The human and financial toll of chronic illness

By Dr. Aaron Cohen

$1.3 trillion every year. That’s the impact of seven chronic conditions on the U.S. economy, according to a 2014 Milken study.1 Maybe it’s not surprising, given the human toll: nearly half of Americans suffer from at least one chronic disease. One in four lives with multiple chronic conditions. 2

According to the Centers for Disease Control and Prevention, a comprehensive approach to prevention could significantly trim health care utilization and costs. Even more important, it could reduce disability and mortality. Education and social support can help people take charge of their health. 3

That’s important, because an individual’s choices can significantly increase the risk of developing chronic conditions. Smoking, inactivity, and other unhealthy habits make conditions worse and affect outcomes.

Then there are risk factors that people have less control over, like being born into poverty. For too many, housing, income, education and work environments are health risk factors. Poor health status combined with low health literacy can lead to catastrophic results.

Yet the impact of preventive measures offers more than a glimmer of hope. A couple examples:

  • For every 1% reduction in results of HbA1c blood tests, the risk of developing eye, kidney and nerve disease is reduced by 40 percent while the risk of heart attack is reduced by 14 percent4
  • Many Americans have high blood pressure that is poorly controlled. A reduction of at least 12 points in systolic blood pressure can significantly reduce myocardial infarction (MI) risk. Care for an average MI can involve around $18,000 for an acute admit and nearly $80,000 in the first 90 days.5

So how do we put preventive strategies into action? We need to meet people where they are. For those with multiple chronic medical conditions, accessing health care is complicated. They may have functional limitations and/or need help with activities of daily living.

We need to overcome these roadblocks to reaching patients, and offer them education, support and resources. If we don’t, patients will become sicker and care will become even more costly. Individuals, families and caregivers will feel the adverse impacts in countless ways.

Several states are implementing unique and successful health promotion and disease prevention programs. These are cost-effective programs with an understanding and emphasis on the diverse, and many times complicated, needs of the multiple chronic condition population.

It’s time for a collaborative approach that bridges health literacy gaps, finds new and innovative digital solutions, and works directly with providers to assist in this challenge. This wise investment can improve quality of life, survivability and reduce health care expenditures.

For health plans, it’s imperative to support, educate and empower their members to better manage their health.  To learn more about a new approach to condition management, read our executive summary.

About the author

Dr. Aaron Cohen has more than 21 years of experience in health care, and joined Optum in 2010. He is national medical director and chief medical director of Population Health Management. In this role, Dr. Cohen is responsible for clinical oversight of medical directors and pharmacists; Case, Condition and Utilization Management; Women’s Health; and Complex Medical Conditions.

Board-certified in Family Medicine, Dr. Cohen is a graduate of Loyala University Chicago Strich School of Medicine. He is a diplomate of the American Board of Venous and Lymphatic Medicine.  A veteran of the U.S. Air Force, he served in family practice and emergency care at Hill Air Force Base, Ogden, UT.

1 Seven conditions include cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions and mental illness. Chatterjee A, Kubendran S, King J, DeVol R. Checkup time: Chronic disease and wellness in America. Milken Institute, January 29, 2014.

2 CDC. Chronic diseases: The leading causes of death and disability in the United States., Updated June 2017.

3 Conditions include heart disease, stroke, some cancers, diabetes, arthritis and asthma. CDC: The power of prevention. Chronic disease: The public health challenge of the 21st century. 2009.

4 Health Resources and Services Administration.

5 Cutler D, McClellan M, Newhouse J. The costs and benefits of intensive treatment for cardiovascular disease. NBER Working Paper 6514; Hewitt Assoc., 2005; UnitedHealthcare data.

Leave a Reply