The CMS national health expenditures report released last week may have overshadowed another report published in Health Affairs that offers some distressing results.
Americans were more likely to be living with chronic diseasesand more than onein 2005 than a decade earlier, researchers wrote in a study published last week in the journal Health Affairs. Not only that, but patients medical expenses, not including premiums, increased significantly during the 10-year period, after adjusting for inflation.
Steady growth in household medical costs prior to the economic downturn may have pushed such expenses beyond what increasingly strained budgets can afford, said Peter Cunningham, senior fellow at the Center for Studying Health System Change, who was not involved in the study. That could jeopardize health, as consumers put off care to avoid expense.
The study found fewer people reported none or one chronic condition in 2005, but those reporting three or more increased by 5.9%. Meanwhile, expenses such as copayments, coinsurance, deductibles or other costs not covered by insurance grew by 39% between 1996 and 2005.
Researchers also found that costs did not rise solely because Americans became increasingly ill. After researchers adjusted for disease, spending increased 19% during the decade.
Still, those living with multiple chronic diseases paid more out-of-pocket than those with none or one disease. An individual with one disease spent $655 for medical copays and other expenses, on average, compared with $1,865 for those with three or more.
Kathryn Anne Paez, a senior research scientist at the Center for Health Policy and Research, Social and Scientific Systems, Silver Spring, Md., who co-authored the report, said the results uncovered a surprising rate of chronic disease among older adults still in the workforce. Roughly 63% of adults between ages 45 and 64 reported one or more chronic diseases in 2005. Fewer reported no chronic diseases in 2005 than in 1996 while the number who reported three or more increased by 9.7%.
Douglas Carr, medical director of education and system initiatives for the Billings (Mont.) Clinic, said the results underscored trends that are fueling the need for healthcare delivery and financing reforms.
Financial incentives dont reward frequent screening and oversight needed to prevent and manage chronic disease, he said. Billings Clinics recent drop off in primary-care visits suggests the worsening economy has prompted some to skip or delay visits. The long-term consequences can be pretty devastating, Carr said.