A blog covering the health/care ecosystem and people.

Financial wellness is integral to overall health. And the proliferation of high-deductible health plans for people covered by both public insurance exchanges as well as employer-sponsored commercial (private sector) plans, personal financial angst is a growing fact-of-life, -health, and -healthcare. Ask any hospital Chief Financial Officer or physician practice manager, and s/he will tell you that “revenue cycle management” and patient financial medical literacy are top challenges to the business. For pharma and biotech companies launching new-new specialty drugs (read: “high-cost”), communicating the value of those products to users — clinician prescribers and patients — is Job #1 (or #2,

People in the U.S. are spending over 20.6% of their income on health care, according to data published by the U.S. Department of Commerce on March 2, 2015. This is up from 15% of personal income in 1990. Note the slope of this curve, moving up the X-Y axes from southwest to northwest. Now note the slope of the curves in the second chart, which illustrates consumer spending on other household goods and services: cars, housing, clothing, education, groceries, and eating outside of the home. Spending on these home budget line items remained relatively flat over the 25 year period 1990-2015,

More employers are recognizing the link between workers who may be overweight or obese on one hand, and health care costs, employee engagement and productivity on the other. As a result, some companies are adopting wellness programs that focus on weight loss as part of an overall culture of health at the workplace. Humana and Weight Watchers are the latest example of two health brands coming together to address what is one of the toughest behavior changes known to humans: losing weight. Humana will extend access to Weight Watchers for the health plan’s enrollees in an integrated wellness program. The program

2 in 3 people in the U.S. would use a mobile app to manage their health, especially for diet and nutrition, medication reminders, tracking symptoms, and recording physical activity. The fifth annual Pulse of Online Health survey from Makovsky finds that digital health is blurring into peoples’ everyday lives. We’ve covered previous Makovsky digital health surveys here on Health Populi; last year, we focused on consumers managing risk in digital health platforms, and in 2013, the state of seeking health information online. That most consumers would go beyond health information search to the more engaging pursuit of managing health over

Just 1 in 5 health-insured people with a primary care provider use the web to look at their health data, and fewer than 1 in 10 people use digital means to book appointments. Welcome to the 2015 State of the Connected Patient, a survey report from Salesforce conducted by Harris Poll among 2,095 adults in January 2015. Perhaps the title of the analysis should more appropriately be the “2015 State of the Unconnected Patient.” While most patients polled are satisfied with their PCPs and most believe doctors are sharing their health records, people lack digital engagement with their primary care providers.

In our ADHD-addled, over-messaged and noisy world, it’s hard to break through the media clutter and binge-watching to get a health message out. Here’s the way it’s done: an engaging, humorous, impactful and crisp campaign focusing on making smoking so un-sexy and un-cool, you swipe the prospective date off of your Tinder app. Watch and learn, from The Truth. You can follow the campaign on Twitter using the hashtag #LeftSwipeDat. Kudos to the truth® anti-smoking campaign and the creative team who got this blend of message and medium so right. truth® is part of the Legacy project which is funded by the

Long an advocate for consumer-directed health in his company, John Mackey, co-CEO and co-Founder of Whole Foods Market, is talking about expanding the food chain’s footprint in retail health. “Americans are sick of being sick,” Mackey is quoted in “Whole Foods, Half Off,” a story published in Bloomberg on January 29, 2015. Mackey talks about being inspired by Harris Rosen, a CEO in Florida, who has developed a workplace clinic for employees’ health care that drives high quality, good outcomes, and lower costs. Mackey imagines how Whole Foods could do the same, beginning in its hometown in Austin, TX. He

Evidence of the rise of retail health grows, with the data point that on-demand health care is in-demand by 2 in 3 U.S. adults. American Well released the Telehealth Index: 2015 Consumer Survey, revealing an American health public keen on video visits with doctors as a viable alternative to visiting the emergency room. Virtual visits are especially attractive to people who have children living at home. [For context, this survey defines “telehealth” as a remote consultation between doctor and patient]. Convenience drives most peoples’ interest in telehealth: saving time and money, not leaving home if feeling unwell, and “avoiding germs

People with more financial skin in the health care game are more likely to act more cost-consciously, according to the latest Employee Benefits Research Institute (EBRI) poll on health engagement, Findings from the 2014 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey published in December 2014. Health benefit consultants introduced consumer-directed health plans, assuming that health plan members would instantly morph in to health care consumers, seeking out information about health services and self-advocating for right-priced and right-sized health services. However, this wasn’t the case in the early era of CDHPs. Information about the cost and quality of health care services was scant,

Three laws that shape the digital world have kicked into high gear, changing our lives in ways we cannot yet imagine. Those three forces are Metcalfe’s Law (in brief, the increasing value of networks), Moore’s Law (that processing power doubles every 18 months, or even faster), and the Law of Accelerating Returns (the fast pace of technological change). The guy who told me about that at the 2015 Consumer Electronics Show (#CES2015) was Shelly Palmer, something of a Renaissance Man in the evolving digital world, advising communications companies, composing music, patenting TV technology, investing in ventures, hosting shows on digital living,

Are you Feelin’ Groovy about wearables? Well slow down, you move too fast… …at least, according to Accenture’s latest survey into consumers’ perspectives on new technologies, published this week in conjunction with the 2015 Consumer Electronics Show in Las Vegas, the largest annual convention in the U.S. featuring technology for people. At #CES2015, we’re seeing a rich trove of blinged-out, multi-sensor, shiny new wearable things at the 2015 Consumer Electronics Show. Swarovski crystals are paired with Misfit Wearables, called the Swarovski Shine, shown here as a shiny new thing, indeed. Withings launched its Activite fitness tracking watch in new colors.

‘Tis the season for annual health trendcasting, which is part of my own business model. Here’s a curated list of some of my favorite trend reports for health care in the new year, with my Hot Points in the conclusion, below, summarizing the most salient trends among them. TechCrunch’s Top 5 Healthcare Predictions for 2015: In this succinct forecast, Walmart grows its presence as a health plan, startups get more pharm-funding, hospitals channel peer-to-peer lending, Latinos emerge as a “most-desired” health care segment, and Amazon disrupts the medical supply chain. Experian 2015 Data Breach Forecast: Healthcare security breaches will be

Mobile and digital technologies will bend the health care cost curve, drive individual and population health, and solve the nagging challenge of health disparities. Mobile and digital technologies will increase costs to health providers, disrupt work flows and lower clinicians’ productivity, and hit a market bubble. Depending on your lens into mHealth, and what product categories and user segments you’re looking at, all of the above can be true. The plenary session of the 2014 mHeath Summit kicked off with Dr. Harry Leider, Chief Medical Information Officer of Walgreens, who spoke of the pharmacy’s evolving role across the entire continuum of care,

This post is written as part of the Disruptive Women on Health’s blog-fest celebrating the 2014 mHealth Summit taking place 7-11 December 2014 in greater Washington, DC. Women and mobile health: let’s unpack the intersection. On the supply side of the equation, Good Housekeeping covered health tracking-meets-fashion bling in the magazine a few weeks ago in article tucked between how to cook healthy Thanksgiving side dishes and tips on getting red wine stains out of tablecloths. This ad appeared in a major sporting goods chain’s 2014 Black Friday pre-print in my city’s newspaper last week. And along with consumer electronics brand faves like

The corporate reputation, brand equity, of the health insurance continues to be low relative to other financial service industry benchmarks, found in the ACSI Finance and Insurance Report 2014. Customer satisfaction with health insurance companies fell between 2013 and 2014, especially attributed to higher costs hitting consumers in group (employer-based) policies. The 2014 American Customer Satisfaction Index (ACSI) is informed by interviews with 6,819 consumers interviewed via phone and email between July and September 2014. Customers of financial services companies (banks, credit unions, health insurance, life insurance, property & casualty, and internet brokerages) were asked to provide their opinions about named-firms

My post, Even Rich Girls Worry About Being Bag Ladies, was published in the Huffington Post this week. In the analysis, I weave the results of several seminal surveys on women, money, and health that have been conducted in the past few months. The bottom-line: even the most affluent women are financially stressed, and that stress is leading women to re-define what it means to be personally successful. When it comes to personal health, financial wellness is part of overall well-being, as defined by women who place being healthy above having money. Avoiding debt is the nuance here, not amassing

Oliver Wyman’s Health & Life Sciences group names its latest treatise on the new-new health care The Patient-to-Consumer Revolution, subtitled: “how high tech, transparent marketplaces, and consumer power are transforming U.S. healthcare.” The report kicks off with the technology supply side of “Health Market 2.0,” noting that “the user experience of health care is falling behind” other industry segments — pointing to Uber for transport, Amazon for shopping, and Open Table for reserving a table. The authors estimate that investments in digital health and healthcare rose “easily ten times faster” than the industry has seen in the past. Companies like

Concerns about Death Panels and government restricting health services for people that have been key arguments used against the Affordable Care Act’s (ACA) detractors and, even before the advent of the ACA, proposed health reforms under President Clinton. But it’s peoples’ self-rationing in the U.S. health system that’s causing true rationing — driven by high deductible health plans (HDHPs) that are fast-growing in the health insurance market, and by the high cost of specialty drugs and prescriptions. There are plenty of data demonstrating the consumer health rationing trend being collected and reviewed by think tanks like RAND here, and by The

This past weekend, 60 Minutes’ Leslie Stahl asked John Castellani, the president of PhRMA, the pharmaceutical industry’s advocacy (lobby) organization, why the cost of Gleevec, from Novartis, dramatically increased over the 13 years it’s been in the market, while other more expensive competitors have been launched in the period. (Here is the FDA’s announcement of the Gleevec approval from 2001). Mr. Castellani said he couldn’t respond to specific drug company’s pricing strategies, but in general, these products are “worth it.” Here is the entire transcript of the 60 Minutes’ piece. Today, Health Affairs, the policy journal, is hosting a discussion

Of all the functions a smartwatch could play, it’s activity tracking that’s top of most consumers’ minds. GfK conducted a survey in August 2014 among 5,000 smartphone-owning consumers in five countries — China, Germany, South Korea, the UK, and the U.S. The market research firm found that 29% of people see “activity tracking” the most important function. Phone calls ranked second with 13% of consumers, telling time 11%, and 10% voted for basic apps and navigation system. 7% of consumers noted the smartwatch would be desirable for basic web search. In this survey, activity tracking included the broad definition covering

More than twice as many patients than physicians are embracing consumers’ use of new digital technologies to self-diagnose medical conditions on their own. On the other hand, 91% of doctors are concerned about giving patients access to their detailed electronic health records, anticipating patients will feel anxious about the results; only 34% of consumers are concerned about anxiety-due-to-EHR-exposure. Welcome to the digital health chasm, that gap between what consumers want out of digital health, and what doctors believe patients can handle at this stage in EHR adoption in doctors’ offices and in patients’ lives. I have the video of Jack

Remote health monitoring is in the Trough of Disillusionment. Wearables are at the Peak of Inflated Expectations, with Big Data leapfrogging wearables from the 2013 forecast — both descending toward the Disillusionment Trough. Mobile (remote) health monitoring, however, has fallen into that Trough of Disillusionment as RHM has been undergoing reality checks in the health care system especially for monitoring and patient self-management of heart disease (most notably heart failure) and diabetes. Welcome to the 2014 edition of the Gartner Hype Cycle, one of my most-trusted data sources for doing health industry forecasts in my advisory work. Compared with last year’s

The supply side of telehealth has been readying itself for nearly a decade. The demand side appears to be aligning in 2014 for adoption to grow and sustain (some) solid business models. On the demand side, Towers Watson’s 2014 survey of large employers forecasts growth among companies that will offer telemedicine in 2015. Towers found that 37% of employers planned to offer telemedicine to workers as a lower-cost site of care; 34% more employers were considering telemedicine in 2016 or 2017.  The health benefits adviser calculates that employers could save over $6 billion if industry replaces virtual health consultations with

In the past few weeks, several events bolster the reality that health and health care are in Blurred Lines mode. Not Robin Thicke Blurred Lines, mind you, but the Venn Diagram overlapping kind. Walmart launched real primary care clinics in South Carolina and Texas. These will provide services beyond urgent care, charging $4 a visit for company employees and $40 a visit for other people The U.S. Department of Agriculture issued a report promoting “nudges” to grocery shoppers enrolled in the Supplemental Nutrition Access Program (SNAP) to buy healthy foods Apple is talking with Cleveland Clinic, Johnson Hopkins, and Mount Sinai Medical

What do you get when you pair Meredith Wilson, the writer-composer of The Music Man, with Robert Preston (who acted the starring role of Harold Hill, the traveling music-band instrument salesman) with a President committed to reversing the “softness” he saw in American health citizens? You get “Go, You Chicken Fat, Go,” a rousing band-and-choir backed anthem to promote people to engage in more exercise and shed their “chicken fat.” President Kennedy was the public health Prez who, in 1960, asked Meredith Wilson to pen a national anthem to motivate Americans who he considered were growing “soft.” Back in the

Three of the world’s biggest technology companies – Apple, Google and Samsung — have made big announcements in the world of connected health in the past few weeks. A fourth is positioned to enter the fray. These major announcements illustrate the convergence of consumer technology, health, and wearables, with the potential for Big Data and population health impacts. Among the three tech giants, Samsung announced its consumer health/tech story first, on May 28, 2014, at its Digital Health Initiative meeting. Samsung unveiled the Samsung Architecture Multimodal Interactions platform, SAMI, along with the Simband prototype wristband that would enable users to

Tomorrow is World No Tobacco Day. The use of tobacco is one of the most preventable public health issues on the planet. And the global tobacco epidemic contributed to 100 million deaths around the world in the 20th century. 6 million people die every year due to tobacco use — including 600,000 deaths due to exposure to secondhand smoke. About 500 million people living today will be dead from the use of tobacco products if current smoking habits continue, the World Health Organization (WHO) expects. WHO sponsors the World No Tobacco Day every year on May 31. For this year’s

The consumer demand side for healthcare transparency is hungry for the light to shine on health care costs, quality and information that’s relevant and meaningful to the individual. The supply side is fast-growing, with websites and portals, government-sponsored projects, commercial-driven start-ups, and numerous mobile apps. These tools endeavor to: Help people find and access services Schedule appointments Compare peer consumers’ reviews for those providers Calculate and prepare for out-of-pocket co-payments deriving from their health plan Negotiate prices with providers Pay for the services, and Reconcile the payment with a high-deductible health plan or health savings account. On the demand side, consumers

Yesterday kicked off this week in Health Populi, focusing on the growing role of transparency in health care in America. Today’s post discusses the results from Change Healthcare’s latest Healthcare Transparency Index report, based on data from the fourth quarter of 2013, published in May 2014. Charges for health services — dental, medical and pharmacy – varied by more than 300% in Q42013 — even within a single health network. Change Healthcare found this, based on their national data on 7 million health-covered lives. The company analyzed over 180 million medical claims. The company built the Healthcare Transparency Index (HCTI)

“In the New Health Economy, ‘patients’ will be ‘consumers’ first, with both the freedom and responsibility that come with making more decisions and spending their own money.”  This vision of the near-future is brought to you by the New Health Economy, a report from PwC’s Health Research Institute (HRI). The chart attests the fact that U.S. “consumers” are already spending nearly $3 trillion (with a capital “T”) on products and services that bolster personal health. This spending includes $94 billion on nutrition, $62 billion on weight loss, $59 billion on sporting goods and apparel, $45 billion on (so-called) organic and

The rising costs of health care in America, and consumers’ growing cost burdens, has many impacts on the U.S. health ecosystem. In particular, patients have been self-rationing due to costs, without necessarily paying attention to quality or medical outcomes. Doctors have begun to pay more attention to costs and their impacts on patients in their practices, addressed in today’s New York Times article, Treatment costs could influence doctors’ advice to patients. Andrew Pollack writes in the Times about the morphing role of doctors, some of whom are taking on the mantle of being a “steward of society,” as characterized by

The price of medicines is a barrier for about one billion people on the planet, for citizens in developing countries as well as middle-class families in the richest country in the world, the United States.  Today is World Health Day, when for 24 hours public health advocates (including me) are calling out key issues preventing people from fully living life. One obstacle for too many people is the cost of drugs and supplies that save lives and help people add life to years. For example, bug bites can be deadly if you’re talking about the 50% of the world’s population

U.S. consumer spending on health care is boosting the nation’s economy, based on some new data points. First, health care spending grew at an annual rate of 5.6% at the end of 2013, USA Today reported. This was the fastest-growth seen in ten years, reversing the fall of health spending experienced in the wake of America’s Great Recession of 2008. Furthermore the Centers for Medicare and Medicaid Services (CMS) anticipates health spending to grow by 6.1% in 2014 with the influx of newly-insured health plan members. Healthcare was responsible for one-fourth of America’s GDP growth rate of 2.6%, which is

In 2014, we are digital omnivores. Most people “consume” information and entertainment on more than one screen: 7 hours’ worth over a 5-hour period. You read that right: most people who watch TV, use a laptop or PC, smartphone or tablet are multitasking use of these devices in parallel. And above all, people are using smartphones as their primary screen. The AdReaction: Marketing in a multiscreen world report from Millward Brown paints a picture of global consumers who are cobbling together multiscreen experiences. The smartphone has become the “do it all” device if you don’t carry a laptop or tablet around, especially favored

Thinking about personal health information technology – the wearable devices, remote health monitors, digital weight scales, and Bluetooth-enabled medical equipment scaled for the home – there are two glasses. One is half-full and the other, half-empty. The half-full glass is the proliferation of consumer-facing devices like Fitbit, Jawbone and Nike, which comprise the lion’s market share in the health wearables segment; the mass adoption of mobile phones and tablets; consumers’ multi-screen media behavior (as tracked by Nielsen); and consumers’ growing share of medical spending, now about 40% of annual spending (or something north of $8,000 for a family of four

Even before stepping into the Orlando Convention Center on Sunday 23 February 2014, my clairvoyant powers know the forecast of the Best in Show: the growing role of patients in health care, reflected in both the education session at the annual 2014 meeting of HIMSS as well as the product/service mix being proffered on the convention show floor. As a member of HIMSS Connected Patient Committee, I know first-hand the conscious effort and energy that the organization has committed to getting real about patients’-peoples’-caregivers’ central role in health care. The organization was built on providers and technology. When I first

Most people face constraints in following a healthier lifestyle, according to new research from Bain & Company. Stress, time constraints, difficulty changing habits, getting enough sleep, and financial issues all militate against people project managing their health on a daily basis. Enter The Health Axioms, 32 mantras for simplifying healthcare DIY to empower and engage people in self-health. Conceived by health/tech designer Juhan Sonin, who teaches at MIT and is part of the team at Involution Studios, Health Axioms are 32 messages each designed on a 2×3 inch card and packaged as a deck to inspire and support health outside

While the prescription drug bill makes up about 10% of U.S. national health spending, the fastest-growing component of pharmacy spending is specialty medications. These are categorized as “specialty” drugs because they rarely have generic equivalents, and treat serious or life-threatening diseases (such as cancer, MS, and rheumatoid arthritis). They are also “special” because specialty pharmaceuticals average $3,000 per patient per month and can surpass $100,000 a year for certain products. As a result, the top two goals for managing specialty medications among employers are #1, to reduce inappropriate utilization, and #2, to reduce drug acquisition costs, based on a survey

Americans have been eating more healthfully in the past couple of years, according to the USDA which examined eating patterns among working-age adults in the U.S. between 2005 and 2010. And most people do believe they are indeed healthy eaters: three-quarters of people in the U.S. say they eat healthfully. On the other hand, it’s difficult to do that consistently. Why? Lack of motivation (37%), busy schedules (33%), lots of stress (30%), and money (29%).  Underneath these numbers are differences between women and men. When it comes to food and healthy eating, it seems men are from Mars and women,

Madame Onassis got nothing on you, Rod Stewart complimented in his hit You Wear It Well in 1972. Now we can all wear it well, based on the fashion-meets-health-mashups at the 2014 Consumer Electronics Show. Several events underline this observation at the CES this year: – Fitbit has signed up Tory Burch to put her mark accessorizing the company’s activity trackers – The CSR Bluetooth smart pendant was designed with the chic jeweler Cellini; the device can receive alerts from an iPhone (think: medication adherence, or a message from mom in Florida). This is featured in the first photo. –

We who are charged with forecasting the future of health and health care live in a world of scenario planning, placing bets on certainties (what we know we know), uncertainties (what we know we don’t know), and wild cards — those phenomena that, if they happen in the real world, blow our forecasts to smithereens, forcing a tabula rasa for a new-and-improved forecast. There are many more uncertainties than certainties challenging the tea leaves for the new year, including the changing role of health insurance companies and how they will respond to the Affordable Care Act implementation and changing mandates

23andme received word from the Food & Drug Administration (FDA) on November 22, 2013, that they must cease and desist selling the company’s Saliva Collection Kit and Personal Genome Service (PGS). FDA explained in their Warning Letter, “Most of the intended uses for PGS listed on your website, a list that has grown over time, are medical device uses under section 201(h) of the FD&C Act. Most of these uses have not been classified and thus require premarket approval or de novo classification, as FDA has explained to you on numerous occasions. “Some of the uses for which PGS is intended are

4 in 5 U.S. patients – 81% of them – want an equal say in health care decisions with their care provider, according to a 2013 Institute of Medicine study. At the same time, patients choose to take “drug holidays,” opting out of taking three or more doses of medicines in a row, or adopt “trail mix” approaches to taking prescriptions, casually and inappropriately mixing Rx drugs. Welcome to your world, pharma industry: where people say they want control, but somehow don’t exercise it in the way you — drug companies — define as “compliance” or “adherence.” Customer experience in

  Money and health are two things most people don’t like to talk about. But if people and their doctors spoke more about health and finance, outcomes (both fiscal and physical) could improve. In late October 2013, Best Practices for Communicating with Patients on Financial Matters were published by the Healthcare Financial Management Association (HFMA). Michael Leavitt, former head of the Department of Health and Human Services, led the year-long development effort on behalf of HFMA, with input from patient advocates, the American Hospital Association, America’s Health Insurance Plans, the American Academy of Family Physicians and the National Patient Advocate Foundation, along

In health care, when money is tight, labor inputs like nurses and doctors stretched, and patients wanting to be treated like beloved Amazon consumers, what do you do? Why, innovate and thrive. This audacious Holy Grail was the topic for a panel II moderated today at the Connected Health Symposium, sponsored by Partners Heathcare, the Boston health system that includes Harvard’s hospitals and other blue chip health providers around the region. My panelists were 3 health ecosystem players who were not your typical discussants at this sort of meeting: none wore bow ties, and all were very entrepreneurial: Jeremy Delinsky

When it comes to retail shopping, most people spend most of their time shopping in brick-and-mortar stores – not online. 92% of spending happens in stores. 3 in 10 people spend most their shopping time online. Brick-and-mortar is far from dead, concludes the report Recasting the Retail Store in Today’s Omnichannel World from AT Kearney. This study looked into the shopping behaviors for consumers in the US and the UK in February 2013. What is true is that the growth of online retail has taught consumers how to shop on the basis of more transparent pricing and supply. This then drives

Women and binge drinking…job and financial stress…sleeplessness…caregiving challenges…sex…these were the topics covered in Health 2.0 Conference’s session aptly called “The Unmentionables.” The panel on October 1, 2013, was a rich, sobering and authentic conversation among 7 women and 1 man who kept it very real on the main stage of this mega-meeting that convenes health technology developers, marketers, health providers, insurers, investors, patient advocates, and public sector representatives (who, sadly, had to depart for Washington, DC, much earlier than intended due to the government shutdown). The Unmentionables is the brainchild of Alexandra Drane and her brilliant team at the Eliza

When certain people use certain dietary supplements, they can  save money, according to a report from the Council for Responsible Nutrition and Frost and Sullivan, the analysts. The report is aptly titled, Smart Prevention – Health Care Cost Savings Resulting from the Targeted Use of Dietary Supplements. Its subtitle emphasizes the role of dietary supplements as a way to “combat unsustainable health care cost growth in the United States.” Specifically, the use of eight supplements in targeted individuals who can most benefit from them can save individuals and health systems billions of dollars. The eight money-saving supplements are: > Omega-3 > B

Since the advent of the so-called consumer-directed health care era in the mid-2000s, there’s been a love-gap between health plan members of traditional plans, living in Health Plan World 1.0, and people enrolled in newer consumer-driven plans – high-deductible health plans (HDHPs) and consumer-directed health plans (CDHPs). That gap in plan satisfaction continues, according to the Employee Benefits Research Institute (EBRI)’s poll of Americans’ consumer engagement in health care. The survey was conducted with the Commonwealth Fund. As the bar chart illustrates, some 62% of members in traditional plans were satisfied (very or extremely) with their health insurance in 2012.