Jane Sarasohn-Kahn

'PwC is placing a strategic bet that healthcare in America will continue to move to value-based payment and outcomes will continue to evolve in the U.S. under a President Trump. It's a sound bet.'

Nurses, pharmacists, doctors rank highest on the honest and ethics in U.S. professions for 2016.

President-elect Trump wants to bring down drug prices

Maybe it's time for a discussion about what people want from the U.S. healthcare system.

Interoperability of medical records across physician offices remained elusive in 2015, according to the latest data reported out by the Centers for Disease Control.

Supply of mobile health apps greatly exceeds the demand for them, based on research2guidance’s report on the mHealth App Developer Economics 2016, analyzing the status and trends of the mobile health apps market.

In an AMA survey, 85 percent of physicians saw advantages for digital health solutions in caring for patients.

Commemorating National Health IT Week with some research numbers.

Some 18 percent of U.S. consumers use a wearable device, according to the 2016 UPS Pulse of the Online Shopper survey. UPS researched tech-savvy shoppers with an eye to understanding where and how people buy stuff – and of course, how they ship it given the company’s core logistics business. (“Tech-savvy” in this study means consumers had purchased at least two items online in a typical 3-month period). Overall, Millennials adopt devices and do more tech-shopping compared with other generations, but UPS notes that other groups are indeed shopping for tech and shipping it, too. Millennials are leading the way, but even older generations can “look” Millennial in their shopping behaviors. The 2015-2016 comparison of wearable device adoption shows growth from 13% in 2015 to 18% in 2016, heavily driven by Millennials’ interest. 1 in 6 people who did not currently own a wearable device are interested in acquiring one in the next year, UPS found. Current wearable users do the following activities: 76% monitor fitness (with more Non-Millennials doing so at 82%, and more women than men) 60% use smartwatches, led by Millennials 38% use GPS functions 30% monitor “health” (as opposed to fitness), 2x the number of Millennials (39% vs. 20% Non-Millennials) 23% use eyewear, again double the number of Millennials (31%) vs. Non-Millennials (15%). The only other device categories showing growth were connected TVs, increasing from 28% in 2015 to 32%, and smartphones growing from 74% of adoption in 2015 to 77% of adoption in 2016, PC purchases and tablets showed flat adoption (95% and 57%, respectively). The most important factors consumers consider when purchasing a wearable device are led by health reasons: 62% say the goal is to establish better fitness and health habits, compared with 47% who are tech-loving (“I like to have the most up-to-date technology”) and convenience-appreciating (47% liking convenient access compared with other devices), with another 47% wanting to listen to music via the device. UPS surveyed 5,330 consumers in January and February 2016 who had purchased at least 2 items online in a typical 3-month period. Health Populi’s Hot Points: UPS has a vested interested in people shopping online, but they also benefit from people shopping in retail stores because they ship “everywhere.” Increasingly, the company finds that consumers want their stuff shipped “everywhere,” too — people in urban areas often find it difficult to receive their goods securely; people in rural areas can also have challenges in getting their stuff to their homes. So shoppers are asking UPS to deliver stuff to retailers’ stores, friends’ and families’ homes, a UPS location, to the workplace, or other location. Increasingly, shopping is being done via smartphones — 25% expecting to do so more frequently going forward; and, 24% of tablet-using shoppers expect to shop more via mobile tablet as well. The bottom-line: consumers shop and live omni-channel, multi-channel, 24×7, in “I-want-it-now” mode. (Thank Amazon Prime, in part, for priming consumers in this regard). 3 in 4 people are looking for a peer-review or recommendation. 70% of people are looking for easy access to information on a retailer’s site, including real-time inventory. And, 59% of shoppers would like product recommendations based on past browsing and buying behavior — that is, personalization. This is the new retail, and a challenge for incumbent retailers. That’s the prime (pardon the pun) reason Walmart purchased Jet.com earlier this month, for the behemoth retailer’s ability to grow omni-channel capabilities. Consumers’ expectation in their retail shopping lives are bleeding over into their health-lives, too. Health/care is expected everywhere, and should be as people take on more health financial responsibility….they’ll exercise more clout and vote with their out-of-pocket spending.   This blog first appeared at Health Populi.

Large employers are taking more control over health care costs and quality by pressuring changes to how care is actually delivered, based on the results from the 2017 Health Plan Design Survey sponsored by the National Business Group on Health (NBGH). Health care cost increases will average 5% in 2017 based on planned design changes, according to the top-line of the study. The major cost drivers, illustrated in the wordle, will be specialty pharmacy (discussed in yesterday’s Health Populi), high cost patient claims, specific conditions (such as musculoskeletal/back pain), medical inflation, and inpatient care. To temper these medical trend increases, large employers are looking to change the way health care is accessed and delivered through funding telehealth (for 90% of companies), providing price transparency tools (among 85% of companies), building and referring workers to Centers of Excellence (in 85% of firms, focused most on transplants, bariatric surgery, joint surgery, heart care, and cancers), and to a lesser extent, promoting accountable care organizations (among about one-fourth of employers). Consumer-directed health plans (CDHPs) will be a universal health insurance plan design by 2020, shown in the second chart. At least 84% of large employers will offer a CDHP option in 2017, and one-third will offer only a CDHP. Most high-deductible health plans in 2017 (92%) will be accompanied by a health savings account (HSA) The median employee cost-sharing amount this year was a $1,600 deductible for employee (single) coverage in a CDHP, and in-network out-of-pocket maximum payments were $4,000. For families, the out-of-pocket max was $7,200 with a $3,200 deductible. Telehealth is expected to be a universally-sponsored service among large employers by 2019, and most companies already use virtual care. One-third of large employers directly contract with telehealth vendors, according to NBGH’s survey. While most employers are offering telehealth services, in the first half of 2016, only 3% of employees had utilized this benefit. Looking to the future, employers are bolstering investments in mental and behavioral health, and in the financial wellbeing of their workforce. Influence physical well-being is a top-three priority among 85% of employers, followed by improvement employee engagement in healthcare decision making (that is, consumerism) for 65% of companies, emotional/mental wellbeing among 59%, and financial security and wellbeing for 58% of employers. Health Populi’s Hot Points:  Large employers are emboldened to drive changes in health care delivery — especially for virtual care via telehealth channels and narrowing networks for high-cost specialty care like transplantation and bariatric surgery via Centers of Excellence. Most employers are also deploying at least one cost transparency tool to support employees’ healthcare consumerism and decision-making chops. However, only 3% of employees have used telehealth services that have been available in the first half of 2016; this is an important proxy for understanding just how “consumerist” employees are with respect to saving money in deductible spending. The consumer-patient’s cost difference  between a virtual vs. in-person visit is significant: a telehealth visit with American Well is currently priced at a low of $49 compared with a face-to-face primary care visit for $95, urgent care for $140, or emergency department admission for $750. NBGH identifies employer tools and programs more companies are offering in 2017, including nurse coaching for care condition management, disease management, lifestyle management, self-service decision support tools, price transparency tools (fast-growing in 2017), and medical decision support/second opinion services. Large employers clearly understand the importance of these tools to support their mass adoption of high-deductible health plans. There’s no consumer-direction without such programs, and less optimal ROI on employers’ significant investments in health insurance without them. This week’s announcement of Accolade receiving a $70 million investment to further scale the company’s healthcare concierge services is an example of the market’s recognition of the importance of these employer-sponsored programs. This is health reform, playing out in the private sector. This blog first appeared at Health Populi.