The Effect of Chronic Conditions and Missed Care on Employers

Today’s employers face growing pressure to manage healthcare costs while keeping their workforce healthy and productive. 

The projected healthcare cost trend rose to almost 8% for 2025, the highest amount in more than a decade, according to Business Group on Health’s 2025 Employer Health Care Strategy Survey. In some states, such as Virginia, the number is even higher (10%).

So, where should employers focus their attention?

Start with chronic conditions. These conditions, including hypertension, Type 2 diabetes, and obesity, are among the biggest and most overlooked drivers of rising healthcare spending. 

Nearly 60% of U.S. adults live with at least one chronic disease, and 40% manage multiple conditions. According to the CDC, treating chronic diseases and mental health conditions accounts for almost 90% of the nation’s $4.1 trillion in annual healthcare costs.

And the price tag doesn’t stop at claims. Employers lose an average of $2,945 per employee each year to absenteeism and presenteeism related to chronic illness.

How can employers turn the tide? 

Advanced primary care is one of the most effective ways to proactively manage chronic conditions, and it’s rapidly catching on. In fact, adoption of advanced primary care models has surged 800% over the past five years according to Hint Health.

The direct costs of unmanaged chronic conditions

When chronic conditions go unmanaged, costs rise fast, and in ways that ripple across your entire benefits strategy.

Without consistent, proactive care, employees face a higher risk of serious health events like heart attacks, strokes, or complications from diabetes. These events often lead to costly hospital stays, specialty care, and long-term medication use.

Even before a crisis hits, the price of inaction adds up. Employees with uncontrolled conditions are more likely to visit the ER, increasing both claims costs and time away from work. Medication needs also escalate as conditions progress, driving pharmacy spend higher.

When caught early, Type 2 diabetes is often reversible through lifestyle changes. However, it becomes a costly condition when left unmanaged. Employees with Type 2 diabetes face medical expenses that are 2.6 times higher than those without the condition.

Proactive care isn't just good medicine, it’s a smart financial investment. And it starts with giving employees access to care that catches problems early and keeps them from spiraling into costlier conditions.

“Complications of our most prevalent diseases are our highest cost conditions,” says Dr. Natasha Parekh, Regional VP of Clinical Leadership at Marathon Health. “What that tells me is there's a significant opportunity to screen and diagnose those highly prevalent conditions early so we can prevent progression to high-cost conditions like congestive heart failure and end-stage renal disease.”

Rising premiums and delayed primary care

As healthcare premiums climb and insurance plans cover less, more employees are skipping the care they need. Cost is a major barrier, but it’s not the only one. Many employees face long wait times to see a provider, difficulty finding appointments that fit their schedule, or frustration from previous negative healthcare experiences. Others simply can’t afford to take time away from work to attend appointments, especially in hourly or shift-based roles.

When employees delay primary care, they miss critical chances to detect and manage health issues early. That includes chronic conditions, which often go unnoticed until they become much harder and more expensive to treat.

Studies show roughly 3 in 5 Americans admit avoiding important screenings, while over 50% of Gen Z and Millennials use the ER/urgent care for their health needs. 

Advanced primary care programs are designed to reverse that trend. They prioritize proactive outreach like biometric screenings and health risk assessments to flag early signs of chronic conditions. From there, employees are connected to the right support, including medications, health coaching, and ongoing chronic condition management.

Managing chronic conditions comes down to a simple equation: Better access to care equals healthier employees. And when employees stay healthy, employers see fewer claims, lower costs, and a more productive workforce.

How advanced primary care addresses chronic conditions

Advanced primary care removes many of the barriers that keep employees from getting the care they need, starting with access.

Rather than waiting weeks for care, employees can typically schedule same- or next-day visits and pay little or no out-of-pocket costs. In fact, many employers waive fees entirely and offer incentives for employees who engage with APC and chronic condition management.

Once they’re in the door, employees get more time with their providers—30 minutes or more per visit. That extra time allows providers to dig deeper, ask about lifestyle factors, and help patients connect the dots between their symptoms and the bigger picture. It also gives space to support critical elements like medication management and long-term adherence.

But APC isn’t just built for patients. It’s designed with employers in mind, too.

The model adapts to each organization’s specific needs, including targeting the chronic conditions most prevalent in their workforce. Employers can tailor offerings to meet their population’s health risks and goals, whether they have remote employees across the country or thousands working on-site.

With a mix of onsite and nearsite centers, as well as a network approach that supports dependents and dispersed teams, advanced primary care access ensures employees can schedule an appointment without disrupting operations.

What advanced primary care means for HR and finance leaders

While the top goals include making employees healthier and reducing costs, APC is also a strategic tool that helps both HR and finance leaders meet their goals.

How APC benefits HR leaders:

• Healthier employees: APC helps employees better manage chronic conditions, seamlessly schedule appointments, and stay healthier overall, resulting in fewer absences and higher productivity.
• More effective benefits: Adding APC strengthens your benefits package with high-impact services like same-day appointments, health coaching, and extended provider visits. Employees feel supported and are more likely to use their benefits.
• A magnet for top talent: APC offers real, visible value to employees. With low or no-cost access to care, it becomes a standout offering that supports both attraction and retention, especially in competitive hiring markets.

How APC benefits finance leaders:

• Employer healthcare cost savings: APC reduces unnecessary ER visits, hospitalizations, and late-stage treatments by catching issues early and managing them proactively.
• Cost-effective medication management: With provider oversight and coaching, medication adherence improves, leading to better outcomes and lower pharmacy and treatment costs.
• Measurable ROI: APC isn’t a vague promise, it delivers. Employers using Marathon Health’s APC and chronic condition management model see $1,100 in savings per engaged member and a 3.7x return on investment by year five.

A five-year analysis of engaged Marathon Health members, including 89,000 members and 29 employer sponsors, found:

• 21% lower claims costs
• 82% higher primary care utilization
• 15% fewer emergency room visits
• 41% fewer inpatient admissions

And the proof goes beyond the numbers. Across all employers, Marathon Health earns a Net Promoter Score (NPS) of 89, a world-class rating that reflects high satisfaction, trust, and loyalty.

Ultimately, APC is a solution built with brokers, for employers. It’s designed to align with the goals of benefits consultants and the real-world challenges of today’s workforce. From customizing care models to tracking results, APC makes it easier for brokers to recommend solutions that deliver measurable value, and for employers to act on them with confidence.