Category Archives: Chronic care

Detecting and treating hepatitis C

The House Oversight and Government Reform Committee yesterday considered a bill to improve detection and treatment of hepatitis C. Here is an excerpt from the testimony of Louisiana congressman Bill Cassidy:

While new HCV infections have declined over the past two decades, there are at least 3 million Americans with chronic HCV. According to the 2009 Milliman Report, Consequences of Hepatitis C Virus: Cost of a Baby Boomer Epidemic of Liver Disease, most of our infected population are baby boomers.

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Minimizing the economic burden of type 2 diabetes

We blogged previously about a new diabetes study that is now available in its entirety. The study, “Improved Management Can Help Reduce the Economic Burden of Type 2 Diabetes: A 20-year Actuarial Projection,” indicates that a 50% improvement in diabetes management and control will have immediate and longer-term implications, including:

  • A reduction in diabetes-associated deaths by 49,000
  • A reduction in diabetes-associated complications by 239,000
  • Annual cost reductions of $196 billion (in 2031 dollars)

Read the full study here.

The risk to Baby Boomers that no one is thinking about

Baby Boomers already have plenty to think about. Recent research into Hepatitis C adds a few significant concerns to the list:

  • Two out of three cases of chronic hepatitis C virus (HCV) are among Baby Boomers
  • Only 22% of those infected with HCV are diagnosed
  • Long-term consequences of HCV include cirrhosis, liver cancer, and liver failure


The financial implications of these dynamics could become significant: the cost of treating advanced liver disease in HCV patients could reach $85 billion annually in the next two decades, according to the study. As many people focus attention on how to reduce the cost of healthcare, lurking risks like these demonstrate the difficulty in solving the healthcare affordability challenge.

Mental health and the ER

A report out of Texas indicates that nine patients in the Austin area accounted for 2678 emergency room visits at a cost of $3 million during the past six years. The causes were not always certain, though seven of the nine have a mental health diagnosis. One doctor at least thinks these diagnoses explain some of the ER visits.

Dr. Christopher Ziebell of University Medical Center at Brackenridge sees many people in the ER who aren’t having emergencies. With mental illness, he said, ‘a lot of anxiety manifests as chest pain.’

We know that mental health, when not treated properly, can be quite expensive. Mental health parity expert Steve Melek has testified before Congress and conducted research on how mental health can pair with other chronic conditions in highly-expensive comorbidities. The recent passage of mental health parity legislation may help mend fractures in care among the insured. But confronting this problem among the uninsured remains a thorny issue.