What Diabetes Costs Consumers, How Prevention Can Save

What Diabetes Costs Consumers, How Prevention Can Save

Earlier this month we reported on America’s rising diabetes rates and what you can do to prevent the disease. The number of Americans diagnosed with full-blown diabetes is fairly staggering: 29 million Americans, about 9 percent of the nation’s population. However, pre-diabetes rates are nearly triple. An additional 86 million people age 20 and older, 1 in 3 Americans, have pre-diabetes.

It’s worth noting for many reasons. Many people are on the cusp of developing diabetes. Many people may potentially avoid such a diagnosis. And many people can reduce the financial impact the disease has on them.

A look at pre-diabetes

When someone has pre-diabetes, their blood glucose levels are higher than normal but not high enough for them to be diagnosed with diabetes, according to the American Diabetes Association. While individuals with Type 2 diabetes, the most common form of the disease, almost always have pre-diabetes, a pre-diabetes diagnosis does not guarantee someone will develop Type 2 diabetes.,

Studies show some people with pre-diabetes can return their blood glucose to normal range and prevent or delay a Type 2 diagnosis through weight loss and exercise. That is fantastic news because if you know you have pre-diabetes, you may be able to prevent it from becoming worse and more expensive.

Diabetes’ financial, healthcare burden

Undiagnosed and diagnosed diabetes cost Americans significantly more than pre-diabetes. Research shows the average annual cost of pre-diabetes and undiagnosed diabetes differs by $2,421 and the average annual cost of pre-diabetes and Type 2 diabetes differs by $9,234.

Annual Cost of Diabetes Per Person

Source: Dall, Timothy M., Yidou Zhang, Yoahzhu J. Chen, William W. Quick, Wenya G. Yang, Jeanne Fogli. “The Economic Burden of Diabetes.” Health Affairs 29, no. 2. (January 2010). http://content.healthaffairs.org/content/29/2/297.short

From 2007 to 2012, the costs of diagnosed diabetes increased by 41 percent and the per capita costs rose 19 percent, according to a 2013 report from the American Diabetes Association. Increased prevalence, not increased cost per patient was cited as the driving force.

Hospitalizations are on the rise, too. From 1988 to 2009, the number of diabetes hospitalizations, those in which diabetes was the first-listed diagnosis, increased from 454,000 to 688,000. For the most part, the number of hospitalizations related to diabetes—those in which another conditioned was listed first in a medical claim and diabetes was also listed—have risen substantially, as well.

Diabetes Hospital Stays

Source: U.S. Centers for Disease Control and Prevention. Diabetes Public Health Resource. “Hospitalization.” Last reviewed: Nov. 19, 2013. http://www.cdc.gov/diabetes/statistics/hospitalization_national.htm

Hospitalizations-Complications-Diabetes

Source: U.S. Centers for Disease Control and Prevention. Diabetes Public Health Resource. “Hospitalization.” Last reviewed: Nov. 19, 2013. http://www.cdc.gov/diabetes/statistics/hospitalization_national.htm.  The average length of stay for diabetes hospitalizations, those in which diabetes was the first-listed diagnosis, decreased from 8.2 days in 1988 to 5 days in 2009. However, patients older than 45 experienced longer stays (5.5 days on average) than those 44 or younger (3.4).

Diabetes By Age

Source: U.S. Centers for Disease Control and Prevention. Diabetes Public Health Resource. “Hospitalization.” Last reviewed: Nov. 19, 2013. http://www.cdc.gov/diabetes/statistics/hospitalization_national.htm.

What diabetes-related hospitalizations cost Americans varies greatly across the United States. Nationwide, the average inpatient hospital charge covered by Medicare in 2012 was $6,052. However, there was a 67 percent difference between the state with the lowest average inpatient hospital charge covered by Medicare (Arkansas, $4,880) and the highest  (Maryland, $8,169). These amounts do not include physician charges, which means they are an underestimate of what a person would likely pay for a hospital stay. Furthermore, they only take Medicare patients; an individual with private insurance will pay more.

Prevention saves

Back to the good news: Pre-diabetes will not necessarily lead to diabetes. But you need to know you have it, and knowing you have it can be tricky since pre-diabetes has no clear symptoms. That’s an especially compelling reason to see your doctor for an annual checkup.

If you have already been diagnosed with pre-diabetes, you should still schedule preventive care visits each year to ensure it hasn’t progressed. The ADA recommends people with pre-diabetes be checked for Type 2 diabetes every year or two. Remember: Early diagnosis and treatment of diabetes and diabetes-related complications can prevent their progression.

Know your risk for diabetes, and discuss it with your doctor to ensure you receive the proper care, testing and treatment throughout your lifetime. Not only will being aware of your risk (or having a diagnosis) potentially reduce your out-of-pocket healthcare spending and prevent or delay the disease from worsening, it may also give you access to free preventive care. Under the Affordable Care Act, diabetes screening for adults with high blood pressure and diet counseling for adults at higher risk for chronic disease are listed among the adult preventive services that qualified health insurance plans must cover at no additional cost.

Contact your health insurance company to confirm your plan benefits, and talk to your doctor about what preventive services you need.

Need a qualified health insurance plan for 2015? Have your healthcare needs changed and made it necessary to increase your level of coverage? Open enrollment runs through Feb. 15, 2015. Visit HealthCare.com to browse plans in your area, and use the HealthCare.com tax subsidy calculator to see if you are eligible for a premium tax credit. 

Not sure what health insurance plan is right for you? Call 877-275-0485 to speak with a licensed agent partner. 

About Jenifer Dorsey

Jenifer Dorsey is a regular contributor to HealthCare.com. She has covered health insurance and health and fitness for more than five years. In her free time she is a competitive track cyclist and loves to travel, especially to places with velodromes.

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