The Challenge

Top Cost Drivers in Healthcare

Chronic illnesses

  • 90% of direct medical treatment costs (6% of GDP) (1)
  • Increases projected well into the future (2)
  • Many can be addressed, treated and potentially reversed:
    Diabetes - Obesity - Hypertension - Dyslipidemia

Acute events

Cancer and cardiovascular disease are top among employer-sponsored plans (3)

Why is it getting worse?

  • Treating symptoms as causes
  • Rx as first-line treatment, not seeking curative measures
  • Lifestyle choices
  • Low engagement
  • Traditional methods & time limitations

    When time limitations impact doctor-patient interaction, traditional diagnostic methods pose challenges in finding correlations.

Why is it not getting fixed?

  • Heavily dependent upon lab results
  • Methods not designed to analyze complex interdependencies
  • Doctors scan for “Normal” vs. “Abnormal” due to time constraints
  • Prone to see what has already occurred
  • Hard to find hidden issues (“Cryptic Risks”)
  • Significant additional costs arise through unexpected and potentially catastrophic events.

So, organizations are asking…

  • Is there a better way to plan than using lagging indicators like claims data?
  • How can I measure success of our healthcare and wellness spend?
  • Are there any new tools HR can deploy for measuring and holding vendors accountable - before we receive the bad news?
  • What kind of contingent liabilities do we have for hidden or unexpected claims risk?

  1. Health and Economic Costs of Chronic Diseases, National Center for Chronic Disease Prevention and Health Promotion, (2020)
  2. The Costs of Chronic Disease in the U.S., Milken Institute (2018)
  3. Workplace Wellness Trends: 2019 Survey Report, International Foundation of Employee Benefit Plans (2020)