Walgreen’s Expanding Telehealth Services to 25 States

Walgreens announced this month an expansion of its mobile app to offer MDLive’s telehealth services to users in 20 additional states, now totaling 25, as well as the launch of an updated telehealth experience within the app to provide better functionality and integration. Patients now have access to MDLIVE telehealth services through the Walgreens mobile app in Alabama, Arizona, California, Colorado, Connecticut, Florida, Indiana, Illinois, Iowa, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nevada, New York, North Carolina, Ohio, Oregon, South Carolina, Tennessee, Virginia, Washington, and Wisconsin.

“Walgreens provides convenient and connected services for our customers, and we are thrilled to be advancing our digital experience to provide patients with more choices when it comes to accessing care,” said Adam Pellegrini, Walgreens divisional vice president of digital health. “We have seen that telehealth solutions play an important role in helping to improve patient outcomes, and we will continue to work to evolve our offerings to ensure our patients can choose what’s most convenient for them whether that’s live doctor consultations, digitally chatting with a pharmacist, or visiting a Healthcare Clinic.”

The platform was launched in December 2014 through the Walgreens mobile app in California and Michigan. In June, the company announced expansion to Colorado, Illinois, and Washington. The mobile app provides 24/7 access to MDLIVE’s network of U.S. board-certified doctors. With the improved seamless experience, it is no longer necessary to install and launch the MDLIVE app separately to continue the session. The company also announced the launch of the Walgreens Connect app, which allows Balance Rewards members to pair their premium-brand blood glucose meter or blood pressure wrist monitor, sync their data, and earn points for taking daily measurements. The data is transmitted to the cloud through a platform and mobile solution from Qualcomm Life’s 2net business. More than 90 percent of active members use a connected device.

Walgreens operates 8,173 drugstores nationwide. Its parent company announced last month plans to buy competitor Rite Aid. That transaction is expected to close in the second half of 2016, subject to federal regulatory approval. 

Employee Share of Health Care Costs Up 134% in a Decade (1)

A recent analysis by Aon shows the average health care rate increase for mid-size and large companies was 3.2 percent in 2015, marking the lowest rate increase since Aon began tracking the data in 1996. Aon is projecting average premium increases will jump to 4.1 percent in 2016. Despite the low rate of increase, the average amount that employees need to contribute toward their health care has increased more than 134 percent over the past decade. According to the Aon analysis, employees contributed $2,490 toward the premium and another $2,208 in out-of-pocket costs, such as co-payments, coinsurance, and deductibles in 2015. In contrast, the amount of employees' premium and out-of-pocket costs combined in 2005 was just $2,001.

"The sluggish growth in the economy has deterred many individuals from using medical services, and there's also been modest price inflation – both factors have been primary drivers for the low rates of premium increases over the past few years," said Mike Morrow, senior vice president of Aon Health. "As prescription drug costs continue to grow at a double-digit pace and the economy picks up speed, it's likely these premium rates will start to climb."

According to the report, low rate increases are prompting most employers to take a traditional “managed trend” approach to mitigating health costs in the short term, though some non-traditional approaches are emerging, including cost sharing and use of high deductible health plans (HDHPs).

The percent of total health care costs covered by employers has decreased about one percent per year since 2012. Recent research shows 38 percent of employers have increased participants' deductibles and/or copays and another 46 percent may do so in the near future. HDHPs are the second most popular plan choice offered by companies, surpassing HMOs. Sixteen percent of companies offer a HDHP as the only health plan option today, and another 41 percent are considering doing so in the next three-to-five years. 

Aon Hewitt research show 18 percent of companies have reduced subsidies for covered dependents, while 17 percent added a surcharge for adult dependents with access to other health coverage. Forty-three percent of companies are considering using unitized pricing – where each employee pays per person (as compared to individual or family coverage).

Public Favors Drug Ad Review Before Airing

Eighty-nine percent of the public favor having the U.S. Food and Drug Administration review drug ads for accuracy and clarity before the public sees them, according to the latest Kaiser Family Foundation Health Tracking Poll.  That review is something the federal agency does not do now.

That’s just one of the results of the October Kaiser poll, which also finds the cost of prescription drugs remains at the top of the public’s health care priority list for the White House and Congress.  

A majority (57 percent) believes that drug companies spend too much money advertising to patients. A similar majority says the same about money spent marketing to doctors (62 percent), and two-thirds of respondents (67 percent) say drug companies have a lot of influence over what doctors prescribe to patients.

A large majority (82 percent) of Americans report they’ve seen or heard drug advertising, and 28 percent say they have talked with a doctor about a specific drug they saw advertised. About half of the public (51 percent) say prescription drug advertising is mostly a good thing. Half (50 percent) say drug advertisements do a good or excellent job of telling consumers which condition or disease the drug is designed to treat. Nearly as many say the ads do at least a good job of telling consumers about the potential benefits (47 percent) and potential side effects (44 percent).


Making sure that high-cost drugs for chronic conditions, such as HIV, hepatitis, mental illness, and cancer, are affordable for those who need them is the top priority, picked by more than three quarters of the public (77 percent). Government action to lower prescription drug costs ranked second, with 63 percent saying it is a top priority, including a majority of Republican voters. That’s similar to the share of Republicans who say repealing the entire Affordable Care Act is a top priority (58 percent).

In contrast, issues specific to the Affordable Care Act, such as repealing several of its provisions or the entire law, fall lower on the list. While the public generally opposes the so-called Cadillac tax (an excise tax on more expensive employer health plans), just 30 percent pick eliminating it as a top priority, ranking it 12th on the poll’s priority list.

Exchange Choice Driven by Current Carrier Bias and Price

A new study examining carrier choice in a multi-carrier private exchange reveals a favorable employee view of incumbent health plans over other carriers, except when prices vary. According to the analysis by Liazon, a national private benefits exchange operator, employee choice is driven almost completely by carrier familiarity and premium price. The survey results also cast a spotlight on the expected rates of carrier gain or loss in market share.

Key findings from the October 2015 study include an incumbency bias, with employees more likely to choose their pre-existing health insurance carrier, all else being equal. On average, an incumbent carrier can expect an advantage of 37 percentage points in market share over non-incumbents. However, that incumbency bias can quickly shift when there are even small differences in plan pricing. If a carrier’s price is just one percent higher than average, it can expect to lose 3.5 percentage points of market share, on average.

In today’s constantly evolving benefits landscape, where control over carrier and plan decisions is shifting from the employer to the individual employee, consumer behavior is becoming increasingly important to providers. While previous industry research focused primarily on plan choice in an exchange environment, the insights uncovered by the new study into carrier choice will likely help brokers and carriers better understand the drivers of competition within each market.

“The major takeaway of these findings is that individuals have significant buying power in a multi-carrier exchange environment,” said Alan Cohen, co-founder and chief strategy officer of Liazon. “Carriers will need to start communicating with this new consumer to relay their value, so buyers can make decisions on factors other than price and familiarity.”


In this inaugural study, data was collected from nine employers who have implemented a multi-carrier private exchange. Group size ranged from 3,000 to 16,000 employees, with exchange participants able to choose from among four or five carriers across a number of U.S. markets. Multivariate regression analysis was used to estimate the impact of “price” and “incumbency” on the market share achieved by carriers in the markets examined.

Employers Making Benefit Changes Ahead of 2018 Cadillac Tax

While most employers (76 percent) are focusing their 2016-2017 health benefit strategies on avoiding the Affordable Care Act excise penalty (the so-called Cadillac tax) set to begin in 2018, the priority for even more employers (81 percent) is increasing employee engagement in health improvement programs and the use of preventive services (77 percent). These are among the findings of an annual survey of 119 employers by the non-profit Midwest Business Group on Health (MBGH), which represents private and public employers spending more than $4 billion on health care benefits annually for more than four million participants.

“To ensure they are getting the most value for their health care dollars, employers are implementing a number of key strategies to manage their company’s health benefits and taking steps to encourage their employees to better manage their health,” said Larry Boress, MBGH president and CEO. “The business community continues to believe health care benefits are an investment in their human capital, and they’re seeking effective and innovative approaches to deal with their largest expense outside of payroll.”

Among the survey’s key findings, managing specialty drugs and creating a culture of health were noted as a priority by 61 percent and 60 percent of employers, respectively. Asked about their expected excise tax timeline, nearly half (47 percent) expect they will reach it beyond 2019, while only 18 percent expect to reach it in 2018 when the tax is set to begin.

Top business strategies employed to avoid the excise tax include increasing the availability of wellness programs, offering high deductible plans, adding or expanding incentives for employee wellness programs, and increasing employee cost share. When asked about possibly offering private health insurance exchanges to their workers, most employers (79 percent) said they will not consider this strategy through 2016; however, the percentage decreases dramatically in 2017 and 2018 to 44 percent and 29 percent respectively.  When it comes to offering high deductible plans, 54 percent of employers will make them available next year. 

New Doctor Lookup Feature Added to ACA Exchange

With open enrollment underway for 2016 coverage, the federal health insurance exchange portal established under the Affordable Care Act (ACA), HealthCare.gov, is piloting a new feature that allows consumers to search plans by preferred providers or health care treatment facilities. Some consumers will be part of a pilot that allows them to use the beta Doctor Lookup feature as they compare their coverage options in shopping for or when selecting a health plan.

“The Doctor Lookup feature at HealthCare.gov is a direct result of consumer demand,” said Kevin Counihan, CEO of the Health Insurance Marketplace. “Our goal is to provide consumers with relevant, personal, and more up-to-date information about a plan before enrolling. We thank the Marketplace health plans who have now made this information available to the public.”

This phased-in approach will reach about one in four website visitors selected at random. The pilot program will allow federal officials to examine the consumer experience and analyze the quality of the data based on consumer feedback. In its early stage, some data will be missing or may be inaccurate. As of its test launch, HealthCare.gov had access to data from more than 90 percent of insurance companies offered on the Marketplace. If an insurance company has not provided validated data, consumers are alerted when they search for a provider. The Centers for Medicare & Medicaid Services (CMS) will continue to provide technical assistance to insurance companies that have not yet provided access to their data and will update HealthCare.gov on a daily basis.

Consumers are reminded that health plans can change the doctors and facilities in their networks on a continual basis and providers can change locations and affiliations frequently. That is why CMS is encouraging consumers to check with their doctors or insurer to confirm plan participation.  Consumers will be asked to opt-in to use the new lookup tool to be sure they understand its data limitations and they will be able to leave comments directly through the site.

HHS Announces November Pharmaceutical Innovation Forum

The U.S. Department of Health & Human Services (HHS) announced a November 20, 2015, public forum to explore pharmaceutical innovation, access, affordability, and better health. The move follows recent reports of price manipulation in the pharmaceutical industry and opinion polls identifying drug prices as a top concern for consumers and voters nationwide.

The forum will bring together consumers, providers, employers, manufacturers, health insurers, representatives from state and federal government, and other stakeholders to share information and discuss ideas to increase access to information, drive innovation, strengthen incentives, and promote competition. HHS Secretary Sylvia Mathews Burwell said the goal is for forum participants to share their views on how to foster a health care system that leads in innovation, delivers the most affordable, highest-quality medicines, and results in healthier people.

While the event invitation makes no mention of price controls, as the New York Times reported, the day-long program is slated to begin with a panel on “the impact of rising pharmaceutical costs.” HHS and the Centers for Medicare & Medicaid Services (CMS) pay billions of dollars annually for prescription drugs through programs for older Americans, individuals with disabilities, and those with low incomes.

Increasingly, the costs of new drugs pose a financial challenge for consumers and health plans alike. Some new cancer treatments can top $50,000 or even $100,000 annually. New hepatitis C drugs cost up to $1,000 a pill. Price gouging has been alleged in the past couple of months, as one company increased its price for a decades-old drug used to treat a life-threatening parasitic infection from $13.50 a tablet to $750.00 virtually overnight. Members of the U.S. Senate have asked the CEO of Turning Pharmaceuticals to appear before an upcoming Senate hearing.

With about 70 percent of Americans taking at least one prescription medication – and more than 40 percent of seniors taking five or more prescriptions daily – interest in the HHS drug forum is expected to be high. The November 20 event will be webcast live. The first hearing before the Senate Special Committee on Aging is set for December 9, with more hearings to follow in 2016.

All-Time High Reached for Health Care Worker Confidence

The latest Randstad Healthcare Employee Confidence Index (ECI) shows a 9.2 percent increase – to 64.8 percent – in worker confidence as compared to the same survey in 2014. The Harris Poll conducted the online survey of employees, which included physicians, nurses, health care administrators, and other professionals working in the health care and other industries. The mid-year 2015 report reflects increased confidence in the overall economy and in employees’ personal employment prospects, particularly among individuals working in health care.

According to the research, 29 percent of health care workers believe the economy is getting stronger, while 36 percent believe there are more jobs available. Job security among health care employees remains high, with 76 percent saying it is unlikely they will lose their job over the next 12 months, and 66 percent saying they are confident in their ability to find a new job. Thirty-two percent of those surveyed say they are likely to look for new employment opportunities in the next 12 months.

The Randstad Healthcare ECI mirrors strong job gains in the sector, according to the Bureau of Labor Statistics' September 2015 Employment Situation Summary. Health care led the way in job creation, adding 34,000 new positions in September and approximately 38,000 jobs each month over the past 12 months. Hospitals gained nearly half (16,000) of the new jobs, while ambulatory health care added 13,000 jobs.

"The fact that health care workers indicated the highest confidence levels we've ever recorded is a sign the job market for these professionals is providing more opportunities, and the sector is experiencing the rapid growth many economists expected," said Abigail Tremble, president of Randstad Healthcare. "We entered 2015 with historically lower-than-average unemployment rates for many health care occupations, so it's no surprise we have already seen increased hiring activity for many key positions."

The Randstad Healthcare survey was conducted in four stages from January through June 2015. It included 3,978 participants ages 18 and older, 243 of whom are employed in health care. 

Many Uninsured Californians Unaware of ACA Assistance

New research conducted by Covered California, the state’s public health insurance exchange established under the Affordable Care Act (ACA), reveals 36 percent of uninsured consumers still do not understand they can get financial help to buy health insurance. In contrast, just 16 percent of those surveyed did not know about the tax penalty for those who do not have health insurance. Open Enrollment for year three of the ACA began Sunday, November 1, 2015, and continues through January 31, 2016. 

“We cannot ignore the reality that too many uninsured Californians still don’t know they can get financial help to buy brand-name insurance through Covered California,” said Executive Director Peter V. Lee. “We are going to take to the airwaves and hit the road with a new campaign to make sure consumers know what we offer and where they can enroll.”

Lee said results from the third California Affordable Care Act “Consumer Tracking Survey,” which was conducted by the independent research organization NORC at the University of Chicago, contained important findings on Californians’ knowledge of the Affordable Care Act, including:

  • Awareness of Covered California has increased substantially since the exchange launched in 2013, with 85 percent of consumers aware of Covered California.
  • Covered California is succeeding in reaching diverse audiences, with high awareness across racial and ethnic groups.
  • Many residents have learned about Covered California through coverage in the news media, with 60 percent exposed to news about the state health insurance exchange in contrast to 56 percent who have seen advertising.

“We feel good about the progress we are making on many fronts,” Lee said, “but the survey results also underscore that we have much work still to do. The fact that many uninsured still do not know they can get a subsidy to dramatically lower their monthly costs is one of the more striking findings,” Lee said. “It’s a reminder that the changes in the Affordable Care Act are sweeping and complex and that we need to be sure everyone understands how Covered California works and that significant financial help is available for low- and moderate-income consumers.” 

The 2015-2016 outreach campaign will include television, radio, digital, and outdoor advertising, a “Spotlight on Coverage” bus tour, and twice as many storefront enrollment locations as during last year’s enrollment.

Prescription Drug Costs Atop Health Agenda for Americans

With several candidates laying out details of their health care platforms, the cost of prescription drugs remains at the top of the public’s health care priority list for the President and Congress, according to the October Kaiser Health Tracking Poll.

Making sure high-cost drugs for chronic conditions, such as HIV, hepatitis, mental illness, and cancer, are affordable for those in need is the top priority for more than three quarters of the public (77 percent). Political party identification was not a factor, with at least seven in 10 of Republicans, Democrats, and independents in each group citing it as important.

Government action to lower prescription drug costs ranks second, with 63 percent saying it is a top priority, including a majority of Republicans (56 percent). That is similar to the share of Republicans who say repealing the entire Affordable Care Act is a top priority (58 percent).

Other priorities picked by more than half of the public include assuring provider networks are adequate, protections against surprise bills for out-of-network services, and increasing price and quality transparency.

In contrast, issues specific to the Affordable Care Act fall lower on the list. For example, while the public generally opposes the so-called Cadillac tax on more expensive employer health plans, just 30 percent pick eliminating it as a top priority, ranking it 12th on the Kaiser poll’s priority list.

Economists generally believe employers will raise workers’ wages if they reduce the cost of their health benefits to avoid the Cadillac tax. However, the poll finds few people with employer-sponsored coverage expect that to happen. Just 20 percent think their wages would increase if their employer offered less generous health benefits, while three quarters (76 percent) think wages would not increase.

The survey also probed the public’s experiences with drug advertisements. A large majority (82 percent) say they have seen or heard prescription advertising, and 28 percent say they have talked with a doctor about a specific drug they saw advertised. One in eight adults (12 percent) say they were given a specific drug after asking a doctor about its advertisements;15 percent say the doctor recommended changes in their behavior or lifestyle;14 percent say the doctor recommended a different prescription drug, and 11 percent say the doctor recommended an over-the-counter option.