Employer Healthcare Costs Are Driven by These Common Conditions

Health is wealth. A statement of fact that never gets old. One of the best gifts you can ever gift yourself is sound health. But this typically comes with a price tag on it—and certain common conditions typically drive up healthcare costs. 

Expenditure for healthcare is steadily on the rise. The Center for Medicare & Medicaid Services revealed that national healthcare spending in the US experienced a 4.6% increase in 2019, an estimated $3.8 trillion or over $11,000 per person. 

And this was all before the global pandemic that shifted the prioritization of healthcare above everything else. The impact the pandemic will have on healthcare spending is still unclear, but one can easily deduce that the cost is north of $3.8 trillion. 

According to a report published by Health Action Council and UnitedHealth Group, there are health conditions currently placing healthcare costs on the high. Health Action Council is a nonprofit organization that comprises over 200 large companies with a workforce of over 2.8 million. In their report, the organization studied 57 large businesses scattered across the country.

They were able to determine the common conditions that were constantly increasing healthcare costs by employers. Knowing the most common conditions potentially effecting an employee base can help an employer and its employees.

Below we discuss these common conditions and how employers can stop them from effecting their bottom line: 


One of the health conditions listed by the Health Action Council is diabetes. Diabetes was 20% more prominent amongst male individuals. 

Also discovered is that 55% of the workforce struggling with the condition are male with an average age of 52 years old. 

North Carolina, Kentucky, Ohio, Arkansas, and South Carolina are the states where a large portion of covered lives with diabetes are geographically concentrated.

The report shows that Asian covered lives were only 3% of the total Health Action Council’s covered lives, and are at higher risk of getting the condition. 

Diabetes is a massive driver of US healthcare expenses, costing Americans around $327 billion in 2017.


Another health condition that increases employer’s healthcare costs is Asthma as 6.4% of covered lives in the report have the condition. 

Asthma cases are more 31% more prevalent in women who than in men. Asthma is also 20% higher amongst black people compared to people of other races. 

The states with the highest cases of asthma include suburban Maryland, Philadelphia, Northeast Pennsylvania, Texas, Arizona, Denver, Colorado, and Ohio. Further studies suggest that black people are 15% more likely to need asthma treatment. 

It was found that 87% of black-covered lives receive asthma medications compared to 97% of white-covered lives.


Hypertension is also another medical condition that is part of the ever-increasing healthcare costs at 6.3% of medical costs. From the report, Black communities face a 63% higher risk of developing hypertension than other races.

Studies suggest that income has a large impact on this medical condition and that the highest occurrences of hypertension was found in low-income earners. 

Common causes of hypertension for women include weight gain (due to pregnancy or obesity), diet, and alcohol use. The causes of the condition in men differ slightly with lack of exercise, genetic disorder, stress, and tobacco use. 

States where hypertension rates are the highest include Ohio, Texas, Missouri, North Carolina, South Carolina, and Arkansas. 

Back Disorders

Back disorder is yet another medical condition that is rife. According to The American Journal of Managed Care, 70% of Americans suffer from back pain at least once in their entire lifetime. 

The report from the Health Action Council revealed that the condition is particularly prevalent in women and white-covered lives. The report stressed that low-income earners tend to suffer more from back disorders. 

Some of these jobs include manufacturing workers in rural and Midwest communities. Some of the states with higher back disorder rates include Tennessee, Ohio, Missouri, Kentucky, and Arkansas. 

Mental Health & Substance Abuse 

From the report, women were more 57% more likely to struggle with substance abuse and mental health issues. Also, substance abuse is prevalent in Caucasians (20%) more than in other races. 

Mental health and substance abuse were evident in both rural and urban communities. Although the data may not show a true representation as there is a significant lack of mental healthcare resources available in rural communities. 

What this Means as an Employer

As an employer you cannot ask employees about their health due to the Health Insurance Portability and Accountability Act (HIPAA). But knowing the information above about these certain common conditions can help when determining the healthcare plans you offer to your employee base. You will need to ask yourself numerous questions and the information above reveals a lot of useful information. Formulating the healthcare plans you offer your employees can help you as a business avoid unnecessarily expensive plans.

At Expense To Profit we have found in the past that many business owners are given a renewal price that does not reflect the profitability of the employer plan for the insurer. It reflects the market accepting higher premium prices common in the marketplace. When we evaluate their plans we often find that we are able to reduce costs for the employers without raising premiums for employees. Finding them true market pricing.

As healthcare costs continue to increase, employers can discuss with health insurance providers solutions that will cut down healthcare costs. This will improve their bottom line in the long run, while also providing substantial healthcare options to employees.

If this is a conversation you may not feel comfortable having or do not feel informed enough to tackle yourself, let’s have a conversation and see how we may be able to help you.

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Marc Freedman

To help you achieve your company's financial growth goals, Marc serves as our Chief Cost Advisor, providing advice to client management teams. He is highly regarded as an expert in his field, and he frequently collaborates with and contributes to other spend consultants to develop and implement cutting-edge strategies for their respective clients.

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