How Cardiometabolic Condition Management Impacts Employer Healthcare Spend

In today’s employer-sponsored health systems, the costs of chronic conditions are among the heaviest burdens. Among these, cardiometabolic conditions—obesity, hypertension, diabetes, cholesterol, and heart disease—are rising in prevalence, complexity, and cost. Employers that don’t actively manage cardiometabolic risk face escalating claims and increased long-term spending from linked conditions like certain cancers that amplify long-term spend. Cardiometabolic condition management is central to controlling employer healthcare expenditure.

The scale of the problem

Chronic diseases dominate U.S. healthcare spending. The CDC states that 90% of the nation’s $4.9 trillion in annual health care expenditures are for people with chronic and mental health conditions. 

Within that, diabetes is a significant contributor to overall cost and often an indicator of likely comorbidities. In 2022, the American Diabetes Association reported the total economic cost of diagnosed diabetes was estimated at $412.9 billion, including $306.6 billion in direct medical costs and $106.3 billion in indirect costs (lost productivity, disability, premature death). On average, a person with diabetes incurs $19,736 annually in medical expenditures, about 2.6× higher than someone without diabetes. 

https://pmc.ncbi.nlm.nih.gov/articles/PMC9633402/?utm_source=lark

From an employer’s perspective, one study found that employees with type 2 diabetes (T2D) had medical costs of about $11,354 per year, compared to $5,101 for non-diabetics, demonstrating roughly ~$6,000 in additional healthcare spend per member. In addition to hard costs, these members often have higher rates of absenteeism, pushing the total per-employee employer cost even higher. 

https://www.fiercehealthcare.com/payers/heres-how-much-diabetes-costs-employers-each-year?utm_source=lark

Diabetes impact on healthcare costs shows no signs of slowing down with Nomi Health reporting diabetics’ care costs are rising ~20% year over year, with per-member costs topping $20,000 in some employer populations.  Diabetes patients with comorbidities had average costs of $68,325 in one data set, more than double the base diabetic spend. 

Importantly, diabetes rarely occurs in isolation: the metabolic dysfunction, chronic inflammation, and vascular damage that accompany it often overlap with cancer risks and other high-cost cardiometabolic conditions. Obesity and insulin resistance are established risk factors for certain cancers, including colorectal, breast, and pancreatic. When multiple chronic conditions intersect, the financial liability multiplies and most importantly, the well-being and health of members suffers significantly. 

Cardiometabolic conditions are a major risk factor for your members’ health that morph into costly clinical crises, including cancers and cardiovascular events.

How cardiometabolic risk drives cost escalation over time

Let’s break down some of the ways cardiometabolic conditions are impacting employers’ healthcare spend:

1. Medication and supply costs

After diagnosis, most members require long-term medication to manage glucose, hypertension, weight, and other related therapies. One published model found that approximately 17% of direct diabetes-related costs stem from medications and supplies. Recently, GLP-1s have grown in demand for both diabetes and obesity, contributing to significant increases in the cost of medication for both conditions. 

2. Complications and comorbid conditions

The downstream complications of poor metabolic health—kidney disease, heart disease, stroke, and even some cancers—account for a substantial share of lifetime cost. The CDC notes that 48–64% of lifetime medical costs for a person with diabetes relate to complications (heart disease, stroke, etc.).  Among Medicare beneficiaries, in 2017 diabetes complications cost more than $37 billion, providing a glimpse into the impact on one population, which is likely even higher when examining broader, privately insured populations. 

3. Productivity loss, absenteeism, presenteeism

Beyond direct medical claims, employers absorb indirect costs. Because chronic disease affects energy, cognitive function, stress, and comorbidity burden, and presenteeism (working while impaired) can be even more expensive than outright absences, while also taking a toll on your members' overall happiness and well-being. 

4. Rising utilization and trend compounding

Cardiometabolic conditions require more frequent monitoring, imaging, specialist care, as well as  potential hospitalizations and emergency visits. Over time, this utilization compounds. Employers find that claims trends for metabolic disease populations often outpace the overall plan trend.

5. Risk crossover to cancer and complex disease

Because metabolic dysregulation shares pathways with oncogenesis, the process of how normal cells evolve into cancer cells, populations with poor metabolic health may drift into high-cost cancer care. Cancer therapies often carry six- or seven-figure price tags along with taxing side effects for the member. Employers who struggle to manage metabolic risk are at potentially high risk of developing cancer diagnoses, which further compromise their overall health.

The role of diabetes management companies and integrated cardiometabolic management

Many employers turn to specialized cardiometabolic and diabetes management programs to mitigate the growing risk. Specialized vendors or platform partners combine coaching, remote monitoring, behavior change, analytics, and clinical oversight to intervene early and sustain control.

A 2023 review found that employer-sponsored interventions targeting cardiovascular and metabolic conditions show promise in reducing risk factors.  Other meta-analyses of workplace wellness programs showed average reductions of ~26% in healthcare costs and ~28% in sick leave absenteeism. 

One real-world example: the University of Rochester Medicine Center for Employee Wellness program, targeted at cardiovascular risk, achieved a $1,224 per-member cost reduction and a 4.9:1 ROI while improving risk categories for nearly half of participants. 

Key advantages of using a specialist vendor include:

• Scale and expertise in disease-specific support and education
• Technology and real-time monitoring, glucose, weight, and blood pressure
• Behavioral and coaching support tailored for member preferences, dietary restrictions, and medication
• Data integration and risk stratification to focus interventions
• Vendor accountability with performance-based contracting 

However, not all programs deliver ROI equally. The best results arise when vendor services integrate tightly with the employer’s pharmacy plan, health benefits, and wellness ecosystem, not as a siloed add-on.

Employer actions: Four levers to control chronic condition costs

To maximize impact, employers should deploy a layered, strategic approach:

1. Risk stratification and predictive analytics

Use claims and biometric data to segment your population into low, medium, and high cardiometabolic risk. Partner with your health plan or PBM to deploy programs and interventions to support members at each stage of need.

2. Tiered and outcome-based vendor selection

Work with vendors to develop an outcomes-based plan and ensure you understand what they are able to deliver for your members.

3. Integrate with wellness, care navigation, and site-of-care controls

Embed cardiometabolic management into your broader wellness and navigation programs. Explore centers of excellence to guide high-risk members to cost-effective, high-quality sites. Monitor and be aware of facility fee inflation, especially when managing complications.

4. Measure, iterate, and scale

Establish and track KPIs: clinical, utilization, cost trends, and engagement. Use regular feedback loops with vendors to optimize resources and communicate expectations.Over time, you can elect to re-invest savings for compounding outcomes. 

Expected impact: From dollars to culture

A strong cardiometabolic strategy yields:

• Slower growth of total medical and pharmacy spend
• Lower incidence of expensive complications — dialysis, amputations, cardiovascular events
• Better predictability of claim trends
• Improved employee productivity, morale, retention, and brand reputation
• Tangible ROI—often in the 3× to 5× range for well-designed programs

Important Considerations for Employers

Engagement is hard — Sustaining long-term participation and adherence is a major obstacle in chronic condition management programs. Expect lulls in engagement and work with vendors for a proactive plan to address.

Vendor fragmentation — Too many point solutions can create silos and prevent a unified cardiometabolic strategy. Focus on vendors who support the members in managing all of their conditions. 

Upfront investment vs. delayed ROI — A significant portion of savings occurs years later. Employers must be willing to invest with long-term strategy in mind before returns fully materialize.

Data integration and privacy — To be effective, these programs often require tight integration with claims, EHR, wellness, and biometric systems. Ensure you have access to critical data and work with vendors to manage data safely and securely.  

Equity and access — Programs must consider socioeconomic, racial, and access disparities in how members engage with digital coaching, remote monitoring, and telehealth. This is where employers should focus on digital solutions that are available and scalable to all members. 

Cardiometabolic conditions form a key backbone of rising chronic condition costs. When unmanaged, they escalate into complications, comorbidities, and productivity losses that compound year over year. Diabetes management companies and cardiometabolic vendor programs offer powerful tools, when aligned with benefits, incentives, navigation, and analytics.

For employers serious about controlling long-term spend, the imperative is clear: proactive, integrated, outcomes-based cardiometabolic condition management is essential. If you are interested in making more effective cardiometabolic management part of your strategy, Lark can help. Schedule a demo to learn more.