The $290 Billion Problem Healthcare Forgot to Fix

Despite causing an estimated 125,000 avoidable deaths each year and $100 billion annually in preventable health care costs, medication nonadherence is barely on the radar of most practicing physicians. Adherence rates for most medications for chronic conditions such as diabetes and hypertension usually fall in the 50% to 60% range, even with patients who have good insurance and drug benefits (1).

The gap between what doctors prescribe and what patients actually do is one of the most significant barriers to better health. That's where a holistic care coordination and management (CCM) plan makes a real difference.

The Adherence Problem

It's not that the patient doesn't care about getting better. The barriers are often invisible to healthcare providers: forgetfulness, confusion about instructions, cost of medications, difficulty obtaining equipment, lack of transportation, competing priorities at home, or simply not understanding why a particular step matters.

Research consistently shows that poor medication adherence alone accounts for nearly 125,000 deaths per year in the U.S. and costs the healthcare system more than $290 billion annually in avoidable medical expenses. When patients don't take their medications or don't follow their care plan, their conditions worsen, they end up in the emergency room, and they wonder why their doctor's treatment isn't working — when the real issue is that the plan was never fully implemented (1).

How Holistic Care Plans Bridge the Gap

A comprehensive holistic care plan goes far beyond a printed handout. It assigns a care coordinator (Care Pro) along with an RN case manager to you, your doctor, and your entire support system. It goes beyond just medication compliance. It provides a holistic framework for setting goals and planning for favorable health outcomes.

Ensuring Adherence

Your Care Pro doesn't just tell you to take your medications—they actively help you remember, understand why each drug matters, and troubleshoot barriers. If you're forgetting doses, they might help set up a pill organizer or reminder system. If a medication is unaffordable, they will help you navigate copay assistance programs or find generic alternatives. This ongoing accountability and support dramatically improve the odds that you'll actually stick with your plan.

Coordinating Multiple Providers

In addition to medication education and instruction, your wellness care team acts as the central hub. making sure all your providers know what you're taking, your goals, and how you're progressing. This prevents dangerous drug interactions, duplicate testing, and conflicting advice. As a holistic care program, not only are your medications monitored, but other providers and therapies may be brought in to help you achieve your wellness goals.

Education and Support

A Care Pro can refer you to an RN Care manager if you need education or evaluation for a possible specialist referral. This could include:

• Physical or occupational therapy, and assistive device instruction
• Diet and exercise guidance,
• Medication education,
• Pain relief through medication or other holistic means
• Sleep hygiene
• Instructions on how to use your blood pressure machine, glucometer, or other devices
• Post-hospital stay- when to call the doctor
• Mental and emotional health evaluation as needed
• Help with locating transportation, if needed.

Your Care Pro can help you find answers. You are not the passive patient waiting to get better-you actively participate in your health. Working as a team, you have someone who works with you to achieve the health goals you set for yourself.

Holistic Care vs. Standard Care

Standard Care Plan:

You leave your doctor's office with instructions. You're responsible for remembering everything, finding and paying for medications and equipment, scheduling follow ups, managing your own symptoms, and hoping you're doing it right. If something goes wrong and you call the office, hoping someone will call you back.

Holistic Care Plan:

A dedicated care team meets with you regularly, checks in on your progress, helps you problem solve barriers, and communicates with all your healthcare providers. They make sure you have what you need—whether that's a medical device, a prescription refill, or a ride to your appointment.

The Outcome: You Actually Get Better

When patients have proper support and coordination, adherence rates jump dramatically. Studies show that patients in care coordination programs are significantly more likely to take their medications as prescribed, attend their appointments, and achieve their health goals.

That means:

• Better control of chronic conditions like diabetes, hypertension, and heart disease (2)
• Fewer emergency room visits and hospitalizations (3)
• Faster recovery from acute illnesses (4)
• Improved quality of life and energy (5)
• Lower healthcare costs (because you're staying out of the hospital) (6)

The Bottom Line

You don't have to white-knuckle your way through your health goals alone. A holistic care plan acknowledges that getting better requires more than just a prescription — it requires someone in your corner, helping you navigate the real-world obstacles that stand between your doctor's good intentions and your actual recovery.

Wellness Care Is Life-Changing, Literally

Wellness Care is designed to optimize your health. Through active collaboration with your Care Pro, you are the one in control of your health and goals.

References

1. McKinsey & Company. (2018, December 13). Improving patient adherence through data-driven insights. Retrieved from https://www.mckinsey.com/industries/life-sciences/our-insights/improving-patient-adherence-through-data-driven-insights
2. Sia, C. H., Krishnamoorthy, S., Zheng, H., Tan, C. H., Tan, B. Y. Q., Chan, M. Y. Y., & Richards, A. M. (2024). The effects of multidisciplinary collaborative care on cardiovascular risk factors among patients with diabetes in primary care. Primary Care Diabetes, 18(1), 35–42
3. Sokol, M. C., McLaughlin, T. J., Rusek, M. B., & Verbrugge, R. R. (2005). Impact of medication adherence on hospitalization risk and healthcare cost. Medical Care, 43(6), 521–530.
4. Naylor, M. D., Brooten, D., Campbell, R., Jacobsen, B. S., Mezey, M. D., Pauley, M. V., & Schwartz, J. S. (1999). Comprehensive discharge planning and home follow-up of hospitalized elders: A randomized clinical trial. Journal of the American Medical Association, 281(7), 613–620
5. Lorig, K. R., Ritter, P., Stewart, A. L., Sobel, D. S., Brown, B. W., Bandura, A., Gonzalez, V. M., Laurent, D. D., & Holman, H. R. (2001). Chronic disease self-management program: 2-year health status and health care utilization outcomes. Medical Care, 39(11), 1217–1223
6. Roebuck, M. C., Liberman, J. N., Gemmill-Toyama, M., & Brennan, T. A. (2011). Medication adherence leads to lower health care use and costs despite increased drug spending. Health Affairs, 30(1), 91–99

Written by Brooke Lounsbury