The $55,087 Backache


It costs an average of $55,087 a year to care for the sickest Americans who have a backache or some other injury affecting the body’s structure of muscles, joints, and bones. That is according to data compiled by HCMS Group on 3.5 million people, and the total is more than 100 times the cost for treating similar conditions among the healthiest Americans.

Why? It’s because people in that part of the population typically struggle with multiple conditions that complicate treatment, HCMS research shows. (See earlier blog post). This group amounts to about 5 percent of Americans, and yet they account for half the medical spending. By contrast, the healthiest group includes 50 percent of the population and spends relatively little on health care. (See overview of population risk analysis).

Figure 3 contrasts the expense of treating musculoskeletal situations with spending on all other conditions. The population is broken into groups based on where they rank in total costs of all medical treatment.

Figure 3: Average Annual Cost for Musculoskeletal and other Conditions, by Spending Group

Further analysis of the data shows that the risk of back or other muscular and skeletal problems is also much higher among the 5 percent who are the least healthy. HCMS Group’s proprietary Human Capital Risk Index®, or HUI, takes into account more than 100 characteristics for each person, including diagnoses, use of medical care, drug prescriptions, and claims for disability and worker’s compensation. A score of 1.0 represents the average risk of the population as a whole.

In Figure 4, the risk of musculoskeletal problems among the sickest group is four times as high as among the healthiest. Across all four groups, the risk of having this kind of condition exceeds that of all other illnesses combined.

Bottom-line takeaway: The difference between a $500 and a $55,087 backache lies in who has it and what other conditions affect that person. The research findings show that healthcare programs need to be designed around holistic primary and preventive care centered on individuals. The programs should also incorporate a tool for identifying those most at risk—the comprehensive HUI score—and a system for helping these individuals to prevent, manage, and recover from their conditions.

Figure 4: Human Capital Risk Index® (HUI) Score for Musculoskeletal and Other Conditions, by Spending Group


— Robert L. Simison, HCMS Communications

On behalf of HCMS Data Analytics



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