A closer look at five key factors shaping health care costs, and how they highlight the need for greater alignment across the health care system.

For clinicians, the affordability challenge is visible every day: more patients are living longer with multiple chronic conditions, and the clinical complexity of managing that care is increasing. While conversations about rising costs often focus on assigning responsibility, the bigger reality is that health care spending is being driven by multiple pressures across the system.

The five primary drivers of rising health care costs

A new research paper by Cigna Healthcare identifies five forces that consistently account for rising costs across employer-sponsored health coverage.

1. Chronic diseases are rising among working-age adults and people are living longer, raising the baseline demand for health care.
2. Hospital cost pressures, pricing dynamics, and consolidation are reshaping market dynamics.
3. Drug pricing, limited competition, and advertising fuel high‑cost demand.
4. Health care workforce shortages and changes in physician ownership are increasing costs.
5. Fragmentation and complexity create waste and absorb value across the system.

At the center of these trends is the rise in chronic disease. More patients are living longer with one or more chronic conditions, and younger adults are increasingly affected. For providers, this means greater demand for ongoing, coordinated care; increased need for proactive management and prevention strategies; and more opportunities to support patients earlier in their care journey.

The remaining drivers all amplify this trend. As chronic disease rises, higher hospital and drug costs, workforce shortages, and system fragmentation make care more expensive, harder to access, and more difficult to coordinate – intensifying affordability challenges across the system.

Moving forward together

While each trend impacts the system differently, together they influence patient demand, care delivery decisions, and the day-to-day realities of practicing medicine. These trends also contribute to the affordability challenges facing employers, patients, and clinicians.

Improving health care affordability requires collaboration across the system. Providers, health plans, employers, and policymakers each play a role in shaping a more connected, efficient care experience.

Efforts to reduce administrative burden, improve coordination, and support earlier intervention can help make care more accessible and predictable, both for providers and the patients they serve.

Read the full whitepaper to better understand the key forces impacting health care affordability, “Understanding the health care affordability challenge.”

For additional Cigna Healthcare resources and tools to help your patients with chronic conditions, as well as statistics on the connection between chronic health conditions and mental health, see “Coaching support for your patients with chronic conditions” and “How chronic conditions and mental health influence each other: What providers should know.”