A path toward improving chronic disease management starts with improving how patients manage the costs  

For many Americans, managing chronic disease is not just a health challenge but a financial one that can be overwhelming and stressful. That stress compounds as people struggle to address the upfront cost of their disease(s) and navigate the complexity of the healthcare system, leading to worse physical and mental health outcomes for many.

Consider that 90% of the $4.9 trillion in annual U.S. healthcare expenditure is for people with chronic and mental health conditions. That’s over 17% of the country’s entire GDP. The cost of chronic disease is not a discrete challenge for those with conditions like heart disease, cancer, diabetes, and obesity – it’s a financial epidemic affecting the entire system. 

Chronic disease and care avoidance 

Chronic disease management challenges households across the nation. 76% of U.S. adults report having a least one chronic disease while over half report having two or more.  A family facing a recent cancer diagnosis must cope with both the health and financial strain. If that diagnosis comes early in the year, they may face thousands in bills before meeting their deductible – for some high-deductible health plans (HDHPs), the out-of-pocket costs could reach up to $17,000.

This dual issue of affordability and complexity has led to troubling trends in the way many interact with the American healthcare system, including those with employer-sponsored healthcare insurance. A recent JAMA Network study found that HDHP enrollment among cancer survivors was associated with more than double the odds of delaying or forgoing care due to cost, including a 92% increase in underuse of medications and a 79% increase in stress about related medical bills. What’s more concerning is that traditional solutions like health savings accounts (HSAs) did not mitigate overall survival risk. HDHP enrollment is associated with a 46% higher risk of death and paired with an HSA, that number jumps to 68%. 

Impact of chronic diseases on the bottom line 

Chronic diseases impact productivity in the workplace and care avoidance compounds the issue. Employees who delay care often report that their conditions worsen as a result, leading to increases in unplanned absences and instances of presenteeism – when sick employees continue to work while they’re unwell. 

Both issues impact employee morale, creating a situation where wellness initiatives degrade, and sick workers take longer to recover. What could have been remedied through primary care and a treatment plan becomes a high-cost emergency visit. 

This dynamic has a real financial impact on employers. It’s estimated that U.S. employers lose a total of $575 billion per year due to illness-related absences and impaired performance. The same analysis found that productivity loss due to chronic illnesses was roughly $2,945 per employee annually. 

When you combine the cost of lost productivity with the cost of increasing medical spend, the financial need for improved chronic disease management and benefits design is particularly urgent for employers seeking to control costs.

Improving affordability through benefit design

Innovative and proven benefits solutions are available, specifically designed to remove the financial barriers associated with delayed care and the resulting negative health impacts. Employers can partner with these benefits providers to lower upfront cost barriers and give employees the flexibility to manage costs through interest-free payment plans that meet their individual needs. These benefits are available to all eligible employees regardless of their credit scores and can come in the form of flexible spending cards or integrated financing through an employer’s health plan.

Access to interest-free payment options, regardless of credit worthiness, is critical to improving health equity. 55% of Hispanic and 49% of Black adults (compared to 39% of white adults) report difficulty affording health care costs. In addition, 46% of households making less than $90k are similarly challenged. Financial barriers are exasperating demographic and economic disparities. 

Employees without the liquidity to manage ongoing care costs currently rely on expensive options to finance their care. In 2024, 4.8% of Americans took hardship withdrawals from their 401K retirement funds, borrowing from their future to take care of short-term cash issues. 21% were rejected for commercial credit. It’s also worth noting that between 2018 and 2020 U.S. citizens paid over $1 billion dollars in interest related to medical credit cards marketed through provider offices. 

Alternatively, when employees have a financial safety net in place through access to interest-free payment options, they enter the doctor’s office with confidence, knowing they can cover and manage the ongoing costs associated with their care.

Employers and consultants need to look at their current benefits plans with a new lens on who they are leaving behind. Ask: How are my employees utilizing benefits based on salary or income? Are my employees pulling money from their retirement savings for medical expenses? Are employees fully benefitting from pre-tax accounts like FSAs and HSAs or are those accounts underutilized and unfunded? 

The answers to these questions may surprise you. Traditional benefits models aren’t cutting it, and that’s why interest-free, credit-agnostic healthcare financing offers a powerful path forward. By layering such solutions into benefits offerings, employers strategically invest in a healthier, more resilient workforce.