According to the Centers for Disease Control and Prevention (CDC), roughly 194 million American adults—including 6 in 10 young adults, 8 in 10 at midlife, and 9 in 10 seniors—live with at least one chronic condition.
This growing challenge has far-reaching implications: When combined with mental health conditions, chronic illnesses drive the majority of U.S. death and disability and account for nearly 90% of the nation’s $5.3 trillion in annual healthcare spending.
Whether you’re a physician managing a mounting panel of complex patients, a health system leader planning capacity, or a life sciences team deciding where to invest R&D dollars, the rise of chronic diseases is remaking your landscape.
Here are three trends to watch in that space:
- The patient population is changing. Chronic disease is no longer primarily an issue of older adults; younger populations are increasingly affected, creating demand for new engagement strategies.
- Obesity therapeutics is entering a new era of innovation. GLP-1 therapies have reshaped obesity care, but their limitations are creating opportunities for next-generation treatments and broader applications.
- Payment models are catching up with digital care. CMS’s ACCESS Model represents a step toward integrating tech-enabled chronic disease management into Medicare reimbursement, expanding opportunities for digital health companies and tech-enabled providers.
Chronic conditions among U.S. adults, 2013 and 2023
Fig. 1 - Age-adjusted prevalence of multiple chronic conditions among U.S. adults, 2013 and 2023. Source: CDC analysis of BRFSS data.
The patient population is getting younger
The default framing for chronic disease has been an aging-population story, concentrated in older adults and driven by late-life conditions. That framing is true, but incomplete.
CDC data show an increase in chronic disease earlier in the life course. Among young adults aged 18 to 34, prevalence of at least one chronic condition rose from 52.5% in 2013 to 59.5% in 2023. Today, nearly 6 in 10 young adults are living with at least one chronic condition. Midlife adults also show a modest increase in chronic disease prevalence, rising from 76.5% to 78.4%, reinforcing that the burden is expanding across working-age populations.
Share of U.S. adults with at least one chronic condition by age group, 2013 and 2023
Fig. 2 – Prevalence of at least one chronic condition among U.S. adults by age group, 2013 and 2023. Source: CDC Behavioral Risk Factor Surveillance System (BRFSS), 2013 and 2023.
The pattern of disease also differs by life stage. Among young adults, the most common conditions are obesity (27.3%), depression (25.0%), and high cholesterol (16.3%), reflecting a mix of behavioral and early metabolic risk factors. Meanwhile, adults aged 65 and older show higher prevalence of long-established cardiometabolic and musculoskeletal conditions, including hypertension (61.4%), high cholesterol (55.1%), and arthritis (51.3%).
Chronic condition prevalence by age group, 2023
Fig. 3 – Prevalence of selected chronic conditions among U.S. adults by age group, 2023. Source: CDC Behavioral Risk Factor Surveillance System (BRFSS), 2023.
These aren’t patients who fit neatly into the care management models built for Medicare populations. They have different expectations around access (being digital-natives), different insurance profiles (more likely to be uninsured or rely on employer-sponsored or ACA marketplace coverage), and different engagement patterns (more episodic and less likely to maintain long-term relationships with a primary care provider).
For health systems, this means rethinking how chronic disease programs are delivered and how patients enter them. Many existing programs assume an ongoing relationship with a primary care provider, but younger adults are less likely to have one. Reaching younger patients may require expanding beyond traditional physician referrals by meeting them through consumer-facing channels like social media and other digital touchpoints. Caring for them may also require more flexible delivery models like virtual care.
For life sciences companies, earlier onsets have implications beyond market potential. Patients diagnosed in their 20s and 30s may spend decades managing chronic conditions, extending treatment journeys and increasing the importance of long-term adherence. Sponsors may also need to reconsider whether clinical development programs and commercial strategies reflect the changing age profile of the populations they hope to serve.
For digital health companies, younger adults with chronic conditions represent an important growth segment because they are more likely than older adults to use virtual care and other digital self-service tools like wearables. But reaching them requires knowing where they are and how they move through the health system.
Digital health use by generation, 2024
Fig. 4 – Digital health usage by generation. Note: Gen Z (ages 18–24), Millennial (ages 25–44), Gen X (ages 45–64), Baby Boomers (ages 65–74), Silent Generation (ages 75+). Source: Rock Health, “Screenagers to Silver Surfers: How Each Generation Clicks with Care,” Consumer Adoption of Digital Health Survey, 2025.
Obesity therapeutics enter a new era of innovation
Obesity affects roughly 42% of U.S. adults and is a leading contributor to the nation’s growing chronic disease burden, increasing the risk of diabetes, cardiovascular disease, certain cancers, and other metabolic disorders. For healthcare organizations, that burden isn’t evenly distributed. Obesity prevalence ranges from 35.9% in the Midwest and 34.5% in the South to about 30% in the Northeast and West, according to the CDC. But across regions, the trajectory is consistent: Obesity is on the rise.
Prevalence of obesity by U.S. state, 2024
Fig. 5 – State-level prevalence of obesity among U.S. adults, 2024. Note: Tennessee excluded due to insufficient data. Source: CDC Behavioral Risk Factor Surveillance System (BRFSS), 2024.
As rising obesity rates continue to drive demand for more effective interventions, GLP-1 therapies have moved to the center of obesity care. Today, 1 in 8 U.S. adults report taking a GLP-1 medication, such as Ozempic or Wegovy, for weight management or conditions like diabetes, according to a poll by KFF.
The rapid adoption of these therapies has also brought ongoing challenges into focus. While GLP-1s have delivered significant weight loss for many patients, outcomes can vary significantly, and some patients regain weight after treatment discontinuation. Adherence has proven difficult, too, with most patients discontinuing GLP-1 therapy within a year. Attention is also turning to the quality of weight loss, including the need to preserve lean muscle mass alongside reductions in fat.
These limitations are fueling the next generation of obesity treatments. Companies are developing therapies with new mechanisms of action, improved pharmacology, and more convenient delivery options such as long-acting and oral GLP-1 formulations. Recent launches, including Novo Nordisk’s oral Wegovy pill and Eli Lilly’s Foundayo, demonstrate growing competition in this space.
At the same time, expansion into related conditions like metabolic dysfunction-associated steatohepatitis (MASH) is helping reframe GLP-1s from weight-loss medications to critical therapies for chronic metabolic disease, strengthening the clinical value proposition while addressing payor skepticism and lingering stigma around obesity treatment.
Even so, innovation alone will not solve the broader access challenge. While federal policy has expanded access to GLP-1 therapies for eligible Medicare beneficiaries starting July 2026, many commercial insurers, employers, state Medicaid programs, and ACA marketplace plans have narrowed or eliminated coverage for weight-loss indications because of cost pressures. For many patients, coverage and affordability are key barriers to starting and staying on these therapies.
CMS ACCESS model opens a new pathway for tech-enabled chronic disease care
The next phase of chronic disease care will be shaped not only by therapeutic advances, but by the delivery models and payment structures needed to scale them across populations. CMS is testing that evolution through the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model, a new reimbursement approach designed to expand technology-supported chronic disease management within Medicare.
Launched in July 2026, the 10-year voluntary model will test outcomes-based payments for tech-enabled chronic disease management across four clinical areas:
- Early cardio-kidney-metabolic conditions (eCKM)
- Cardio-kidney-metabolic disease (CKM)
- Musculoskeletal conditions (MSK)
- Behavioral health
Nearly 200 participating organizations, including provider groups and health tech companies, will receive recurring payments for managing Medicare beneficiaries’ chronic conditions, with payment tied in part to outcomes such as blood pressure control, glycemic management, functional status, and patient-reported outcomes.
ACCESS also formalizes integration with primary care. Participating organizations are expected to coordinate with referring clinicians, supported by structured referral pathways and co-management payments designed to improve collaboration.
For digital health companies, ACCESS opens new market opportunities. Many digital health companies have historically relied on employer contracts, health plan partnerships, or direct-to-consumer models to reach patients. By creating a clear pathway into Medicare reimbursement, ACCESS gives participating organizations a chance to demonstrate their value within a broader healthcare delivery system, provided they can integrate with clinical workflows and show measurable improvements in patient outcomes.
While still a pilot model, ACCESS reflects a broader direction of travel. Several major insurers, including Blue Shield of California, CVS Health, Humana, UnitedHealthcare, and Cigna, have announced plans to align elements of their payment structures with similar outcomes-based approaches, suggesting early convergence across public and commercial reimbursement models.
The future of chronic disease management
The chronic disease landscape is entering a new phase; one defined not only by rising prevalence, but by changing patient populations, expanding treatment options, and new models for delivering care. Organizations that understand these changes, and can act on them, will be better equipped to meet shifting patient and market needs.
Want a first-hand look at how Definitive Healthcare’s data and analytics can help you spot opportunities in the chronic disease treatment market? Sign up for a demo today.
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