The Invisible Cost of Chronic Diseases

Chronic diseases aren’t just a burden for the affected individual; these illnesses can actually impact the overall healthcare system. Given the current state of healthcare in the U.S., especially with regard to burgeoning expenditures, properly managing and monitoring these diseases is becoming increasingly important.

Tightening the Lens

Researchers from the Centers for Disease Control and Prevention (CDC) have created a tool to help monitor and predict the costs of chronic diseases, according to LiveScience. The CDC’s Chronic Disease Calculator Version 2 is downloadable, provides estimates for arthritis, asthma, cancer, cardiovascular diseases, depression and diabetes. For each of the aforementioned conditions, the calculator provides estimates based on current medical expenditures, the impact of absenteeism/days missed at work, and projected future medical costs until 2020.

The tool was created to help tighten the focus of the lens through which these diseases are viewed. Previously, national numbers for chronic diseases were available, but anything on a smaller, more regional level wasn’t available.

Now, however, thanks to the tool, more localized data is available. The CDC released a report in which they outlined why having a tighter lens is important for chronic disease management.  The report said that chronic disease costs are expected to rise across the board, across the country. Given the difference in treatment models for chronic diseases, annual costs varied per illness – median state-specific medical costs ranged from $410 million for asthma to $1.8 billion for diabetes.

The authors of the report hope that the calculator, and resulting cost estimates “highlight possible areas of cost savings achievable through targeted prevention efforts or research into new interventions and treatments.

Controlling the Costs

The calculator will also show the magnitude of the issues facing the U.S. with regard to chronic diseases. Shockingly, as of 2012, half of all adults – roughly 117 million people – had one or more chronic health condition. In fact, the CDC said that 86 percent of all healthcare spending in 2010 was for individuals with one or more chronic disease. Therefore, curbing the incidence of the diseases, or at least controlling and managing such illnesses for those who are already afflicted, could begin to reign in U.S. healthcare costs.

And one way – a seemingly paradoxical one – to control these costs could arise thanks to an increased diagnosis rate for the diseases. According to a study from the Harvard T.H. Chan School of Public Health, more Americans are getting health insurance because of the Affordable Care Act (ACA) of 2009, and thus more people are getting diagnosed and treated for chronic conditions.

The researchers looked at data from the Congressional Budget Office’s 10-year projections for the ACA and estimated that if the law is able to affect the number of uninsured Americans, even by enrolling half of these individuals, significant progress will be made regarding chronic diseases.

“These effects constitute a major positive outcome from the ACA,” said Joshua Salomon, professor of global health at the Harvard T.H. Chan School of Public Health in Boston, in a school news release. “Our study suggests that insurance expansion is likely to have a large and meaningful effect on diagnosis and management of some of the most important chronic illnesses affecting the U.S. population.”

More Savings

While broad progress is coming to fruition thanks to the ACA, more targeted efforts could help to spur treatment of individual diseases like diabetes. The American Diabetes Association, the YMCA and the American Medical Association (AMA) released research regarding the Medicare Diabetes Prevention Act (MDPA).

The research, headed by Avalere Health, found that the MDPA will not only reduce spending on diabetes, but will help to reduce the incidence of the disease among seniors in the U.S.

“Coverage of diabetes prevention programs under Medicare will advance the fiscal health of our nation by reducing overall healthcare spending on diabetes,” said John Anderson, MD, immediate past president, Medicine & Science, American Diabetes Association. “With the cost and prevalence of diabetes reaching unprecedented levels, there has never been a more critical time for Congress to support cost-effective, evidence-based programs that will improve the lives and health of America’s seniors.”

The idea behind the MDPA is that an evidence-based, prevention program, covered by the legislation, could operate at the community level and effect change. By targeting individuals with prediabetes, the number of people who actually see the disease progress to full, type-2 diabetes could be decreased.

Access to such a program has been an issue in the past, so the MDPA is geared toward providing a chance for individuals to get help. Given that diagnosed diabetes costs the U.S. roughly $245 billion – though it’s tough to pin down an exact number – annually, increased access to care is desperately needed.

“With nearly 50 percent of our country’s seniors at risk for developing type 2 diabetes, it is critical for seniors to have access to diabetes prevention programs,” said Ardis Dee Hoven, MD, president, American Medical Association. “That is why the American Medical Association has made diabetes prevention a key part of our mission to help improve the health of the nation.”