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 white paper

A strategic imperative to control costs

Access our white paper to learn more about complex, chronic conditions and how we can work together to improve outcomes and lower costs.

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Overview

Health care spending has eclipsed the trillion-dollar mark and is expected to rise over the next few years. More than a quarter of all health care costs ($455 billion) are associated with four complex condition categories:

  • Cardiovascular disease
  • Musculoskeletal conditions
  • Oncological disease
  • Kidney disease

OptumHealth examined these condition categories and identified key areas of opportunity for employers and health plans to better control rising health care costs and help those with chronic conditions. Access our white paper for the full report.

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Oncology trends: Improved care leads to higher survival

Cancer incidence will continue to increase by 45 percent over the next two decades. But ongoing research and excellent care coordination among providers have pushed cancer survival rates higher over the years. Researchers predict that the number of cancer survivors will increase by nearly 70% through 2040. This research is promising news for the millions of families affected by cancer, but payers and providers need to prepare for a much larger cancer population to manage as time goes on.  

The cost of cancer care has increased by nearly 62% in the last decade alone. Innovations in care, including new therapies and technology, are behind the staggering price increase.

And scientists aren’t finished. Nearly 70 new therapies have been approved in the last five years. These advancements are expected to continue to push the cost of cancer care even higher.

Musculoskeletal trends: Prescription drugs driving sharp spending increase

A major force driving costs in musculoskeletal (MSK) spending is pharmaceuticals. Prescription drugs costs have risen across the board. Anti-inflammatory drugs used to manage many MSK conditions alone have jumped 9% in just one year.

Looking across the industry, it’s easy to see why spending in MSK conditions has increased by 60% in just 12 years.

One important advancement in treating and managing MSK conditions is improved access to minimally invasive treatments, often performed or provided in outpatient settings. Inpatient MSK spending has decreased by 7%. However, costs of outpatient treatments and therapies are expected to rise.

Kidney disease trends: A top 10 contributor to health care costs

Chronic kidney disease (CKD) affects an estimated one in seven adults, many of whom aren’t even aware they're in the early stages of the disease. Left undiagnosed and untreated, CKD can present serious health problems down the road.

When early-stage renal disease leads to late-stage renal disease, patients often require complex and costly medical care. Dialysis causes major life disruptions, and costs for ESRD patients on dialysis are over a quarter million dollars a year.

Cardiovascular trends: Better care with growing costs

Heart disease continues to be the leading cause of death among men and women. It ripples across families, organizations and communities.

Some factors have helped temper the spending growth in cardiovascular disease treatment, including:

  • Decreased outpatient utilization
  • Smaller-than-average increases in pharmacy and inpatient growth
  • More generic options of previously high-priced medications available
  • Improved treatment protocols
  • Reduced treatment rates

However, not all trends point to promising news. As more and more individuals are diagnosed with cardiovascular disease, major heart condition-related spending is expected to increase dramatically by 2035.

Costs for the following diseases are expected to double in the next 15 years:

  • Coronary artery disease
  • High blood pressure
  • Stroke
  • Atrial fibrillation
  • Congestive heart failure