The 5% of the population with multiple chronic conditions is by far the biggest cost driver of total U.S. healthcare expenditures. According to KaiserEDU.org, 2010 expenditures were nearly $2.6 trillion for all healthcare, over ten times the $256 billion spent in 1980. While new medical technology has been a large cost contributor, the demand for the technology is driven significantly by the market for treating the 5%. More than 25 percent of Americans have two or more chronic conditions according to The Department of Health and Human Services. Of Americans over 65, two-thirds have multiple chronic conditions and three-quarters over 80 have three or more chronic conditions. Sixty-nine percent of Medicare dollars are spent on people with five or more.
By 2020, the number of people with multiple chronic conditions is expected to increase to 81 million, up from 57 million in 2000. Unfortunately, much of the healthcare delivered today does not address the problem of multiple conditions being treated by multiple clinicians, each prescribing various tests, treatment procedures and prescription medications. Clinical practice guidelines typically are developed to treat a patient’s specific chronic conditions, not combinations of them. This treatment of individual ailments and not the whole patient often leads to unintended consequences making treatments ineffective or even harmful.