Becker’s Healthcare Podcast Strategies for Reducing the Total Cost of Care: Part 1
Mar 4, 2026
Mandy Leonard, Senior Director of Drug Use Policy and Formulary Management at Cleveland Clinic, draws on deep experience managing drug costs and health spending. She discusses the biggest drivers of rising healthcare costs. She covers chronic and multiple conditions, costly disease combinations, rare disease burdens, and domains of waste driving excess spending.
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U.S. Health Spending Outpaces Outcomes
- The U.S. spends more on health care than any other nation with healthcare at nearly 18% of GDP in 2023.
- Federal government pays for about one-third of expenditures while outcomes like life expectancy lag other countries.
Small Patient Segment Accounts For Huge Costs
- Aging and high utilizers drive a disproportionate share of costs; people 65+ are growing as a share of the population.
- Just 5% of the population accounts for nearly half of all healthcare spending, concentrated among older adults and those with serious chronic illness.
Chronic Conditions Drive Most Spending
- Chronic and mental health conditions dominate spending, responsible for about 90% of U.S. healthcare expenditures.
- Around 60% of Americans have at least one chronic disease and they account for most hospitalizations and prescriptions.