While the human cost of chronic illness may be the primary concern for patients and providers, the financial burden is another crucial consideration — not just for patients and their families, but also for insurers, employers, and healthcare systems as a whole.
When it comes to reducing health care costs, prevention is key. And for those already living with chronic conditions, targeted, high-impact chronic care solutions that minimize or even reverse disease progression offer a way to curb excessive healthcare spending.
Here, we’ll explore how a new approach to lifestyle medicine — behavioral nutrition counseling — can help patients build lasting habits that not only improve their health and wellbeing, but also ease the economic burden associated with chronic disease. With these behavior-focused nutritional interventions, individuals, organizations, and public programs alike can shift away from reactive treatment models towards preventive, whole-person healthcare.
Unpacking the cost of chronic disease
The Centers for Disease Control and Prevention (CDC) reports that chronic conditions account for 90% of the nation’s annual health care expenditures, or more than $4 trillion. These costs span every part of the healthcare system, including:
- Prescription medications to manage symptoms and prevent complications
- Office visits for ongoing diagnostics, monitoring, and referrals
- Hospitalizations and emergency care due to disease progression or acute events
- Medical devices and durable equipment like glucose monitors, CPAP machines, or mobility aids
- Home health services for patients with limited mobility or advanced illness
- Long-term care for chronic and degenerative conditions
- Administrative costs tied to claims, authorizations, and care coordination
But it’s not just the upfront costs of healthcare that take a toll. Lost productivity, absenteeism, and increased reliance on social services also create an economic burden, as people with chronic disease are often limited in their ability to fully participate in school or at work.
These healthcare and opportunity costs strain families, communities, and the economy as a whole, with individuals, insurers, employers, and government agencies all absorbing the impact in different ways.
Who bears the cost of chronic disease?
Chronic disease doesn’t just affect the individual: families and caregivers, employers, community programs, insurers, and state and federal agencies are also stretched thin by the financial and logistical strain associated with these conditions.
- Individuals and families face high out-of-pocket costs for doctor visits, prescriptions, and medical equipment, as well as lost income from missed work or early retirement. Even with good health coverage, deductibles, copays, and non-covered services can add up to thousands of dollars per year.
- Employers may experience increased absenteeism, reduced productivity, and higher health insurance premiums, as well as higher workforce churn due to health-related job loss. According to 2023 data from UnitedHealthcare, chronic conditions account for 29% of employer healthcare spending.
- Insurers bear much of the cost of healthcare in the United States, and must also contend with the added administrative load associated with managing more complex claims. Private health insurance spending accounted for about 30% of all U.S. healthcare expenditures in 2023, with much of that driven by the enormous cost of managing chronic conditions.
- Local, state, and federal governments carry a substantial share of the burden — not just through healthcare systems, but also social programs. National survey data reveals a clear link between chronic disease and social service utilization: Those with chronic illnesses are significantly more likely to participate in SNAP, transportation assistance, or other support programs.
Given the scale and complexity of chronic disease across the healthcare and economic landscape, effective prevention and disease management is a critical consideration for stakeholders at every level.
Targeting habits, not just symptoms: A behavioral approach to prevention & chronic care
Heart disease, obesity, and diabetes are among the most prevalent chronic conditions in the U.S., and are closely linked to modifiable health behaviors. Even conditions not always thought of as lifestyle-driven (e.g. cancer, arthritis, and Alzheimer’s) can be influenced by behavioral factors like diet, physical activity, alcohol use, and tobacco exposure.
Given the critical importance of lifestyle in both preventing and managing these conditions, stakeholders in healthcare must consider how to invest in holistic interventions that support long-term adoption of positive health behaviors: Treatments that center exercise, healthy eating, sleep hygiene, and stress reduction can yield sustainable improvements at the individual and population level, ultimately leading to reduced healthcare spending.
One such intervention — behavioral nutrition counseling — is gaining popularity as a way to bridge the gap between these daily habits and long-term health outcomes. By addressing the psychological factors that influence dietary choices and behavior patterns, it goes beyond the scope of traditional dietetics to help patients create habits that support long-term health and reduce reliance on short-term fixes.
Understanding behavioral nutrition counseling
Behavioral nutrition counseling is a new approach to dietetics that combines nutritional guidance with behavioral therapy. Practitioners are registered dietitians trained in evidence-based therapeutic techniques like cognitive-behavioral therapy, motivational interviewing, and interpersonal psychotherapy.
These therapeutic modalities are well-supported by research for treating binge eating and related concerns, and can also help support non-food related lifestyle changes (e.g. exercise, sleep hygiene, smoking cessation, or alcohol moderation). Here’s how it works in practice:
- Identifying patterns and triggers that influence eating habits, such as stress, emotions, or social situations
- Educating the patient on macronutrient balance, portion control, and meal timing
- Exploring thoughts and beliefs around food, body image, and self-control
- Setting realistic, achievable goals tied to nutrition, activity, and behavior change
- Building coping strategies to manage cravings, emotional eating, and setbacks
- Developing self-monitoring tools like food journals, habit tracking, or reflection exercises
- Supporting non-food behaviors like improving sleep routines, increasing physical activity, or reducing alcohol and tobacco use
- Fostering a healthier relationship with food through mindful eating and self-compassion techniques
From outcomes to savings: Why behavioral nutrition counseling works
For healthcare stakeholders, investing in interventions that help patients stay engaged in self-care can help them better manage and prevent complications from chronic disease; in some cases, patients may even reverse disease progression or avoid it altogether. These outcomes can mean significant reductions in long-term healthcare spending and system strain.
Behavior change & clinical outcomes
By addressing the psychological processes that shape daily habits, behavioral nutrition counseling can help patients build the kinds of skills and routines that move the needle on long-term disease outcomes.
Small shifts in daily behavior — such as preparing meals at home, reducing sugar intake, or taking an evening walk — can compound over time. As patients feel better and achieve their health goals, they build self-efficacy in taking control of their health, paving the way for better disease management, fewer complications, and reduced healthcare utilization.
Economic impact
Ultimately, the positive outcomes associated with lifestyle-focused interventions translate to major time and cost savings for providers, payers, and even employers.
Improved patient self-management reduces the burden on healthcare providers by decreasing unnecessary visits and acute care needs, while insurers benefit from fewer high-cost claims and better resource utilization. For employers, healthier employees mean reduced absenteeism, improved productivity, and lower long-term health insurance premiums.
Integration & scalability
Behavioral nutrition counseling can be easily integrated into existing chronic disease prevention and management models using simple referral systems and virtual delivery models.
Services like Everlong, for example, make it easy for patients to access behavioral nutrition care while also streamlining the referral process for PCPs, case managers, and care coordinators. Insurers can easily add this service to existing weight management coverage, such as for members using GLP-1 medications. Because this intervention is delivered by credentialed, billable providers (registered dietitians), it fits nicely into existing healthcare structures.
Takeaway
Behavioral nutrition counseling is not just an effective way to improve patient outcomes — it’s a scalable solution for healthcare stakeholders seeking to minimize long-term healthcare costs. Employers, insurers, and public health agencies alike can benefit from integrating behavior-focused dietetics into existing care models, enabling scalable, population-wide preventive care.
With specialized behavioral nutrition providers like Everlong, you can connect patients with highly-trained registered dietitians equipped to deliver tailored strategies that lead to meaningful habit change and improved health. To take the next step, read more about Everlong’s behavioral nutrition services — or refer a patient in just a few clicks.
