pushing peoples’ out-of-pocket costs up. This has raised the importance of price transparency, which is based on the hypothesis that if patients had access to personally-relevant price/cost information from doctors and hospitals for medical services, and pharmacies and PBMs for prescription drugs, the patient would behave as a consumer and shop around. That hypothesis has not been well proven-out: even though more health care “sellers” on the supply side have begun to post price information for services, patients still haven’t donned

The U.S. Olympic team will be competing in Tokyo for first-place medals across many athletic events, each nation’s most physically-fit citizens going for gold. When it comes to the U.S. ranking on the world roster of population health outcomes, American ranks low on many key metrics, especially given that the U.S. does rank #1 in one key stat: healthcare spending. Reminding us of America’s lowly-placed health outcomes, the Eli Lilly Company is collaborating with Team USA, the US Olympic and Paralympic teams, to promote “Our Collective Health” with the message that, “Watching the success of our athletes will once again

“Self-care” took on new meaning and personal work-flows for people living in and through the coronavirus pandemic in the U.S. Acosta, the retail market research pro’s, updated our understanding consumers evolving as COVID-19 Has Elevated the Health and Wellness Trends of the Recent Years, results of a survey conducted among in May 2021. In the U.S., consumers’ take on self-care has most to do with healthy eating and nutrition (for 1 in 2 people), getting regular medical checkups (for 42%), taking exercise, relaxing, using vitamins and supplements, and getting good sleep. Healthy relationships are an integral part of self-care for