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Healthcare Business News

More diabetics likely to join Medicare rolls in coming years, report says

By Steven Ross Johnson
Posted: December 16, 2013 - 2:15 pm ET

Diabetes is on the rise among Americans with employer-based health plans, signaling that a wave of Americans with complex and expensive medical needs will join the Medicare rolls in the coming years, according to a new report.

The study, issued Monday by the not-for-profit Health Care Cost Institute, found the highest concentration of cases among adults age 45 and older living in the southern and eastern regions of the country.

Rates of diabetes among workers enrolled in employer-sponsored plans increased to 8.8% in 2012 from 6.4% in 2008, the according to an analysis of 40 million health insurance claims from employer-sponsored plans between 2008 and 2012.

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Increases were found among all age groups except for children younger than 18. For adults between the ages of 19 and 64, the rate increased to 11.6% in 2012 from 8.4% in 2008. Among those diagnosed with diabetes, 76% were between the ages of 45 and 64, with the highest prevalence among those ages 55 to 64, at 43%.

“About 25% of the Medicare population is estimated to have diabetes,” said Carolina-Nicole Herrera, director of research at HCCI and one of the authors of the study. “The population that is about to enter Medicare has a higher share of individuals who are either pre-diabetic or have diabetes—that's going to be quite a difference from the current population.”

The highest prevalence of diabetes' cases was found in southeastern states such as Florida, as well as North and South Carolina, where nearly 10% of people with employer-sponsored health insurance were diagnosed with diabetes.

According to data from the American Diabetes Association, the estimated total health cost related to diabetes was $245 billion in 2012, with $176 billion in direct medical cost and $69 billion in lost productivity.

About 55% of Americans in 2011 received health coverage through an employer-based plan, according to U.S. Census data.

Diabetes is a significant factor as the cost of providing health benefits continues to rise, and employers are responding with wellness programs that reward healthy lifestyles.

“It's nice to see that employers themselves are unilaterally engaging in this (wellness programs) and see value in it,” said Matt Petersen, managing director of medical information and professional engagement for the diabetes association. “Expensive medical interventions are not what we want for people with diabetes, we want to get them as needed but we prefer they not need them.”

Follow Steven Ross Johnson on Twitter: @MHSjohnson

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