Top 5 conditions driving employer healthcare spending
In a study of 57 large employers across 50 states, accounting for a total sample of 281,000 people covered and 125,000 total employees covered, the Health Action Council in partnership with the UnitedHealthcare Group analyzed categories of spending across all organizations. They found that the largest portion of healthcare spending, which affects the amount of money spent by the employer on each employee, can be attributed to 5 conditions, most of which are chronic. We also must take into account that the Pandemic may have worsened or exacerbated some of these conditions, and do take that into account. As an additional disclaimer, this data is based on a sample of employers and by no means applies these findings to all employers. We simply bring these things to light as trends across a sample of employers. Of the sample of covered individuals, 63% of them had at least one of the five conditions mentioned.
The top 5: asthma, diabetes, hypertension, back disorders, mental health & substance use.
Asthma- The Health Action Council found that 6.4% of the sample suffer from asthma. Those who do have the condition are predominantly women and African Americans. As we might expect, the prevalence of the condition centers around cities or urban centers where there is typically greater amounts of pollution in the air and surrounding environments. The states that showed the most prevalence are Maryland, Pennsylvania, Texas, Arizona and Ohio. Among those African American’s with the condition, we see they are undertreated in comparison to their White counterparts.
Diabetes - Diabetes affects the same portion of the sample as asthma, with 6.4% of the covered individuals having diabetes. Of that group, diabetes was more prevalent among males and Asain people. The seemingly “diabetes hotspots” from the sample are Kentucky, Ohio, North Carolina, South Carolina and Arkansas. We also see a disparity in treatment of diabetes, with those in a lower income bracket receiving less care. Diabetes is not a new issue to the United States, as the main driver of country-wide healthcare spending, totaling around $327 billion in 2017.
Hypertension- Hypertension affects about 13% of the sample with a predominantly higher trend among Black communities. Conflated with race, low-income populations are the main demographic affected by hypertension. We see the lack of treatment for hypertension specifically affecting women. Although the treatment or therapeutic interventions for hypertension are widely understood and known, women were severely under treated. The geographic locations of hypertension among the sample population was in the south and midwest, specifically in South Carolina, Arkansas, Texas, North Carolina and Missouri.
Back Disorders- 3.4% of the sample reported having a back disorder with the highest prevalence among White females. We see a direct correlation with income and back disorders, those with lower incomes making up the majority of those reported. This is most likely because of the nature of work for low income people being manual labor, factory work, and manufacturing overall. We see the highest prevalence in the Midwest and rural communities. People with back disorders often went to the hospital or emergency room and were admitted. These numbers were much higher than the part of the sample that adhered or was prescribed physical therapy or chiropractors. One could extrapolate these findings regarding the lack of use for alternative therapies due to the nature of their work, demanding schedules, out of pocket co-pays and that the nature of their work is causing the injury, therefore therapies will most likely recommend abstaining from the cause of the pain. Low income people cannot afford not to work or to work less. We also see that people who tended to be obese received less care for back disorders.
Mental Health & Substance Use- Mental health and substance use accounted for about 2.7% of the sample population. A staggering 57% of the broader sample of all people covered (not just paying employees) had a mental health or substance use disorder. We see that the sample is predominantly female. The data shows that predominantly White people had substance use and mental health disorders in the sample. Because mental health support is so low in rural areas, we see the reported numbers predominantly in low-income rural areas, but they are widespread in urban areas as well.
We bring this to employers attention so they can pay attention to the main conditions experienced by their staff members and can then begin to work toward effective healthcare solutions, with their staff, to alleviate and reduce the conditions, while bringing down healthcare spending, subsequently reducing cost for employees as well.