Sustainable Health Care: Patients, Doctors and Hospital Executives See Different Futures

Jane Sarasohn-Kahn

Posted 11/16/11 on Health Populi

There is broad consensus among doctors, patients and health administrators that the current U.S. health system is broken and unsustainable; preventive services is under-utilized and -valued, quality is highly variable from region to region and patient to patient, and costs continue to spiral upward without demonstrating value.

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Workplace Wellness: The Cost of Unhealthy Behaviors in America is $623 per Worker

Jane Sarasohn-Kahn

Posted 11/14/11 on Health Populi

The health status of the American workforce is declining. Every year, unhealthy behaviors of the U.S. workforce cost employers $623 per employee annually, according to the Thomson Reuters Workforce Wellness Index. People point to smoking, obesity and stress as the 3 most important factors impacting health costs.

Continue reading “Workplace Wellness: The Cost of Unhealthy Behaviors in America is $623 per Worker”

Primary Care Everywhere – How the Shortage of PCPs is Driving Innovation: Especially for Patients’ Participation in Their Own Care

Jane Sarasohn-Kahn

Posted 11/04/11 on Health Populi

The signs of the primary care crisis in America are visible:

  • A growing number of visits to the emergency room for treating commonplace ailments
  • Waiting lists for signing up with and queuing lines to see primary care doctors
  • Fewer med students entering primary care disciplines
  • Maldistribution of primary care practitioners (PCPs) in underserved areas, rural, exurban and urban.

The implementation of the Affordable Care Act will (try to) enroll at least 30 million newly-insured health citizens into the U.S. health system. That’s the objective: whether being insured will actually provide people access to needed primary care is a big question given the current supply of internists, general medicine specialists, family physicians, pediatricians, and OB/GYNs.

Continue reading “Primary Care Everywhere – How the Shortage of PCPs is Driving Innovation: Especially for Patients’ Participation in Their Own Care”

Prescription Drug Spending in 2012

Jane Sarasohn-Kahn

Posted 11/3/11 on Health Populi

growth in prescription drug costs covered by employers and Rx plan sponsors are driving them to adopt a long list of utilization management and price-tiering strategies looking to 2012, according to the 2011-2012 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda Pharmaceuticals.

The average drug trend for 2011 — that is, the average annual percentage increase in drug cost spending — was 5.5%, 1.5 percentage points greater than general price inflation of about 4%. The generic fill rate was 73% of prescription drugs purchased at retail. While drug price inflation is expected to increase in 2012, plan sponsors will implement several programs targeting enrollees who are most responsible for high cost and volume Rx consumption; the most popular programs will be disease management (to be used by 62% of plan sponsors), therapeutic substitution (50%), and outbound telephone calls (42%), retrospective drug utilization review (DUR, 40%), and face-to-face pharmacist consults (39%). Disease management and retrospective DUR both fell in use since 2010. Utilization management programs are also commonly integrated into prescription drug plan designs, with the most common tactics being prior authorization, quantity limits, and limits on “refills-too-soon.” Step therapy, too, is growing in use, particularly for medications treating depression, asthma, high cholesterol, and high blood pressure.

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Unretired: The Number of Americans Planning to Retire at 67 is Plummeting

Two publications this week reinforce the new reality of health and financial insecurity: The Vanishing Middle America issue of Advertising Age (October 17, 2011 issue) and the Sun Life Financial U.S. Unretirement Index – Fall 2011 with the subtitle, “Americans’ trust in retirement reaches a tipping point.”

The chart shows the retirement coin’s two sides: since 2008, the proportion of people in the U.S. who expect to retire by 67 dropped from 52% down to 35%; and, those who believe they will be workingfull-time (I emphasize “full,” not “part,” time) grew from 19% to 29%. 61% of working Americans plan to delay retirement at least three years due to economic factors.

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Walmart’s Rolls Back Employee Health Insurance: Just Another Employer Facing Higher Health Care Costs?

Jane Sarasohn-Kahn

Posted 10/24/11 on Health Populi.

Walmart is increasing premium sharing costs for employees subscribing to health insurance, and cutting the benefit for part-timers.

Quoted in the New York Times, a company rep said, “over the last few years, we’ve all seen our health care rates increase and it’s probably not a surprise that this year will be no different. We made the difficult decision to raise rates that will affect our associates’ medical costs.” In so doing, Walmart told the Times that they will, “strike a balance between managing costs and providing quality care and coverage.”

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America’s New Normal in Health: Paying Attention and Responding To Costs

Jane Sarasohn-Kahn

Posted 10/10/11 on Health Populi

The passage of health reform in the U.S. has not enhanced peoples’ confidence in the American health system. In fact, U.S. health consumers’ high confidence level in the future of employer-sponsored health benefits has eroded over the past ten years, according to the Employee Benefit Research Institute‘s (EBRI) 2011 Health Confidence Survey: Most Americans Unfamiliar with Key Aspect of Health Reform. Most people are dissatisfied with the U.S. health system overall, with 27% of U.S. adults rating the system as “poor” and 29% giving a rating of “fair.” High costs may be at the root of peoples’ dissatisfaction with the U.S. health system. Only 18% of people are satisfied with the cost of health insurance; only 15% satisfied with the cost of health services not covered by insurance. EBRI looked into peoples’ health-consumer behaviors, detailed in the chart. Most people who have visited doctors ask them to explain why a test is needed, as well as inquire about risks of treatments and medications and their success rates. Nearly one-half of people ask about less costly treatment options often or always. Consumers also adjust their health care utilization when facing higher health care costs:

  • 74% of U.S. adults try to take better care of themselves
  • 69% choose generic drugs when available
  • 64% talk to the doctor more carefully about treatment options and costs
  • 59% go to the doctor only for more serious conditions or symptoms
  • 44% delay going to the doctor
  • 36% switch to over-the-counter (OTC) drugs
  • 34% look for cheaper health insurance
  • 31% look for cheaper health providers
  • 25% skip medication doses or don’t fill prescriptions.

Continue reading “America’s New Normal in Health: Paying Attention and Responding To Costs”

The Edelman Health Barometer: Health Care is a Team Sport

Jane Sarasohn-Kahn

First posted 10/06/11 on Health Populi

Lifestyle, nutrition, the environment and the health system are four key factors that people globally say have the most impact on their health. Underlying these influences, its friends and family who most shape our health, followed by government and business.

Welcome to the 2011 Edelman Health Barometer, the third year the communications firm has polled health citizens around the world on their views on health, behavior change, and the use of information and digital tools.

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Working for Health Care: What $15,000 Will Buy An American Worker

Jane Sarasohn-Kahn


What could $15,000 get you?

$15,404 was the average annual cost of health insurance for a family of four with a PPO plan in the U.S. in 2011. The cost was fairly uniform across U.S. regions, with the lowest of $14,743 found in the West, and the high of $15,981 in the Northeast.

This health cost watermark finding was published in the always-informative annual Kaiser/HRET Survey of Employer-Sponsored Health Benefits for 2011. This study slices and dices the employer-based health insurance market across many dimensions, in terms of size of employer, type of employer, employee cost sharing, prescription drug plans, among other parameters.

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Less is More: Top-Performing Hospitals Spend Less on Pharmacy and Supplies

Jane Sarasohn-Kahn

First posted 9/11/11 on Health Populi

The Top 100 performing hospitals in the U.S. spend 13% less on supply costs and 6% less on pharmacy costs, according to a research brief fromThomson ReutersAssociations Between Supply and Pharmacy Service Intensity, System Membership, and Hospital Performance.

Lower pharmacy intensity translated into lower inpatient and post-discharged mortality, and reduced complications, in the high-performing hospitals. Furthermore, these hospitals had better safety records, and shorter lengths-of-stay.

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U.S. Hospitals Face Gloomiest Economic Outlook in 20 Years

Jane Sarasohn-Kahn

First posted 9/08/11 on Health Populi

Revenues = volume x price. This is the financial reality for every organization that makes its money serving customers, whether for-profit or not-for-profit.

For the U.S. hospital sector, both volumes and prices are falling, leading to a depressed top-line. Reimbursement reductions from Medicare, Medicaid and commercial health plans are all under pressure: that’s the ‘price’ part of the equation. On the volume multiplier, the recession economy has caused patients to delay care, such as elective surgeries. Hospitals are forced to scrutinize every aspect of operations, according to Hospital Revenues in Critical Condition; Downgrades May Follow, from Moody’s Investors Service.

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Connecting the Dots Between Personal Fiscal Health and Personal Health

Jane Sarasohn-Kahn

First posted 9/5/11 on Health Populi

Home foreclosures negatively influence health in several dimensions: they cause stress on the lives of the home’s residents, including children, driving mental and physical illness; they impact neighbors who worry that home values will fall in their community; and, they can motivate unhealthy behaviors, such as drinking and foregoing medical treatment such as seeing the doctor and filling needed prescriptions for drugs treating chronic conditions.

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Health Plans Enter A New World of Retail

Jane Sarasohn-Kahn

First posted 8/26/11 on Health Populi

Health plans are more aggressively managing medical costs, leaning out administrative inefficiencies, and looking for new customers. Plans are undertaking these strategies as they face uncertainties over the next couple of years leading up to the full implementation of the Affordable Care Act, according to a paper from Boston Consulting Group (BCG), Innovation, Diversification, and a Focus on Fundamentals, looking at how health reform will change the insurance landscape.

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Is It Contagious? A Health App Targets Kids Health

Jane Sarasohn-Kahn

First posted 8/15/11 on Health Populi

‘Tis the season for pink eye, strep throat, head lice, walking pneumonia, and that unpronounceable malady, Molluscum Contagiosum (a viral skin rash). Back-to-school time means time for parents to brace for their kids passing infectious diseases to each other.

It’s timely, then, for the launch of Is It Contagious?, a free mobile health app developed by The Nemours Foundation. Nemours is the pediatric health system with locations in Delaware, Florida, New Jersey and Pennsylvania. Originally funded with a legacy from Alfred I. duPont’s will in 1936, the institution carries on Alfred’s vision that, “it is the duty of everyone in the world to do what is within his power to alleviate human suffering.”

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More Clinicians Understand That Patients Want To Communicate Online

Jane Sarasohn-Kahn

First posted 6/26/11 on Health Populi

As people take on more DIY approaches in their daily lives for travel planning, photo management, and investing, they’re looking for health care touchpoints to do the same — especially, their physicians. In 2011, more doctors are responding to this patient-driven demand, based on data published in the InformationWeek digital health care issue July 25, 2011, titled The Pain of Change.

Most patients would be willing to change physician practices if their doctors don’t offer online access to tools, based on a recent survey from Intuit which Health Populi covered in March 2011 here.

Continue reading “More Clinicians Understand That Patients Want To Communicate Online”