Navigating the rising tide of cardiovascular disease

Cardiovascular disease (CVD) isn’t just a leading cause of death, it’s quickly becoming one of the biggest financial risk factors to U.S. health plans. That means insurers face growing pressures to contain spending without sacrificing quality or provider relationships.

The American Heart Association estimates that cardiovascular disease could cost nearly $1.8 trillion by 2050  — almost three times more than today. The good news? Evidence highlights effective strategies that can improve cardiovascular health, lower expenses, and strengthen how stakeholders work together. Keep reading to explore key trends, rethink traditional approaches, and discover evidenced-based approaches to help health plans take control of cardiovascular care.

A growing trend with growing impact

Cardiovascular disease already accounts for significant health care spending. Costs in the U.S. alone are projected to nearly triple by 2050. By that time, about 184 million U.S. adults (roughly 61% of the adult population)  are expected to have some form of cardiovascular disease. Direct medical spending alone could increase from roughly $393 billion today to about $1.8 trillion annually by mid-century.

Several demographic and lifestyle trends are accelerating this path:

• An aging population: An aging American population is expected to drive substantial increases in cardiovascular disease.
• Lifestyle factors: Obesity, hypertension, diabetes, and sedentary behaviors increase cardiovascular risks.
• High-cost treatments: Innovative cardiovascular therapies promise meaningful outcomes but add significant costs, complicating resource allocation decisions.

Recent developments in therapeutic interventions, notably GLP-1 receptor agonists such as semaglutide and tirzepatide, show the potential for innovative treatments to change cardiovascular care. These medications have demonstrated up to a 13% reduction in major cardiovascular events , highlighting their role beyond diabetes management and weight loss. However, challenges remain in ensuring consistent clinical adherence and appropriate utilization.
 

Driving better outcomes with evidence

In large randomized trials, statins have been shown to reduce mortality and major adverse cardiovascular events , particularly in patients with established vascular disease. Yet fewer than half of patients remain on statin therapy  one year after diagnosis of vascular disease. This underscores significant adherence challenges and demonstrates the need for a more coordinated approach to effective interventions.

Health plans that include collaborative, evidence-based strategies can see significant benefits. By fostering more open communication between clinicians, patients, payers, and using data and digital tools, organizations can better overcome challenges to treatment use and adherence. This teamwork improves patient care and outcomes. It promotes a value-focused culture by supporting smarter use of resources, greater patient satisfaction, and a more sustainable healthcare system.

Evidence-based strategies to manage cardiovascular disease — focused on appropriate care, patient needs, and smart use of both new and the re-evaluation of existing treatments — are more effective than traditional approaches. Instead of just cutting costs in the short term, such strategies aim to improve care quality, health outcomes, and long-term savings.
 

Shared goals, shared responsibilities

To effectively reduce cardiovascular disease, different groups need to work together. Here’s how each one can play a meaningful role, based on the latest evidence and best practices:

Patients and caregivers
Make it easier for people to live healthier lives by offering simple, personalized resources, like tips on eating better, staying active, quitting smoking, and taking medications as prescribed. Engaging family members, community-based organizations, and peer networks can greatly enhance social support and reduce barriers to behavior change, fostering patient-centered care models. Health plans, providers, employers, and policymakers all have a key role to play in creating a supportive system that helps members stick with healthier habits.

Providers
Use the many highly beneficial interventions for prevention and treatment that exist but aren’t used often. Using decision-support tools and streamlined workflows can help focus on the most effective, high-value care, and avoid treatments that offer little benefit or come at a high cost. By consistently adopting and applying guideline-directed cardiovascular prevention and treatment, informed by updates such as the cholesterol management and primary prevention standards, improved outcomes can be achieved by following  the latest heart health guidelines, like those for cholesterol and prevention.

Health plans
Work more closely with providers to streamline utilization review, build mutual understanding and alignment around care goals, and reduce unnecessary administrative friction. This can help promote the use of evidence-based treatments that improve health outcomes. Making care easier to access and focusing on results-oriented treatments helps support both patients and providers. This is especially important for marginalized groups and populations.

Employers
Invest in wellness programs that improve heart health and reduce costs. A recent study showed the University of Rochester’s program cut cardiovascular risks  and saved $1,224 per person, with a nearly 5-to-1 return. Employer programs have been shown to help improve blood pressure, cholesterol, weight, and physical activity. Improving workplace factors such as hours, reducing stress, and creating a healthier workplace culture can boost heart health and productivity. Also, employers can support healthcare improvement by encouraging value-based care and matching health benefits with provider incentives.

Policymakers
Put policies in place that support healthier environments, like funding for programs that bring nutritious food to underserved communities. Adapt urban areas to encourage active movement such as walking and biking to help improve heart health. Promote advocacy-driven policy interventions to reduce tobacco use and restrict trans fats from the food supply to effectively reduce population-level CVD risks.
 

Partnering for long-term stability

As cardiovascular disease continues to rise, it's clear that working together and using proven strategies is key. Organizations that use advanced data tools, build strong partnerships, and adopt new treatments wisely will be better equipped to manage both health outcomes and costs. Focusing on long-term outcomes, teamwork, and data-driven care helps organizations deliver better results for overall health.
 

Moving forward

The evolving challenges of cardiovascular disease management demand fresh strategies built on evidence, collaboration, and innovation. Health plans prepared to lead these efforts can achieve improved member health, provider relationships, and financial sustainability.

Visit carelon.com to learn how we’re helping health plans manage the rising complexity of cardiovascular disease, or connect with our team.