Of Adults with High Costs, Most Have Multiple Chronic Diseases, With or Without Functional Limitations Percent with high needs: Three or more chronic diseases,

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TABLE OF CONTENTS CHAPTER 7.0: Community Health Indicators Chart 7.1: U.S. Population Trends and Projections by Age, 1980 – 2050 Chart 7.2: U.S. Population.

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THE COMMONWEALTH FUND Source: McCarthy and Leatherman, Performance Snapshots, Percentage of Community-Dwelling Adults Ages.

Total adult population

Percent with unmet medical need

Among People with High Financial Burdens, Prescription Drug Expenses Compose the Largest Share of Out-of-Pocket Costs for Those with Chronic Conditions.

The Impact of a Behavioral Health Condition on the High-Need Patient

Ratio of percentile groups

Exhibit 1 Adults with High Needs Have Higher Health Care Spending and Out-of-Pocket Costs Average annual out-of-pocket spending Average annual health.

Community Health Indicators

Chronic Disease Under Control: Diabetes and Hypertension

Exhibit 1 Despite Much Greater Health Care Spending, High-Need Adults Reported More Unmet Needs and Mixed Care Experiences Total adult population Three.

Total adult population

Community Health Indicators

Has individual components of medical home care

Percent of Total Health Care Spending

Multinational Comparisons of Health Systems Data, 2010

Adults with High Needs Have Unique Demographic Characteristics

Adults ages 19– Uninsured now 15%

Receipt of Recommended Screening and Preventive Care for Adults

Fewer Women Say They Are Not Getting Needed Care Because of Costs

Total adult population

Percent with good patient–provider communication

Percent of adults ages 19–64

Health Care Spending Was Higher at Every Level for Adults with High Needs Than for Adults with Multiple Chronic Diseases Only Total adult population Three.

Receipt of Recommended Screening and Preventive Care for Adults, by Family Income and Insurance Status, 2002 Percent of adults (ages 18+) who received.

Current national average Impact on number of people

Percent adults ages 19–64 with a health problem or condition^

Health Status by Income

Average annual out-of-pocket spending

Insurance Complexity and Restrictions Create Concerns for Patients and Doctors Adults, 2013 Insurance did not cover as expected/spent a lot of time on.

Percent of adults ages 19– In the past 12 months:

More Than One-Third of Young Adults Experienced a Medical Bill Problem or Were Paying Off Medical Debt Percent of adults ages 19–29 who experienced the.

Community Health Indicators

Average number of medical office visits per year

Women in Switzerland and the U.S. Report Very High Out-of-Pocket Costs

One-Quarter of Women in the U. S

Deductibles Have Become a Growing Factor in Underinsurance Rates

High Chronic Disease Burden Among U.S. Women

High-Need Adults Are More Likely to Be Socially Isolated

Uninsured and Underinsured Adults with Chronic Conditions Are More Likely to Visit the ER for Their Conditions Percent of adults ages 19–64 with at least.

Two of Five Insured Adults with Incomes Below the Federal Poverty Level Spent 5 Percent or More of Their Income on Medical Out-of-Pocket Costs Percent.

Percent of adults ages 19– In the past 12 months:

2008 Survey Profile of Sicker Adults with Any Chronic Condition

Multinational Comparisons of Health Systems Data, 2008

Medical Bill Problems and Accrued Medical Debt, 2005–2007

16 Million Adults Under Age 65 Were Underinsured in 2005

Current national average Impact on number of people

Percent of adults ages 19–64 with at least one chronic condition*

Adequately insured 48% Uninsured anytime 15% Uninsured anytime 36%

Adults ages 19–64 with either marketplace or employer coverage

Adults with Health Problems Who Have an Excellent Patient Experience Report Greater Support to Help Manage Their Health Condition Percent of adults 18–64.

Despite Much Greater Health Care Spending, High-Need Adults Reported More Unmet Needs and Mixed Care Experiences Total adult population Three or more chronic.

Medical Bill Problems or Medical Debt

Total Population = 299 million Under-65 Population = 260 million

Two of Five Adults Uninsured or Underinsured 25 Million Underinsured 60 Percent Increase in Underinsured from 2003 to 2007 Percent of adults (ages 19–64)

Multinational Comparisons of Health Systems Data, 2008

QUALITY: EFFECTIVE CARE

Minorities with medical homes are just as likely as whites to receive reminders for preventive care visits. Percentage of adults ages 18 to 64 receiving.

Problems with Medical Bills or Accrued Medical Debt Increased, 2005–2007 Percent of adults ages 19–64 with medical bill problems or accrued medical debt.

Among those with Internet access, percent reporting ability to:

Uninsured during the year

Uninsured and Underinsured Adults with Chronic Conditions Are More Likely to Visit the ER for Their Conditions Percent of adults ages 19–64 with at least.

Total current marketplace and Medicaid enrollees* ages 19–64

Adults with Health Problems Who Have an Excellent Patient Experience Are Most Likely to Be Well-Informed About Their Prescription Medications Percent of.

Patient Engagement in Care Management for Chronic Condition, by Medical Home Percent reporting positive patient engagement in managing chronic condition*

Chronic Disease Under Control: Managed Care Plan Distribution, 2006

EQUITY: EFFECTIVE CARE

Distribution of Survey Respondents with High Needs

The Number of Adults Reporting Not Getting Needed Care Because of Cost Declined in 2014 for the First Time Since 2003 Percent of adults ages 19–

Age-standardized* prevalence and number of cases of diagnosed diabetes among individuals aged 1 year and older, Canada, 1998/99 to 2008/09. *Age-standardized.

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Of Adults with High Costs, Most Have Multiple Chronic Diseases, With or Without Functional Limitations Percent with high needs: Three or more chronic diseases, with functional limitations Percent with multiple chronic diseases only: Three or more chronic diseases, no functional limitations Percent who were comparatively healthy (less than three chronic diseases, no functional limitations) 6.0 million adults in top 10% of spending two years in a row 2.4 million adults in top 5% of spending two years in a row Notes: Noninstitutionalized civilian population age 18 and older. Data: 2009–2011 Medical Expenditure Panel Survey (MEPS). Analysis by C. A. Salzberg, Johns Hopkins University. Source: S. L. Hayes, C. A. Salzberg, D. McCarthy, D. C. Radley, M. K. Abrams, T. Shah, and G. F. Anderson, High-Need, High-Cost Patients: Who Are They and How Do They Use Health Care? The Commonwealth Fund, August 2016.