Study: Chronic diseases, out-of-pocket spending rise

The prevalence of chronic diseases among U.S. residents is on the rise, with about 44 percent of people reporting at least one condition in 2005, up from 41 percent in 1996, and 13 percent reporting three or more, up from 7 percent in 1996, a new study shows.
In the same period, the study found, changes in health plans have sharply increased out-of-pocket costs for all Americans, from $427 in 1996 to $741 in 2005, a 39-percent increase after adjusting for inflation. Medicare beneficiaries who had three or more chronic conditions spent an average of $2,588 in out-of-pocket medical costs in 2005.
The study, conducted by Kathryn Paez of the Center for Health Policy and Research, Social & Scientific Systems, and colleagues, used data from nationally representative government surveys that included responses from about 32,000 residents in 2005 and about 22,000 residents in 1996.
It found the prevalence of chronic conditions is rising among “not only the old-old but also people in midlife and earlier old age.” And it warned that “policymakers should be aware that cost-sharing at the point of care can disproportionately burden people with chronic conditions and discourage adherence to drugs that prevent disease progression.”
In recent years, the study notes, employers have coped with medical inflation by increasing employees’ premium contributions and out-of-pocket obligations alike, but it’s the latter that has risen far more, through multi-tier pharmacy plans, a shift from copayments to coinsurance, increased deductibles, combining deductibles with copayments, and smaller provider networks that force consumers to get their care outside their plan’s network.
The full study is available at content.healthaffairs.org/cgi/content/full/28/1/15.