TTA’s Blooming Spring 3: Masimo’s cyberattack takes it down, WW’s Chapter 11, Neuralink’s ALS success, UHG’s 1K bet on AI apps, NIH/CMS autism data project, a look at payer earnings, more!

May 9, 2025 | by

9 May 2025

This week’s drama was all about Masimo, developing literally as this Editor was writing. Their website outage was revealed to be from a cyberattack that took down nearly all their systems. Not good for a monitoring/tech company. But their good news was that they sold Sound United to Samsung–2/3rds off. The others deserving of more attention are Neuralink’s successful BCI implant in an ALS subject and UHG’s 1,000 app bet on AI. Not so dramatic: WeightWatchers’ prepackaged, quick bankruptcy, the NIH/CMS autism data project, and Amedisys divesting to salvage their UHG sale. 

Short takes: HHS forms NIH/CMS autism data project; Oscar Health beats Street w/Q1 $275M net; Centene’s $1.3B earnings; UHG has class action suit on earnings, 1K AI apps in production; Cedars-Sinai and Redesign Health partner on development; FDA, Lilly, Novo Nordisk win vs. compounders (Big step forward for autism research)

News roundup: WeightWatchers in 45-day prepackaged Ch. 11, Neuralink BCI successful in ALS subject, telehealth VR reduced TMD pain–study, AliveCor maxes up KardiaMobile 6L, TytoCare-Allina Health partnership, UHG-Amedisys divest some more (WW losing runway, a Neuralink win, Amedisys divesting to save their two-year-old UHG deal)

Breaking–Masimo Mystery SOLVED–cyberattack, website down for days, new websites up–and where’s the public explanations? Sound United sold. (Another cleanup on Aisle 10–the Sound United albatross flys off)

From last week: Cherry blossoms are starting to fall, much like Teladoc’s revenue for Q1 in our lead story. Can their acquisition of a small virtual mental health provider with insurance coverage help turn around BetterHelp? And what about their main business? Novo Nordisk would rather partner than fight with teleprescribers Hims & Hers, Ro, and LifeMD for GLP-1 Wegovy–will this be a trend? Commure adds to its ‘house that Jack built’ tech stack with a HealthTap partnership. And Masimo’s latest episode of its ongoing soap opera is that its former CEO (and major shareholder) is claiming ownership of shares as part of his severance–but they haven’t been granted and very much in dispute. (Irony alert: they’ve increased in value since his departure!)

This just in: Teladoc acquires UpLift for $30M, bolstering struggling BetterHelp telemental health; Q1 revenue down 3% (Can this telemental health be saved with one acquisition?)

News roundup: Hims, Ro, LifeMD and Novo Nordisk partner on Wegovy prescribing (updated); Commure partners with HealthTap for virtual care after hours; WebMD Ignite adds texting to member health ed; hellocare.ai raises $47M for virtual nursing  (When you can’t beat ’em in weight loss meds, join ’em. With a side of Commure’s interesting M.O. on acquisitions.)

Masimo updates: former CEO Kiani claims 13.2% ownership, and a review of the new management’s style (updated) (The soap opera continues)

Holding this over: The weekend read: why SPACs came, went, and failed in digital health–the Halle Tecco analysis/memorial service; why OpenAI is going to be a bad, bad business (Grab the cuppa and lunch for a good read and podcast. Updated–Also Tecco’s blog post on why she quit being an angel investor.) 

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News roundup: WeightWatchers in 45-day prepackaged Ch. 11, Neuralink BCI successful in ALS subject, telehealth VR reduced TMD pain–study, AliveCor maxes up KardiaMobile 6L, TytoCare-Allina Health partnership, UHG-Amedisys divest some more

May 8, 2025 | by

WeightWatchers (WW) unburdens itself of debt in a prepackaged Chapter 11 bankruptcy. The reorganization under the bankruptcy filed yesterday in the US Bankruptcy Court for the District of Delaware will take $1.15 billion of a total $1.62 billion (as of March 2025) in debt off their books while providing it with enough capital to reemerge in an estimated 45 days or around 1 July, or less. The Chapter 11 plan retains $175 million from their revolving credit facility, reduces its annual interest payments by $50 million, and extends their debt maturity dates. With bankruptcy court approval, their lenders receive new secured debt and equity. In the company statement, CEO Tara Comonte expressed confidence about WW’s future:  “The decisive actions we’re taking today, with the overwhelming support of our lenders and noteholders, will give us the flexibility to accelerate innovation, reinvest in our members, and lead with authority in a rapidly evolving weight management landscape.” The first day hearing is on 8 May. WW release, Kroll case information

WW entered the GLP-1 prescription weight loss drug race relatively late, last October, with compounding semaglutide, which boosted their fortunes for a time. They acquired telehealth provider/clinical weight manager Sequence in mid-2023 [TTA 2 Mar 2023], then formed the WeightWatchers Clinic program by December [TTA 21 Dec 2024] Results this year were projected at 140-160,000 subscribers. But that was not enough to correct WW’s problems, which were a profound loss of total subscribers: in Q1 2025 3.4 million subscribers versus 4 million in Q1 2024, with 2.8 million of them. Stock had traded on Nasdaq for some months below $1, with today’s trading below $0.50. Shares had lost 71.9% over the past 12 months, making it a (money) loss for nearly all common stock holders. Morningstar

The (physical) weight loss segment now dominated by Hims & Hers, Ro, LifeMD–now with prescription deals for Novo Nordisk’s Wegovy—and other telehealth providers and teleprescribers such as Teladoc, FuturHealth, RemedyMeds, Eden, and many others, made WW a latecomer. Even CVS Caremark got into the partnering act when it switched over to Wegovy from Lilly’s Zepbound in its standard formulary. This move may lure more members to its weight management program. As with Ro and LifeMD, the lowered cash pricing is $499/month. Healthcare Dive. For WW, is this a lasting cure or just kicking the can down the floor?

Brain-computer interfaces (BCI) notch a big win. At the end of April, Neuralink confirmed its third successful implant, this one in an ALS patient, Brad Smith. The disease rendered him non-verbal, on a ventilator, and paralyzed below the shoulders. With the Neuralink brain implant, about the size of five quarters, he can now communicate verbally through his MacBook Pro and play video games only with his thoughts–essentially telepathy. He created a video using a voice cloned from previous recordings when he could speak, and using a mouse to create the narration. Previously, he used an eye gaze controller to communicate. This is truly miraculous and flying under the radar. Mobihealthnews, RedState  The previous recipients, Noland and Alex, are both paraplegics[TTA 21 Feb 2024].

Next up is Blindsight, which Elon Musk has said that will be tested in humans by the end of 2025 [TTA 10 Apr]. There is also a Canadian clinical trial, the “Canadian Precise Robotically Implanted Brain-Computer Interface” (CAN-PRIME) for subjects with tetraparesis or tetraplegia resulting from cervical spinal cord injury or the neurological disease ALS [TTA 27 Nov 2024].  A competitor of Neuralink, Precision Neuroscience, closed a Series C at $102 million last December.

A telehealth virtual reality (VR) solution effective for reducing chronic pain. A study published last month in Nature/NPI Digital Medicine demonstrated significan reductions in a 54-participant group, with some receiving telehealth-based immersive VR intervention on chronic orofacial pain (temporomandibular disorders or TMD) versus an audio-only (MP3) same-content control intervention and non-intervention on five-day ‘waves’. Pain intensity, unpleasantness, anxiety, sleep disturbance, and mood were monitored. There was significant reductions achieved with the immersive VR on pain intensity and other factors, with lesser results achieved with the MP3 intervention. The study directionally confirms results in other studies on lower back pain and other pain studies. Researchers were based in the University of Maryland School of Medicine, School of Nursing, and Towson University.

Short takes:

AliveCor is adding to its new KardiaMobile 6L Max KardiaAlert. KardiaAlert is now integrated into KardiaCare, a subscription service for the KardiaMobile 6L Max AI-assisted ECG monitor. The consumer purchase of the KardiaMobile 6L Max includes the device and a one-year subscription to KardiaCare, which now includes the KardiaAlert feature. The six-lead KardiaMobile 6L Max identifies up to 20 arrhythmias with a clinician review. Introductory price is $169. Release

Allina Health deploying TytoCare at 12 urgent care locations. The Midwest health system is adding the TytoCare Pro Smart Clinic service to a dozen of its urgent health locations in order to shorten wait times and offer additional remote treatment. For Allina, this allows their urgent cares to see more patients, offer hybrid care, and additional services such as heart and lung exams (featuring AI-driven wheeze and crackle detection), throat and ear assessments, skin exams and body temperature measurements. Allina Health, with hospitals in Minnesota and western Wisconsin, already uses TytoCare remote monitoring in hospital settings. TytoCare release

UnitedHealth Group and Amedisys persist. The long-running and DOJ-challenged acquisition by UHG of Amedisys home care is once again trying to remove the anti-competitive stumbling block by divesting more home care and hospice operations, this time to BrightSpring Health Services and Pennant Group. This was disclosed in Amedisys’s SEC Form 8-K. It is contingent of course on the closing of the UHG buy. BrightSpring is based in Kentucky and Pennant in Idaho. Pennant’s own SEC filing lists their purchase price as $102.5 million. The total number of operations to be sold is not disclosed. UHG and Amedisys extended their runway on closing to 31 December in January.  Healthcare Dive, Home Health Care News

The Department of Justice has been prominently blocking the $3.3 billion UHG acquisition, announced in what seems an eon ago in June 2023, on anti-trust grounds nearly immediately after the Hart-Scott-Rodino Act (HSR Act) premarket notification was filed, but most recently in a civil lawsuit filed last November in District Court in Maryland. The DOJ was joined by the Attorneys General of Maryland, Illinois, New Jersey, and New York. It alleges elimination of competition, harm in over 100 markets, falsely certifying compliance with HSR Act requirements, withholding documents, and much more. Additional background on that lawsuit is here. As this Editor said when UHG won in Federal court on acquiring Change Healthcare, a win they have 190 million reasons why to regret, “DOJ has a long memory, a Paul Bunyan-sized ax to grind, and doesn’t like losing.”

Now CVS Health may be reviewing ‘options’–including a possible breakup–report

October 1, 2024 | by

Perhaps CVS needs to take a medication for Corporate Indigestion. It turns out that CVS did not entirely avoid the agita that is sickening Walgreens. Instead, it has other reasons. Reuters reported that according to their sources (unnamed), their management, board, and financial advisers are exploring ‘options’ that may lead to a partial breakup of the company. Prominently mentioned: a spinoff of their insurance businesses from their retail business. CVS acquired Aetna for this back in 2018 for a pricey $69 billion. Being debated: where the Caremark pharmacy benefit manager (PBM) unit will reside, under retail or insurance. PBM feeds into both retail and the insurance plans.

Glenview Capital Management is reported to be one of the financial institutions in talks with management on an improvement plan. Glenview owns 1% of CVS stock according to the Wall Street Journal, but that 1% accounts for over $700 million of its $2.5 billion war chest. That gives them cause for concern–and leverage.

CVS has confirmed none of this, going to the Boilerplate Folder to pull copy about “driving performance and delivering high quality healthcare products and services enabled by our unmatched scale and integrated model.”

Industry observers aren’t expressing anything more than mild surprise about this, based on a concatenation of recent events and backwash from their 2022-2023 spending binge.

  • CVS cut its 2024 outlook again in August for the third quarter running…and has lost 25% in share value YTD.
  • The kneejerk of a $1 billion cost-cutting plan is being implemented; this week, about 2,900 corporate jobs will be cut. This is after a 5,000-employee layoff that was announced in October 2023, taking place into 2024.
  • Aetna’s Brian Kane was booted in August after less than one year on the job due to his numbers going the wrong way–and his job filled in and not replaced [TTA 8 August]. Who’s next?
  • The outlook for Medicare Advantage is glum into 2025 and later, with utilization costs soaring, new lower Federal reimbursement rates for diagnoses, and Federal clawbacks on overpayments from 2018 on. 2025 plan exits have multiplied with CVS’ affecting about 10% of their membership.
  • PBMs are under attack. The latest is a 20 September FTC administrative complaint (= suit) against the Big Three (CVS Caremark, Express Scripts/Cigna and Optum/UHG plus their respective group purchasing organizations for inflating insulin drug pricing. Insulin is the prime example of inflated drug costs in the FTC view. The latest action doubles down on FTC’s mid-year report. MedCityNews  Readers should note that drug costs have been consistently under attack in Washington not only with this administration, but the prior one, which makes the current election a continuation of the same negative atmosphere.
  • In May, CVS openly sought private equity partners to expand their Oak Street Health locations to a promised 300 by 2026. No partner nor expansion has been announced to date. OSH was bought for a stunning $10.6 billion only 17 months ago.at the very tail end of the ‘buy anything/FOMO’ boom.  This Editor noted that this summer, there were direct response TV commercials to rustle up members airing on various cable channels that target the mature demographic. OSH was regarded as the runt of the litter of primary care practice groups since the larger ones had already been bought by Walgreens and Amazon. Its drawbacks in addition to small size: its model was overly wedded to Medicare value-based (ACO REACH) and Medicare Advantage models, and it had never turned a profit nor was about to. Even at the time, CVS was heavily criticized as making “a deal that made no sense” and “CVS better have a plan they implement in 18 months or they’ll get slaughtered” by an industry figure. [TTA 2 Mar 2023,16 Mar 2023]  We’re at 18 months. Is OSH quietly on the block?
  • Signify Health was another expensive 2022 buy that sounded good on calls to support the “integration” objective ($8 billion, cash). It put CVS into burgeoning home health and practices–but cost not only the inflated purchase price but also part of the cost of unwinding Remedy Health’s failed Episodes of Care model. CVS also put $100 million into Carbon Health which had to unwind several lines of business including public health before their Series D [TTA 11 Jan 2023], and earlier this year had both their CEO and their president depart. Biotech Networks

Is it time to call healthcare the Sick Man of the American Economy? Or just these big pillars? Crain’s Chicago Business. FierceHealthcare, Healthcare Dive

The CVS-Aetna merger hearing draws to a dreary, weary close

July 24, 2019 | by

The train is moving so slowly on the tracks that even Pauline is getting some shut-eye. The minimal coverage given to last Wednesday’s hearings in the Court of Judge Richard Leon on the CVS-Aetna merger is understandable, as the hearing trod the well-worn path without a hint of when this will all Wind Up:

  • The Department of Justice argued that the concerns over the merger were settled via divestiture of its pharmacy benefit management (PBM) operation
  • The amici curiae witnesses (AIDS Healthcare Foundation (AHF), the American Medical Association (AMA), Consumer Action and U.S. PIRG) countered that it’s nowhere near enough, that the PBM competition represented by a new company would not be enough and higher drug prices would result.
  • Anything said by the DOJ attorneys or the ability to call more witness after the earlier hearing was derided by Judge Leon as “phantasmagorical,” “violating the first rule of holes”, and typified by the generally favorable to the judge Columbus Dispatch as “scolding”.

This Editor found no mention of the five states–California, Florida, Hawaii, Mississippi, and Washington–which were supposed to participate in the hearing to support the DOJ position [TTA 17 June]. One has to presume that they were not very vocal or permitted to be so.

Instead much was made of the judge’s interest in the AIDS Healthcare Foundation (AHF) remedies targeting relief for specialty and community pharmacies:

  • All rival pharmacies should have non-discriminatory access to CVS Caremark’s pharmacy networks at fair reimbursements that cover actual drug costs and dispensing costs.
  • Managed care plans should not be denied access to CVS Pharmacy networks, and that managed care plans’ access should be at a fair price.
  • All Aetna plan members must be allowed to opt out of any CVS/Caremark specialty or other mail order programs.

So the hearings wind down, with increased speculation that Judge Leon will simply disallow the merger sometime in the future, which will set up another round of court actions by the merged organizations on the merits and whether the Tunney Act can even be used in this way. And meanwhile, online pharmacies like PillPack scoop up the cream off CVS Caremark’s business. Healthcare Dive, Yahoo News.

Forced to wear a fitness tracker for insurance? (US)

August 28, 2014 | by

For those covered by corporate health policies, the day is not far away where employee health insurance programs will require wearing a fitness tracker and meeting certain metrics, such as walking a million steps or sleep quality. Already some programs have the employee log food, exercise, blood glucose, heart rate and other vital signs to qualify for a discount. The trajectory is much like BYOD–once unheard of, now it is expected to be the norm in 50 percent of US companies by 2017, with a concomitant loss of personal security and privacy. CVS Caremark and other companies have already made the stick, not the carrot, the norm of employee wellness programs [TTA 12 April 2013]. Writer Adrian Kingsley-Hughes asks: “How much access do we want our employers to have to our medical data? How much access to our daily activities do we want our employers and insurers having?” And what about spoofing those Fitbits and Jawbones? His ZDNet article notes the interest that Apple (plus Samsung and Google, despite Sergey’s and Larry’s vapors–Ed.) has in health, then takes it out a few more yards with Wearables and health insurance: A health bar over everyone’s head (and do check out the comments.)

Soapbox: How healthcare disruption can be sidetracked

April 10, 2014 | by | 3 Comments

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”170″ /]Ron Hammerle’s comment on Disruptive innovation in healthcare hasn’t begun yet: Christensen (TTA 31 Mar), posted on LinkedIn’s Healthcare Innovation by Design group, made the excellent point that a potentially disruptive and decentralizing healthcare service–retail clinics–has been sidetracked, at least in the US, leaving an open question on their reason for being. This Editor thought it was worthy of a Soapbox. Mr. Hammerle knows of what he speaks because his Tampa, Florida-based company, Health Resources Ltd., works with retail and employer-based clinics to connect them via telemedicine/telehealth systems with medical centers.

When Clayton Christensen first anticipated that retail clinics would be disruptive to the established healthcare industry, their business model was potentially disruptive. What has subsequently happened, however, is a prime example of how potentially disruptive movements can be sidetracked.

After acquiring MinuteClinic and laying the foundation for taking retail clinics national, CVS Caremark chose to make deals with hospitals, which could easily afford to rent, open and operate such clinics without making money on the front end or facing real disruption. Retail clinics were a loss leader to hospitals in exchange for large, downstream revenues, and slightly-enhanced market share for the retailer’s pharmacy.

After CVS shocked Walgreens with one-two punches involving MinuteClinic and Caremark acquisitions, Walgreens came back with three counter-punches of its own:

1. They doubled the number of their clinics (to 700) in less than two years, thwarted AMA opposition, leapfrogged ahead of CVS in clinic count and totally changed the retail clinic model by setting up politically-invisible, broader service, make-your-profit-up-front, employer-based clinics. (more…)

CVS Caremark’s employee wellness ‘stick’ revisited–in court (US)

March 25, 2014 | by | 3 Comments

Exactly a year ago, retail drug store/onsite clinic/PBM giant CVS Caremark unveiled its ‘big stick’ approach to employee wellness–if you are in their health plan, you must participate in their ‘voluntary’ health screenings and management program or be charged $50 per month. One employee is now suing about this in Alameda County (Oakland/San Francisco, California area) Court.

According to the Courthouse News Service, the complaint states that “During the ‘Wellness Exam,’ a doctor performs blood work, which, upon information and belief, is utilized by defendants to ‘flag’ employees who are at risk for a variety of medical conditions.” Also from CNS, “In addition to the exam, which Watterson says she had to pay for, CVS made her fill out a survey that asked personal questions such as weight, body fat percentage, whether she drinks or smokes and is sexually active. The survey was “required in lieu of a $600 fine,” according to the lawsuit.” (Editor’s emphasis) If she had the exam in-house–at a CVS MinuteClinic–it also would have cost her $125 out of pocket, so she went to a private physician who charged her the co-pay, $25. She’s seeking compensation for “class certification and damages for failure to pay hourly and overtime wages, failure to indemnify, illegal wage deductions, failure to provide accurate wage statements and unfair competition.” 

All of which was easily predictable that CVS Caremark would be asking these questions, as they are fairly standard in a health workup –but is the ‘cross the line’ part (and what most of the dither may be about) the last item noted?  (more…)

Powerhouse DC lobbying for telehealth, telemedicine

February 13, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The Gimlet Eye observes from a houseboat anchored at a remote Pacific island, with coconuts and occasional internet to Editor Donna.

Telehealth and telemedicine have reached a US milestone of sorts: the formation of a Washington, DC-based ‘advocacy’ (a/k/a lobbying) group constituted as a business non-profit. The Alliance for Connected Care is headed by three former Senators (two of whom were ‘amigos’) from both sides of the aisle and backed by a board including the expected (giants Verizon, WellPoint, CVS Caremark, Walgreens)–and the surprising (much smaller remote consult provider Teladoc and HealthSpot, the developer of the HealthSpot Station kiosk–hmmm, must be a fair chunk of their marketing budgets there) flanked by six well known ‘associate members’ including Cardinal Health and Care Innovations (another hmmm). There’s also a hefty ‘advisory board‘ including the American Heart Association and the NAHC (home care). The leadership team members are all members of major Washington law/lobbying firms. Tom Daschle is recognized as one of the most influential former Senators in town via DLA Piper, though himself not a registered lobbyist (OpenSecrets.org). Trent Lott and John Breaux hung out their own shingle and were recently bought by mega-lobbyist Patton Boggs. To put a fine point on it, more high-powered one does not get. The Eye sees that the time is prime for the Big Influence and…

What the Eye sees is Big Financial Stakes: Private insurers are required to cover telehealth in 20 states, as does Medicaid in most. The VA is a major user. But the great big trough of Medicare is new territory; covering 16 percent of the population, the use of telemedicine and telehealth is limited to certain geographic areas. (MedCityNews) This marks the infamous tipping point: the clarion call to ‘build significant and high-level support for Connected Care among leaders in Congress and the Administration’, ‘enable more telehealth to support new models of care’ and ‘establish a non-binding, standardized definition of Connected Care through federal level multi stakeholder-input process’ (whew!) Big companies want in, insurers want reimbursement, and they want it from somewhere as well. Toto, we’re not in the Kansas of Small anymore with ‘connected health’–we are now in the Oz of Big Money and Power Players. Alliance release (Oddly the website looks preliminary despite the big announcement and backing.)

More on this strategy: It’s called ‘soft lobbying’ and it is the latest thing in the Influence Wars. The Alliance for Connected Care is a 501(c)6 non-profit, similar to a business league like the Chamber of Commerce, and this has become a popular tactic. It’s also a less regulated, less transparent way to shape coverage, public opinion and exert influence on legislators. See this well-timed examination from the Washington Post on the corn syrup versus table sugar wars. ‘Soft lobbying’ war between sugar, corn syrup shows new tactics in Washington influence

Health tech scenes we DON’T want to see

August 20, 2013 | by | 2 Comments

The real reasons for wellness monitoring in the corporate world, as seen through the eyes of the Dilbert comic strip. Could this be CVS Caremark or the average employer in five years or less? [TTA 12 April] Hat tip to Neil Versel in his Meaningful HIT News; note comment from our own Contributing Editor from Australia, George Margelis, on algorithms missing the healthcare point.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/192722.strip-Dilbert.gif” thumb_width=”650″ /]

Employee wellness: Carrot? Stick? Or something else?

April 12, 2013 | by

The actions of companies like CVS Caremark [TTA Telehealth Soapbox] have aimed a white-hot klieg light onto corporate wellness and the various methodologies companies are using to force a change in employees’ behaviors to positively affect their healthcare spend. Both positive and negative incentives have their pros and cons–positive incentives tied to completion of wellness ‘tasks’ seem not to work long term, penalties can be a blow to morale and verge on full-blown discrimination and lawsuits. Increasingly the price of being in a corporate health plan seems to be acceptance of ‘intrusion for your own good’ and privacy loss. On the other hand, why should health insurance be any different than home or auto, at least in the US?  The Wall Street Journal has written several non-firewalled articles on this issue in recent days: Your Company Wants to Make You Healthy; Carrots and Sticks: Which One Works The Best (infographic); If Workers Are Out of Shape, Should Companies Make Them Pay? (At Work Blog–read over 85 comments)

In terms of effectiveness, the only study this Editor has seen was published this month in the Journal of Occupational & Environmental Medicine from wellness/disease manager Healthways’ Center for Health Research, as mentioned in a secondary article by the Integrated Benefits Institute. According to IBI’s summary:

Looking at over 19,000 employees at five employers, the authors find that employees who reduced their total health behavior risks over a 12 month period—for example, by increasing exercise or improving their diet—had a lower likelihood of absence, less presenteeism [working while sick–Ed.], and better job performance.

But some of those 19 factors included work-related risks such as “poor supervisor relationship, not utilizing strengths doing job, and organization unsupportive of well-being” (JOEM)–not health related at all. And the total reduction was a whopping 5 percent.

Magic 8 Ball says: ‘picture cloudy, try again’.

So perhaps the real choice has become this: adhere to employer requirements–or not have any coverage at all. There’s been a 10 point decline in Americans covered by employer-sponsored insurance, from 69.7 percent in 1999/2000 to 59.5 percent in 2010/2011 (SHADAC/Robert Wood Johnson Foundation). Much of that is also the US 7.6 percent ‘official’ unemployment rate (U-3)–but the real accelerator here is the 13.8 percent U-6 rate which counts in part-timers and the ‘marginally attached/discouraged’ who are not going to have employer insurance. The Affordable Care Act and its requirements/fees have also discouraged many smaller employers who are simply dropping insurance coverage.

So what is the bottom line? And where there are the opportunities for consumer engagement and self-maintenance linked to telehealth and mobile health which can mitigate cost? Understanding the ill-defined situation companies are in, especially in the US, will help in identifying them.