1. Introduction to the Chronic Disease Cost Calculator Presented by Diane Orenstein, Ph.D., and Justin Trogdon, Ph.D. April 1, 2010

2. Purpose of the CDCC (1 of 2) Estimate medical expenditures at the state level separately by insured population for the following select chronic diseases:  Arthritis  Asthma  Cancer  Cardiovascular disease (CVD), including  Congestive heart failure (CHF)  Coronary heart disease (CHD)  Hypertension  Stroke  Other CVD (including other cerebrovascular disease)  Depression  Diabetes Estimates of medical expenditures are provided for the entire state population (all payers, including the uninsured) and separately for Medicaid, Medicare, and privately insured.

3. Purpose of the CDCC (2 of 2) Estimate absenteeism costs for the above chronic diseases at the state level. Allow the user to generate estimates of the costs of selected chronic diseases using customized inputs. Project estimates of the medical costs of selected chronic diseases in the near future.

4. Accessing the CDCC Download Version 1 of the software at http://www.cdc.gov/nccdphp/resources/calculator.htm

5. What’s New in Version 2 Estimates of the prevalence and costs of Asthma, Arthritis and Depression Expanded estimates of the medical costs from Medicaid only to Medicare, private insurance, and “all payers” Estimates of absenteeism costs Projections of future medical costs (10 years) Charts

6. Intended Audience Chronic disease directors State Medicaid directors Other state and federal policy and decision makers Federal agencies and others interested in reviewing the burden of chronic disease across states and across the nation

7. Intended Use Provide estimates of medical expenditures and absenteeism costs due to select chronic diseases at the state level.  Many states do not have the resources (financial and personnel) to do this themselves Help policymakers quantify and understand the financial impact caused by chronic diseases Inform decisions on investments in chronic disease prevention and disease management programs

8. DRAFT—Please do not cite

24. What the Calculator Does Estimates for arthritis, asthma, cancer, cardiovascular disease (CHF, CHD, hypertension, stroke, and other CVD), depression, and diabetes at the state level: 1) prevalence, 2) medical costs by payer, and 3) absenteeism costs Minimizes double-counting of Medicaid dollars going to multiple diseases Creates sound estimates with no additional data required Allows users to input their own data in place of default estimates

25. What the Calculator Does Not Do Does not provide exact prevalence or medical and absenteeism costs of the chronic diseases for each state—only estimates Not designed for comparisons across states Does not include other costs of chronic disease, including productivity losses and reductions in the quality of life Does not make policy or value judgments on spending for chronic disease

26. Next Steps Update source data (e.g., MEPS) through 2007, the most recent year available Expected release—Summer 2010

27. Investigators CDC Investigators  Diane Orenstein (DHDSP)  Isaac Nwaise (DHDSP)  Brett Miner (DHDSP)  Nicole Blair (DHDSP)  Florence Tangka (DCPC)  Donatus Ekwueme (DCPC)  Rui Li (DDT)  Tursynbek Nurmagambetov (NCEH)  Louise Murphy (DACH)  Daniel Chapman (DACH) RTI Investigators  Susan Haber  Eric Finkelstein  Justin Trogdon

28. Other Collaborators Agency for Healthcare Research and Quality (AHRQ) National Association of Chronic Disease Directors (NACDD)  Especially Chris Maylahn and John Robitscher National Pharmaceutical Council (NPC) External Review Panel  Ken Thorpe (Emory)  Steve Teutsch (Merck)  Allison Rosen (U. of Michigan)