Entries in Surveys & Reports (106)

Friday
Jun232017

A virtual tour of new studies on virtual visits

A virtual tour of new studies on virtual visits
 

By Clive Riddle, June 23, 2017

 

The Advisory Board reports that “up to 77% of consumers would consider seeing a provider virtually—and 19% already have,” according to just published results from their Virtual Visits Consumer Choice Survey of 4,879 U.S. consumers, “designed to better understand the tradeoffs that consumers make when they need different types of care.”

 

The survey found consumers “would be willing to consider a virtual visit in each of the 21 primary and specialty care scenarios tested,” with over 70% of respondents interested in “a prescription question or refill, pre-surgery and select post-operation appointments, receiving ongoing results from an oncologist, and ongoing care for chronic condition management. Select pregnancy checkups, weight loss or smoking cessation coaching, dermatology consults, and psychologist consults also ranked among top offerings.”

 

The survey also addressed consumer telehealth concerns, with 21% citing care quality as their top concern, “followed by the provider not being able to diagnose or treat them virtually (19%), meaning they would have to go to the physical clinic anyway. Only 9% of respondents said they had no concerns about virtual visits.”

 

The current issue of Annals of Family Medicine includes the article “Patient Perceptions of Telehealth Primary Care Video Visits, in which co-authors from the National Academic Center for Telehealth, Thomas Jefferson University conducted “in-depth qualitative interviews with adult patients following video visits with their primary care clinicians at a single academic medical center.” They found that “all patients reported overall satisfaction with video visits, with the majority interested in continuing to use video visits as an alternative to in-person visits. The primary benefits cited were convenience and decreased costs. Some patients felt more comfortable with video visits than office visits and expressed a preference for receiving future serious news via video visit, because they could be in their own supportive environment. Primary concerns with video visits were privacy, including the potential for work colleagues to overhear conversations, and questions about the ability of the clinician to perform an adequate physical exam.“

 

The May 1, 2017 North Carolina Medical Journal includes the article A Clinical Pharmacist in Telehealth Team Care for Rural Patients with Diabetes which describes a study of the “diabetes telemedicine program funded by the Health Resources & Services Administration and Kate B. Reynolds Charitable Trust was offered in 13 sites in eastern North Carolina, including federally funded Community Health Clinics. A telemedicine team offered interdisciplinary care in the primary care provider's (PCP's) office without the patient needing to travel. The interdisciplinary team included a clinical pharmacist, dietician, behavioral therapist, and physician specializing in diabetes. The PCP referred the patient to 1 or more disciplines depending on the patient's needs. The program targeted underserved rural adults with uncontrolled type 2 diabetes.” The study found that “92% of telehealth patients were ‘very satisfied’ with their care and 83% agreed that telemedicine made it easier to get care.”

 

Referring physicians (vs direct consumer demand) may indeed be the potential driving force for telehealth, at least in rural settings. The current issue of the Journal of the American Board of Family Medicine includes the article Family Physicians Report Considerable Interest in, but Limited Use of, Telehealth Services. A survey of 1,557 Family Practitioners found "15% reported using telehealth services during 2014, and that FPs using telehealth were:  26% more likely to be located in a rural setting; 40% more likely to work in a practice with <6 FPs; 22% less likely to work in a privately-owned practice; and 76% less likely to provide general primary care to patients. Of the FPs using telehealth: 22% used it 1-2 times, and and 26% using it 3-5 times; 55% used telehealth for diagnosis and/or treatment; 68% used telehealth to refer patients to specialists; and 28% used telehealth to refer patients to mental health providers.

 

Still, a rosy future telehealth market is projected according to Hospital & Health Systems 2016 Consumer Telehealth Benchmark Survey results released this month, with health systems cited as a primary driver. They report that “seventy-six percent of U.S. hospitals and health systems either have in place or expect to implement a consumer telehealth program by 2018. Drivers for the rapid adoption growth include the desire to improve access to care, improve care coordination, increase efficiency, prevent readmissions and expand population health programs. In addition, 69 percent of organizations that currently have consumer telehealth programs are planning to expand their offerings, and 76 percent of organizations without consumer telehealth indicate it is a high strategic priority for their organizations.”
 
Friday
Jun162017

A Dozen Takeaways From PwC’s Medical Cost Trend: Behind the Numbers 2018 Report

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By Clive Riddle, June 16, 2017

 

PwC’s Health Research Institute has released Medical Cost Trend: Behind the Numbers 2018, their twelfth annual report projecting the growth of private sector medical costs in the coming year and identifying the leading trend drivers. The findings are largely based upon PwC’s annual Health & Well-being Touchstone Survey results, which draws from responses of 780 employers from 37 industries, and have also just been released.

 

Here’s a dozen takeaways from this year’s 32 page Behind the Numbers report, and 114 page Touchstone Survey report:

 

1.       PwC’s HRI projects a 6.5 percent growth rate for next year, a half percentage point increase from the estimated 2017 rate.
 

2.       This growth rates steadily decreased from 11.9% in 2007 to 6.5% in 2014, and has fluctuated slighly above or below that figure since then
 

3.       PwCs provides this definition of their projected medical cost trend: the “increase in per capita costs of medical services that affect commercial insurers and large, self-insured businesses. Insurance companies use the projection to calculate health plan premiums for the coming year.”
 

4.       PwC's HRI has identified three major inflators expected to impact medical cost trend in the coming year: (A) Rising general inflation impacts healthcare. As the U.S. economy heats up, a rise in general inflation during 2016 and 2017 will likely put upward pressure on wages, medical prices and overall cost trend in 2018; (B) Movement to high-deductible health plans is losing steam. The wave of growth in high-deductible health plans, employers' go-to strategy in recent years to curb health spending, may be plateauing; and  (C) Fewer branded drugs are coming off patent. Employers may have less opportunity to encourage employees to buy cost-saving generics in 2018.
 

5.       PwC's HRI has identified two major deflators expected to impact medical cost trend in the coming year: (A) Political and public scrutiny puts pressure on drug companies. Heightened political and public attention could encourage drug companies to moderate price increases; and (B) Employers are targeting the right people with the right treatments to minimize waste. They are doubling down on tactics such as prescription quantity limits and exploring new technologies such as artificial intelligence to match people with the best treatment.
 

6.       The report also cites these healthcare drivers affecting the 2018 cost trend:  Technology and treatment innovation: Provider and Plan Consolidation; Government regulation; and Evolving Payment models.
 

7.       The report allocated these proportions of costs by component for 2018: Pharmacy 18%; Inpatient 30%; Outpatient 19%; Physician 29%; Other 4%
 

8.       The Touchstone Survey cites that “Medical plan costs have continued to increase, but employers expect that the rate of increase will start to slow. Plan design changes contributed towards slightly lower-than-expected increases in 2016;” and that “the average increase in 2016 was 6.8% before plan design changes and 3.6% after plan design changes. In 2017, participants expect to see a 6.0% increase before plan design changes and a 3.2% increase after plan design changes.”
 

9.       The Touchstone Survey notes that “participants appear to be in a "wait and see" mode – rather than considering broader and more transformational changes, they continue to use traditional cost-shifting approaches to control health spend;” and that “57% of participants expect to continue to increase employee contributions in the next three years, while 38% (29% for Rx) plan to increase employee cost-sharing through plan design changes.”
 

10.   The Touchstone Survey finds that “participants are increasing contributions in the form of surcharges for spouse, domestic partner and dependent coverage. This may be contributing towards a decrease in enrolled family size and slowing the rise in net employer spend.”
 

11.   The Touchstone Survey also finds that “participants are utilizing High Deductible Health Plans (HDHPs) more and Preferred Provider Organizations (PPOs) less, although PPOs remain more popular among employees. PPOs are the highest-enrolled plan 44% of the time, compared to 46% in 2016 and 60% in 2009. HDHPs are the highest-enrolled plan 34% of the time, up from 32% in 2016 and 8% in 2009.”
 

12.   The Touchtone Survey found that employer interest in population health is strong but private exchange interest is waning. They report that “79% offer wellness programs compared to 76% in 2016, and 63% offer DM programs compared to 56% in 2016;” while  “8% of participants are considering moving their active employees to a private exchange; 2% have already done so. Interest seems to have dropped off as the discussions on public exchanges and ACA have increased. However, 36% of participants who offer retiree medical coverage are considering moving pre-65 retirees to a private or public exchange.”
 

 
Monday
Jun052017

In your member enrollment process leaving you exposed? 

By Claire Thayer, June 2, 2017

In September last year, the Government Accounting Office released a new study on findings from its undercover enrollment eligibility testing of federal and selected state marketplaces. As part of the study, GAO submitted 15 fake applications for subsidized coverage through the federal Marketplace in Virginia and West Virginia and through the state marketplace in California. GAO’s applications tested verifications related to (1) applicants’ making required income-tax filings, and (2) applicants’ identity or citizenship/immigration status. Through this extensive under cover testing process, GAO found that eligibility determination and enrollment processes continue to remain vulnerable to fraud.

This weeks’ edition of the MCOL Infographic, co-sponsored by LexisNexis, highlights some of findings presented in the GAO report: 


MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.

Friday
Oct072016

Opportunities With Consumer Angst About ACA Exchanges and Out of Pocket Costs

By Clive Riddle, October 7, 2016

GfK has just released updated survey results on consumer health insurance purchasing which found that “one-third of consumers who purchased on ACA exchanges do not expect that their present insurer (33%) – or any other carrier (34%) – will offer insurance through their exchange in 2017. And 32% do not think they will find options on the exchange that meet their needs.”

Additional findings they report include:

  • 13% of consumers purchasing through ACA exchanges plan to revert to becoming uninsured if their current coverage was not offered.
  • For ACA exchange consumers earning less than $25,000 a year, 34% plan on becoming uninsured if current coverage isn’t available
  • 43% of exchange users say they would seek new options through the exchanges – with levels highest among 50 to 64 year olds.
  • 35% of exchange users would go directly to an insurer or agent for solutions if their coverage lapses
  • 66% say they would choose the best option to meet their needs, regardless of the insurance company
  • Only 12% would make a point of staying with their current carrier
  • 20% say they would explore coverage through a different insurer

Liz Reyer, GfK Vice President and health insurance lead concludes that “as a ’brand,’ the ACA has taken some hits in 2016. While most observers expected insurance companies to reassess their offerings on the exchanges now and then, the outright defections we have seen have quickly limited consumers’ choices and eroded confidence that the ACA will find ways to meet their needs. We need to see a high-profile campaign making clear the options that consumers still have – so no one goes without insurance unnecessarily – and stronger collaboration between the insurance industry and the government in keeping the ACA viable.”

Health Plans remaining on the ACA exchanges certainly have a market opportunity to mop up the mess left by large national plans exiting the exchanges. Outside the ACA exchanges, plans active in individual markets, and applicable private exchanges have a major opportunity to gain ground with consumers not eligible for subsidies (which are only available through the ACA exchanges.)

Meanwhile, Navicure, in conjunction with Porter Research has just released provider survey results from a study on how healthcare organizations are responding to patient engagement and consumerism, with a focus on consumer concerns about price transparency, financial responsibility and payment options. The survey included hospitals (19%) and medical groups ranging in size (33% in practices with ten providers or less and 21% with 100 providers or more.)

Of the most common questions patients ask about their financial responsibility, provider respondents said “58 percent inquire about payment plans, and 56 percent ask about total treatment cost. Other top questions include asking what balance is due (53%) and what payment options are available (43%).”

67% of provider respondents say patients do not understand their payment responsibility versus their insurance provider’s responsibility, and 42% of providers find that attempting to estimate prices for services is a major problem.

The study found that most healthcare organizations aren’t using available tools to help with consumer confusion over out of pocket costs, with 33% of providers using patient bill estimation tools, 26% sending patients electronic statements, and 25% securely store debit or credit card information on file.

In this era of ever increasing consumer cost sharing, a major market opportunity exists for providers and health plans that can easily answer patient questions on what their out of pocket will be, and offer a range of options for how patients can pay for them.

Friday
Jun242016

Millennials Are (Not) So Different

By Kim Bellard, June 24, 2016

If we believe conventional wisdom about them, they like to live with their parents, at least until they can move into their urban-center condo.  They hate to drive.  They're maddening in the workplace, demanding lots of frills and constant praise yet returning little loyalty.  They're hyperconnected through their various digital devices.  And, when they deign to think about health care, which isn't often, they want all digital, all the time. 

There's some truth to the conventional wisdom, but not as much as you'd think.  A new study from Credit Karma flatly asserts that "everything you thought you knew about Millennials may be wrong," finding that they still have aspirations to much of the same "American Dream" as previous generations.   

The hyperconnected part is certainly true.  Millennials are much more likely to have a smartphone,  and -- jawdroppingly -- on an average day they interact with it much more than with anyone else, even their parents or significant other.  

Things get really interesting when it comes to health.  Millennials are often viewed as not very interested in health care, but it is the second most important social issue for them, right after education and ahead of the economy. 

deep dive on millennials and health care by the Transamerica Center for Health Studies had some results that also don't necessarily fit the stereotypes. Taking care of their health was tied with getting/keeping a job as their top priority. 70% have been to a doctor's office within the last year, although for minor issues they're more likely to head to urgent care/a retail clinic. When it comes to getting health information, this supremely digital generation still relies most heavily on health care professionals and friends/family (especially their mothers!).

There has been a dramatic drop in being uninsured -- 11% versus 23% as recently as 2013 -- but millennials don't like much about health insurance.  They feel much more informed about their health and how to improve it than they do about how to find health care services or their health insurance options.  

Perhaps that is why two-thirds have never comparison shopped for health insurance.

Lastly, TCHS found that millennials rate affordability as the most important aspect of the health care system, but many don't find it affordable.  About 20% can't afford routine health expenses, even though millennials' median health expenses are under $100 per month.  Nearly half have skipped care to reduce their expenses. Similarly, most millennials view monthly premiums over $200 as unaffordable.

If there is a key difference with millennials' health care, it may be in their emphasis on technology.  A report from Salesforce.com found that 76% of millennials valued online reviews in choosing a doctor, and 73% want doctors to use mobile devices during appointments to share information. 60% are interested in telehealth options in lieu of office visits.

It is perhaps no wonder millennials are turning to technology when it comes to their health.  They highly value face time with their doctor, but they may not be getting it.  According to the Salesforce report, 40% of millennials don't think their primary care doctor would recognize them on the street. 

Many of us might suspect the same thing, and that should trouble us all.

When it comes to health care, as with many other aspects of life, it may be less that millennials are different in what they want as it is that they're quicker to adopt newer options for getting it.  The rest of us should learn from that, not shake our heads at it.

This post is an abridged version of the posting in Kim Bellard’s blogsite. Click here to read the full posting