US Healthcare: From Reactive Spending to Prevention

Moving US healthcare from reactive spending to proactive investment means putting more resources into prevention, early detection and chronic disease management instead of paying mainly for acute care after problems escalate. For employers, which fund coverage for millions of workers, it means designing benefits and workplaces that make preventive care easy to use.

Key takeaways

• CMS reports national health spending of $5.3 trillion in 2024, about $15,474 per person.
• CMS projects health spending to grow faster than the overall economy through 2034.
• The CDC identifies chronic diseases as leading drivers of national health care costs.
• Employers can influence prevention through plan design, access and workplace practices.
• Results take years, so measure participation and access, not only claims costs.

What does US health spending look like today?

The Centers for Medicare and Medicaid Services publishes the official national health expenditure figures. Its fact sheet reports that national health spending reached $5.3 trillion in 2024, or $15,474 per person, equal to 18.0 percent of gross domestic product. CMS projects that health spending will grow faster than GDP over the next decade, raising its share of the economy to 20.6 percent by 2034.

The CDC states that chronic diseases, such as heart disease, cancer and diabetes, are leading drivers of the nation's annual health care costs. Many of these conditions can be prevented, detected earlier or managed better, which is the core argument for proactive investment. We covered broader employer concerns in the future of employee healthcare; this article focuses on the shift toward prevention.

Reactive versus proactive care: what is the difference?

Area	Reactive approach	Proactive approach
Entry point	Emergency or urgent care when symptoms appear	Regular primary care and screenings
Chronic conditions	Treated during flare-ups or complications	Ongoing management with care plans and follow-up
Data use	Claims reviewed after costs occur	Risk identified early and outreach offered
Payment	Paid per service delivered	Rewards for outcomes and coordinated care
Employer role	Renew the plan and absorb increases	Design access, incentives and supportive workplaces

What is driving the shift toward prevention?

Evidence-based preventive services

The US Preventive Services Task Force, an independent volunteer panel of experts in prevention and evidence-based medicine, issues recommendations on screenings, counseling and preventive medications. Its graded recommendations give employers and plans a credible basis for deciding which services to cover and promote.

Data and technology

Electronic health records, analytics and remote monitoring make it easier to spot risk earlier and follow up between visits. Clinical decision support, discussed in our article on decision support systems in healthcare, helps clinicians apply prevention guidelines consistently. Health systems are also directing technology budgets toward these capabilities, a trend we examined in how AI and machine learning shape healthcare IT spending.

Payment models

Value-based arrangements, where providers share in savings or are paid for outcomes, give health systems a financial reason to keep patients healthy. Adoption varies widely by region and payer, so employers should ask their carriers and networks what models are actually in place locally. Direct contracts with health systems or primary care groups are another option some large employers explore, though they require careful evaluation of quality data and network access.

What can employers do now?

Employers cannot fix national spending, but they control meaningful levers for their own workforce.

• Remove friction from preventive care. Make recommended screenings easy to schedule and clearly communicate which services are covered without cost sharing under your plan.
• Support primary care relationships. Help employees find and keep a primary care clinician, including virtual options where appropriate.
• Design for shift workers. Frontline employees often cannot leave mid-shift for appointments. Consider onsite clinics, screening events or paid time for preventive visits.
• Invest in chronic condition programs. Offer evidence-based programs for conditions common in your population, chosen with your benefits adviser.
• Use data responsibly. Work with aggregated, de-identified reports and keep individual health information out of employment decisions.

Questions for your benefits broker or carrier

• What share of our members had a preventive visit last year, and how has it changed?
• Which chronic conditions drive our claims, in aggregate?
• Which networks in our area use value-based payment?
• What access barriers do our shift and remote workers face?

Frequently Asked Questions

Does preventive care always save money?

Not always in the short term. Some preventive services reduce later costs, while others mainly improve health and quality of life at added cost. The case for prevention rests on better outcomes, earlier detection and a more productive workforce, as well as potential savings. Employers should set realistic expectations and track health and access measures alongside spending.

Who decides which preventive services are recommended?

The US Preventive Services Task Force reviews evidence and issues graded recommendations on screenings, counseling and preventive medications. Other bodies, including CDC advisory committees for vaccines and professional medical societies, also publish guidance. Health plans use these recommendations to shape coverage, so employers should confirm with their carrier how their plan applies them.

How long before a prevention strategy shows results?

Participation and access measures, such as screening rates and primary care visits, can improve within a year. Effects on chronic disease outcomes and claims trends usually take several years and can be obscured by workforce turnover. Set short-term participation goals and long-term health goals, and review both annually with your benefits adviser.

Next steps

1. Request an aggregated preventive care utilization report from your carrier.
2. Identify the biggest access barrier for your frontline employees and fix one.
3. Align your wellness communication with USPSTF-recommended services.

Last reviewed: October 2026.

Sources

• NHE Fact Sheet, Centers for Medicare and Medicaid Services
• About Chronic Diseases, Centers for Disease Control and Prevention
• US Preventive Services Task Force, USPSTF