Conference Presentation, Panel, Roundtable
The Economic Impact of Chronic Disease
Milken InstituteRoss DeVol, Nancy Brown, Neal Kaufman, Kristen Miranda, Hugh Waters, Otis Webb Brawley
- The economic burden of dementia on female caregivers is characterized as enormous, while the Milken Institute plans to prioritize prevention and disease management alongside cure research.
- The American Heart Association aims to improve public understanding of heart disease and stroke risks to drive action, facing projected cardiovascular disease costs exceeding $1.1 trillion by 2030 and 17.5 million annual global deaths, including 800,000 in the US.
- Smoking intensity correlates with significantly elevated cancer risks, including a ten-fold increase in lung cancer for those smoking 25+ cigarettes daily and a three-fold increase in bladder cancer risk.
- Secondhand smoke exposure is projected to increase the likelihood of coronary heart disease by 1.3 times and lung cancer by 1.2 times, justifying government intervention as the state bears significant costs for related conditions.
- Obesity is currently the second leading cause of cancer and is projected to become the primary cause within the next 20 years, driven by a rise in childhood obesity from 4% in 1970 to over 20% by 2010.
- Obesity significantly increases relative risks for specific conditions, including 3.4 times for type 2 diabetes, 3.57 for end-stage renal disease, 3.2 for ovarian cancer, and 2.21 for Alzheimer's.
- Despite a 40% decline in US breast cancer deaths over 25 years, disparities persist with 12 states showing declines of only 10% or less, and 148,000 fewer annual cancer deaths are projected if all Americans matched the mortality risk of college-educated peers.
- Expanded health insurance access under the Affordable Care Act is expected to improve cervical disease treatment for women in their 20s and shift colon cancer diagnoses in Medicaid expansion states to earlier stages 1 or 2 rather than 3 or 4.
- Early-stage colon cancer diagnoses are critical given that stage 3 or 4 diagnoses carry a life expectancy of two to three years and require expensive chemotherapy, whereas a third to 40% of current healthcare spending could be eliminated by adhering to evidence-based practices.
- Accountable Care Organizations (ACOs) include over 350 registered entities with a Pioneer program closed to new enrollment, having saved an average of $40 to $45 per member per month over nearly seven years.
- The ACO shared savings program is projected to save Medicare approximately $5 billion between 2010 and 2019, though many health plans seek returns on investment within two years, potentially hindering long-term value creation.
- Stakeholders face hurdles in reaping ROI due to uncertainty regarding member retention over two to four years, though successful chronic care models could save substantial funds for 20 to 40% of the population at risk.
- Digital technologies are identified as critical for future access expansion, while current data indicates that while weight gain leads to poor health, data supporting health restoration through weight loss is insufficient.