Safeguarding Medicare | Deloitte Insights
Do prevention and early disease detection simply delay inevitable costs?
No. Prevention and early detection can do more than just postpone health care expenses; they can reduce total lifetime costs and improve quality of life. Chronic diseases such as diabetes and heart disease are significant drivers of health care spending, but preventing these conditions or managing them early can help avoid expensive treatments, hospitalizations, and complications.3 This approach tends to minimize the frequency and severity of high-cost medical events, especially in an aging population.
Deloitte actuaries found that proactive health measures can deliver a clear return on investment (ROI). By preventing disease or identifying and managing it early, individuals can experience significantly lower lifetime health care costs. Staying healthier longer can also reduce the duration and associated costs of serious illness at the end of life. For example, up to half of heart disease cases are linked to modifiable lifestyle factors such as diet, tobacco use, and physical activity.4 By adopting healthier behaviors—and investing in prevention, screening, and early detection—it is possible to delay the onset of heart disease and reduce its severity.
Longitudinal research conducted by the American Heart Association,5 and research published in The New England Journal of Medicine,6 indicate that adults with healthy hearts in midlife can delay the onset of heart disease by nearly seven years and compress the period of severe illness from almost five years to a little more than one.7 This phenomenon—known as compression of morbidity—means people can live longer, healthier lives while spending less time and money managing serious illness.8 Deloitte’s actuarial models estimate that more than $125 billion could be saved on heart disease alone by preventing or delaying onset, shortening the duration of severe illness and reducing hospitalizations.
Similar trends are seen with other conditions. For instance, up to 80% of strokes are considered preventable,9 yet 50% of stroke survivors experience long-term disability.10 Deloitte’s analysis found that advances in hypertension management, rapid surgical response, and digital interventions can not only decrease the incidence of stroke but also reduce the duration and severity of disability, resulting in substantial savings in hospital and rehabilitation costs.
For the individual, these interventions—in addition to lifestyle changes and regular primary care visits—can spark meaningful improvements in health and add multiple years of life span (the average expected number of years between birth and death) and health span (the average number of healthy years between birth and death). Previous Deloitte research concluded that proactive measures for managing health can add more than 20 years of health span.
This analysis shows that targeted investments in prevention and recovery can help bend the health care cost curve. Deloitte’s projections recognize that only a portion of the population will likely adopt healthier behaviors during their working years. While health care costs generally increase with age due to increased health needs and greater prevalence of chronic conditions, this is not inevitable for everyone. Some individuals might incur lower costs later in life if they maintain good health when they are younger. However, many factors can influence health as people age.11
The analysis suggests that—with the appropriate proactive investments—it may be possible to slow Medicare spending growth without raising taxes or reducing benefits. By making targeted investments in preventive care programs, enhancing care coordination and navigation, and promoting healthier lifestyles, Medicare could reduce health care costs over a beneficiary’s lifetime. As mentioned earlier, these strategies could help save Medicare more than $500 billion a year in medical and prescription drug costs, strengthen the program’s long-term financial future (see Medicare spending is on pace to more than double by 2031), and increase the number of years that beneficiaries enjoy in good health. The findings highlight the importance of considering innovation and strategic investment in health care delivery as policymakers address the long-term sustainability of the Medicare program.
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