From Siloed Care to Integrated Cardiometabolic Solutions

The moment someone is diagnosed with a cardiometabolic condition, their likelihood of receiving a diagnosis for a comorbidity increases. Considering that less than 7% of Americans are in optimal cardiometabolic health. The secondary concern is how our current healthcare system treats each condition as an individual health risk, often without a comprehensive lens of total member health.

Members visit a cardiologist to manage their heart disease.  
An endocrinologist to manage blood sugar and diabetes.  
A primary care provider who tries to connect the dots in 15-minute visits.  

Meanwhile, employers see rising claims, pharmacy spend, and absenteeism, but rarely a clear picture of why.

This is the cost of siloed care in cardiometabolic disease.

Fragmented care impacts members and employers, and cardiometabolic conditions continue to be a significant cost driver. Cardiometabolic risk cannot continue to be managed with a siloed, condition-by-condition approach and deliver the health outcomes members need. 

The true cost of siloed cardiometabolic care

1. Members with multiple conditions fall through the cracks  

Cardiometabolic disease is rarely a single diagnosis. Obesity, type 2 diabetes, hypertension, and high cholesterol are commonly diagnosed in clusters,  dramatically increasing the risk of heart attack, stroke, and kidney disease. 

Yet health systems and benefit designs are typically organized around individual diseases and specialties, not the lived reality of people with multiple chronic conditions. Research on comorbidities has identified a disconnect between disease-specific care and patient needs, resulting in fragmented, sub-optimal care for people with multiple chronic conditions. 

Studies on fragmented care in chronic condition management consistently show that when care is spread across many providers and settings without strong coordination, patients experience:

• Higher risk of hospitalizations and emergency visits  
• More potentially inappropriate medication use 
• Higher mortality and worse overall outcomes 

For a member with obesity, diabetes, and hypertension, fragmentation can also mean members receive conflicting lifestyle advice from different health apps and publications, along with duplicative or missing tests and labs due to disparate care models. 

2. Employers pay for the fragmentation—and often twice  

Chronic conditions are the main driver of health costs in the U.S. The CDC estimates that about 90% of the nation’s $4.9 trillion in annual health care expenditures go to people with chronic and mental health conditions, including cardiometabolic conditions. The burden of cardiometabolic disease alone is vast, with multiple risk factors that increase the risk of cardiovascular events and mortality. 

For employers, that shows up both in medical claims and in productivity losses:

• Analysis from Kaiser Permanente notes that chronic conditions account for around $1.1 trillion in direct health care costs and $2.6 trillion in lost productivity annually, including billions from employee absences.
• Employees with type 2 diabetes alone have been shown to incur roughly $11,354 in annual medical costs versus $5,101 for employees without diabetes—about $6,000 in additional spend per member per year, even before counting lost productivity.
• The more conditions a person has, the steeper the cost curve. One study of working-age adults found that average costs rose steadily with each additional chronic condition from 0 to 4, and then increased even more sharply for individuals with 5 or more chronic conditions.

From an employer's perspective, siloed care means:

• Paying separate vendors and point solutions for weight, diabetes, hypertension, and behavioral health, each with its own engagement strategy and data set.
• Funding duplicative or misaligned interventions that don’t change the underlying cardiometabolic trajectory.
• Struggling to identify which members with multiple risk factors truly drive outlier costs.

In other words, you’re likely paying for solutions to address each cardiometabolic condition without getting a truly coordinated strategy for your members.

3. Siloed data hides the real impact of comorbidities

When member care is fragmented, oftentimes, critical data becomes disjointed, making it difficult to understand the full picture. 

Claims for cardiology, endocrinology, behavioral health, and weight management often live in different systems or are owned by different partners. Employers and health plans may see:

• Pharmacy data on GLP-1 use from their PBM
• Claims data for cardiology and diabetes visits from their Health Plan
• Separate program data for a digital weight app or diabetes point solution from different vendors

But very few have an integrated view that shows, for example:

• How a member’s weight, blood pressure, A1c, and medication regimen are changing together
• Whether that member’s cardiometabolic risk is truly improving 
• Where overlapping programs are producing diminishing returns or gaps in care
• Level of member engagement in tracking meals and activity

Without that integrated lens, it’s nearly impossible to quantify the total impact of comorbidities on cost, utilization, and long-term risk.

Why cardiometabolic risk must be managed comprehensively

The science is clear: cardiometabolic risk factors are deeply interconnected. However, our healthcare system continues to treat them in siloes

Obesity, insulin resistance, and hypertension increase the risk for coronary artery disease, stroke, heart failure, and chronic kidney disease.

Studies have shown that sustained weight loss and improved fitness reduce the risk of developing type 2 diabetes and hypertension and are associated with better long-term cardiometabolic outcomes.

For your members, integrated cardiometabolic management should mean:

• A single, cohesive plan that addresses weight, glucose, blood pressure, cholesterol, and lifestyle behaviors together
• Centralized support for medication adherence and education of side effects. 
• Behavioral support that considers mental health, sleep, stress, and social determinants, not just isolated diet tips

For employers and health plans, the question becomes: how do you design benefits and partnerships that reflect this reality in action?

What integrated cardiometabolic solutions look like

Early adopters of this strategy are showing that integrated cardiometabolic care can work and improve outcomes while using resources more efficiently.

Multidisciplinary cardiometabolic clinics

One cardiometabolic clinic model that co-located endocrinology, cardiology, and lifestyle interventions found that patients in the integrated clinic had greater weight loss and A1c reduction over six months compared with those receiving usual primary care. The program also optimized medication use, increasing prescriptions of evidence-based cardiometabolic therapies while deprescribing potentially harmful older medications. 

Digital-first and hybrid cardiometabolic programs

On the digital side, modeling of digital cardiometabolic support programs has shown that sustained improvements in weight, A1c, and blood pressure can translate into fewer downstream events and lower projected costs for payers and employers. 

These programs typically integrate:

• Continuous lifestyle and behavior change support
• Medication adherence support and side effect monitoring
• Remote tracking of biometrics
• Integration with pathways for members to contact their personal care teams.

Done well, they extend the reach of integrated care beyond clinic walls and into members’ daily lives, exactly where behavior change actually happens.

From fragmented spend to strategic investment

For employers, moving from siloed to integrated cardiometabolic programs is also a financial strategy.

Consider the current state:

• Chronic conditions account for the majority of employer health care costs, and those costs rise steeply as members accumulate additional conditions.
• Cardiometabolic risks are associated with billions of dollars in lost productivity. One analysis estimated $17.3 billion annually in the U.S. due to common cardiometabolic risk factors alone. ‍
• Obesity has been linked to significantly higher care utilization and cardiovascular costs for employers.

Integrated cardiometabolic solutions give plans a way to convert fragmented, reactive spending into a more deliberate investment strategy:

1. Focus on the highest-risk, highest-cost members

Use combined data (weight, A1c, BP, meds, utilization) to identify members with overlapping cardiometabolic conditions who drive disproportionate spend for additional support through integrated programs.

2. Deploy one coordinated solution rather than multiple disconnected ones

Instead of separate vendors for weight, diabetes, and hypertension, invest in a solution that supports the full cardiometabolic picture.

3. Track outcomes and ROI at the whole-person level

Measure changes in combined risk, like ASCVD risk scores, and connect them to avoided events, medication optimization, and productivity gains.

How to move from siloed care to an integrated cardiometabolic strategy

If you’re an employer, health plan, or consultant thinking about this shift, here are practical steps to take.

1. Map your current fragmentation

• List all vendors, programs, and benefits that touch weight, diabetes, hypertension, cardiovascular disease, and behavioral health.
• Identify where members might be in more than one program or in none at all.
• Look at whether data from these programs flows back in a way that supports comprehensive insights.

2. Redesign around the member, not the condition

• Ask: if one person has obesity, diabetes, and hypertension, how do they experience your ecosystem?
• Is there a clear “home base” for their cardiometabolic support?
• Do they receive aligned coaching, education, and medication strategies across conditions?
• Are behavioral health, sleep, and social factors part of the plan or an afterthought?

Use that lens to evaluate current offerings and to shape RFPs for future partners.

3. Prioritize partners that can integrate across the continuum

• When evaluating cardiometabolic solutions, look for:
• Evidence that they can address multiple conditions on a single platform or within a unified care model.
• Proven improvements in weight, A1c, and blood pressure, not just engagement metrics.
• Clear data-sharing capabilities so you can integrate their insights with your own claims and pharmacy data.
• Integrated pathways to clinical support (virtual or in-person) when needed.

Siloed cardiometabolic care asks too little of the system and too much of the member. It fragments responsibility, obscures the true impact of comorbidities, and drives up costs for employers and health plans without reliably improving outcomes.

Integrated cardiometabolic solutions, whether in multidisciplinary clinics, digital-first programs, or hybrid models, offer a different path: one that treats cardiometabolic risk as a single, complex, but ultimately manageable challenge.

For organizations serious about bending their cost curve and improving member health, the next era of strategy won’t be “programs for conditions.” It will be solutions for cardiometabolic risk, designed, measured, and managed holistically. If you are interested in building a strategy that works for your budget and your members, connect with Lark to learn more.