Written by: Dr. Wyatt Decker
Published: May 28 2026

America is facing a crisis that’s hiding in plain sight: 90% of the nation’s $4.9 trillion in annual health care spending comes from treating chronic diseases. These conditions — including cancer, diabetes, heart disease and obesity — affect three in four Americans and represent the leading cause of disability and death in the country.

It’s a shocking statistic at face value. But the details are more complex.

As Dr. Aaron Carroll notes in a recent Washington Post opinion piece, higher rates of chronic disease isn’t necessarily surprising given Americans are living longer, clinical guidelines are shifting and testing and screening rates and have increased.

It’s true: Advancements in screening and earlier testing can catch diseases like cancer and hypertension sooner and give people a better chance at effective treatment and management. The question is: How do we broaden that approach to reach more people and help them live longer and healthier lives?

It requires our health care system to shift significantly – from managing the consequences of chronic diseases to preventing them in the first place. There are patient-centered, accountable care models that show how this is done. Instead of paying for individual procedures, they reward outcomes. Instead of incentivizing volume, they prioritize prevention and coordination.

And the evidence shows it’s working.

• Patients in these models are 43% less likely to be hospitalized for a chronic condition and 19% less likely to go to the emergency department.
• Patient-centered, accountable care models are better at controlling glucose levels, blood pressure and cancer diagnoses.
• Oncology value-based cancer care programs have reduced inpatient admissions by 30% compared with benchmark care, and generated 75% fewer emergency department visits and 25% improved total cost of care.

There are many opinions about the best path forward in addressing chronic disease. The one thing we can all agree on: continuing with our current approach is the least efficient way to prevent and manage chronic diseases. The costliest thing about our current model isn't the $4.9 trillion we spend annually, it's the patients we could have helped earlier and the lives cut short due to preventable conditions.

It’s time to make a change.