How Targeting Moderate Risk Patients Can Lower Costs

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High Costs of Obesity

A leading cause of health care spending in the United States is obesity. According to the Centers for Disease Control (CDC), obesity afflicts almost 35% of the US adult population, mostly in the South and Midwest regions. Individuals with obesity have a high amount of body fat in proportion to their height, resulting in a body mass index greater than 30.

The Physical Cost

Information from the National Heart, Lung, and Blood Institute states that obesity can put individuals at higher risk for one or more of these chronic diseases:

  • Coronary heart disease
  • High blood pressure
  • Stroke
  • Type 2 diabetes
  • Abnormal blood fats
  • Metabolic syndrome
  • Cancer
  • Osteoarthritis
  • Sleep apnea
  • Obesity hypoventilation syndrome
  • Reproductive problems
  • Gallstones

These diseases can lead to severe complications, organ failure, and death. Moderate risk individuals, who are still in early stages of a chronic disease, comprise 25-35% of the population. Their conditions are relatively mild, but without proper care, they can progress to high risk very quickly.

The Economic Cost

An important fact to keep in mind is: the higher the risk, the higher the cost. As a disease progresses, treatment, hospital fees, medication, etc. begin to add up. Facts from the CDC state that national medical spending in 2011 was $2.7 trillion and 51% of those costs were attributed to hospital care and physician services.

A 2009 study, conducted by Finkelstein, estimated annual medical spending of $147 billion in 2008 from obesity alone. They concluded that the cost per year is $1,429 higher for those who are obese as compared to those of normal weight. This cost increases even further with the development of a chronic disease. 75% of health care spending goes toward chronic disease treatment.

What Can Be Done?

Because most chronic diseases are caused by obesity, one method for prevention and better quality of life is weight loss. This can be quite difficult to achieve, but for obese individuals, even moderate weight loss (defined as 5-10% of one’s body weight) can significantly lower their risk of developing a chronic disease. For those who already have a chronic disease, this can still be a big step in decreasing further health risks.

Most treatment and disease management programs tend to concentrate on those at high risk. However, targeting moderate risk patients before they reach high risk can be key to improving health care and reducing costs. Programs should promote a change in lifestyle and focus on implementing health and wellness behaviors, such as exercise and a balanced diet. These programs, rather than those focusing solely on treatment, are likely to be more successful in influencing better habits. Patients should also be encouraged to become more involved in their own care so that they understand their risk level and how they can prevent it from worsening.

Author: Apoorva Anupindi

One thought on “How Targeting Moderate Risk Patients Can Lower Costs

  1. While moderate risk individuals are still in the early stages of a chronic disease, without proper care, they can progress to high risk very quickly. Health education programs should be provided to patients at a young age in order to prevent obesity before it causes serious harm.

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