The Growing Challenge of Chronic Disease and Its Impact on
Health Care Costs
Chronic disease is a growing problem in the United States. More
than 125 million Americans had at least one chronic care condition
in 2000, and this number is expected to grow to 157 million by the
year 2020.1 And almost half of the people with chronic conditions
have more than one chronic condition to manage.
The number of Americans with chronic disease is growing
significantly due to a number of factors, including advances in
medical science and technology that are resulting in an increase in
the number of people living with chronic conditions, our nation’s
increasing ability to screen and diagnose chronic conditions with
greater frequency and success, and the aging society in general.3
As baby boomers continue to age, the number of individuals living
with chronic conditions will continue to grow. While 12.7% of the
population during the year 2000 was aged 65 years or older, this
number is expected to grow to 20% by the year 2030.4
People with chronic conditions absorb a majority of health care
spending in the United States, accounting for 78% of all health
care spending in 1998.3 Seventy-six percent of all hospital admissions
are attributable to people with chronic conditions, and
people with chronic conditions account for 88% of all prescriptions
filled and 72% of all physician visits.3 The costs associated
with chronic conditions are primarily borne by private, employersponsored
insurance, government programs such as Medicare and
Medicaid, and individuals through their insurance premiums and
out-of-pocket spending for services. Fifty-five percent of people
with chronic conditions have private insurance, while 33% are
covered by Medicare or Medicaid.3 Almost all Medicare dollars
and about 80% of Medicaid resources are spent on people with
chronic conditions, with 85% of Medicare enrollees and 39% of
Medicaid enrollees having 1 or more chronic conditions.