The Cost for a Patient with One Chronic Condition Was Nearly Double That for a Patient with No Chronic Conditions

High Cholesterol Was the Most Common of 44 Chronic Conditions Studied

NEW YORK, Feb. 2, 2026 /PRNewswire/ -- The majority (57.5 percent) of commercially insured patients had at least one chronic condition in 2024. The average allowed amount¹ for a patient with no chronic conditions was $1,590, while the average allowed amount for a patient with one chronic condition was nearly double ($3,039). Of 44 common chronic conditions studied, hyperlipidemia, or high cholesterol, was the most common, with a crude prevalence² of 21.2 percent. These and other findings are reported in a FAIR Health white paper released today: Chronic Conditions in the United States: A Study of Commercial Claims.

Chronic diseases or conditions are the leading cause of illness, disability and death in the United States. FAIR Health Atlas, an epidemiological reporting platform to be launched in 2026, uses FAIR Health's repository of commercial healthcare claim records—the largest in the nation—to measure prevalence and costs associated with chronic conditions. This study of common chronic conditions in the commercially insured population in the United States in 2024 draws on that platform. The study focuses on prevalence, co-occurring conditions, costs, geography and correlation of prevalence rates to the poverty rate. The key findings, all from 2024, include the following:

• Many patients had more than one chronic condition. For example, 11.5 percent of patients had two conditions, and 9.1 percent had three.
• Some chronic conditions frequently co-occur. In the commercially insured population, 33.4 percent of patients had hyperlipidemia, hypertension, obesity or some combination of these, and 4.3 percent had all three.³ Half the patients with any one of these conditions had more than one.
• The number of chronic conditions per commercially insured patient per year drives healthcare spending. The average allowed amount rose per number of chronic conditions, reaching $21,730 for 10 or more chronic conditions—13.7 times higher than for a patient with no chronic conditions.
• Chronic conditions vary in their median and average number of co-occurring chronic conditions and average allowed amount per year. Of the 44 chronic conditions studied in the commercially insured population, lung cancer had the highest average allowed amount per year ($22,740) and ADHD the lowest ($4,175).⁴ Acute myocardial infarction, non-Alzheimer's dementia and Alzheimer's disease had the highest median number of comorbidities (six) and pneumonia and autism the lowest (one). Acute myocardial infarction had the highest average number of co-occurring chronic conditions (6.19) and autism the lowest (1.63).
• When analyzed in pairs, the crude prevalence rates of hypertension, hyperlipidemia, obesity and diabetes⁵ had a moderate to strong positive correlation.⁶ The prevalence rates of hypertension and diabetes had the strongest positive correlation (86.0 percent); those of obesity and hyperlipidemia had the weakest (45.0 percent).
• Some clusters of chronic conditions—such as the cluster of hypertension, diabetes, obesity, chronic kidney disease and hyperlipidemia—are more strongly correlated to the poverty rate than others. The prevalence rates of all of the conditions in the cluster just mentioned had a positive correlation to the county-level poverty rate. By contrast, the cancers studied all had negative correlations to the poverty rate, with breast cancer showing a -24.3 percent correlation.

The findings in this report have implications for stakeholders across the healthcare spectrum, including patients, providers, payors, policy makers and researchers. The report also demonstrates some of the capabilities of the forthcoming FAIR Health Atlas on which it is based. Among those capabilities are measuring chronic condition prevalence, comorbidities and costs in the commercially insured population; mapping the prevalence of chronic conditions; using correlations to measure how closely chronic condition prevalence rates are related; and using correlations to measure how closely chronic conditions are related to risk factors such as poverty.

For the complete white paper, click here.

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About FAIR Health
FAIR Health's mission is to supply objective, unbiased information for all stakeholders to improve healthcare quality, access and affordability. It holds the nation's largest collection of commercial healthcare claims data, which is growing at a rate of about four billion claim records a year. A national Qualified Entity certified by CMS, FAIR Health also receives all claims for individuals enrolled in traditional Medicare Parts A, B and D. As a testament to its reliability and objectivity, FAIR Health's data products—including pricing benchmarks and custom analytics—are widely used by commercial insurers and self-insurers, providers, hospitals and healthcare systems, government, researchers and more. FAIR Health has been designated an official data source for state health programs, including workers' compensation and personal injury protection (PIP) programs, and surprise billing laws that protect consumers. FAIR Health's free consumer website and mobile app, available in English and Spanish, enable consumers to estimate and plan for their healthcare expenses and offer a rich educational platform on health insurance. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger's Personal Finance. FAIR Health is a national, 501(c)(3) nonprofit organization. For more information on FAIR Health, visit fairhealth.org.

Contact:
Rachel Kent
Executive Director of Communications and Marketing
FAIR Health
646-396-0795
rkent@fairhealth.org

¹ An allowed amount (also known as an eligible expense) is the maximum amount an insurance plan will pay for a covered healthcare service before application of deductibles or coinsurance. This study includes both in- and out-of-network allowed amounts.
² Crude prevalence is the proportion of the commercially insured population receiving medical services who had a specific condition at a given time, not adjusted for factors such as age and gender.
³ Patients can have additional chronic conditions beyond these three.
⁴ The average allowed amount for a condition, such as lung cancer, is based on the overall spending for all the treatments received by patients with that condition, not just spending for the individual condition.
⁵ "Diabetes" in this paper includes both type 1 and type 2 diabetes.
⁶ A correlation is positive when one variable increases as the other increases; it is negative when one decreases as the other increases. In this paper, a correlation is regarded as strong if it is 60 percent or higher in either the positive or negative direction, moderate if it is 40 to 59 percent and weak if it is 39 percent or lower. Complete absence of correlation is zero percent.

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SOURCE FAIR Health