Health systems interested in preserving their operating margins will need to be proactive in addressing a growing minority population responsible for an outsized share of care utilization: patients with multiple chronic conditions.
In a newly released analysis of 2025 claims data, Vizient found that 11% of the U.S. population with multiple chronic conditions accounted for 52% of inpatient admissions. These patients also represented 35% of emergency department visits and 32% of office visits.
To put it another way—compared to those without any chronic disease, these patients have about 10 times more inpatient admissions and ED visits, as well as six times as many office visits. Further, ED and office visits among those with multiple chronic conditions are projected over the next decade to grow at nearly double the rate of those with a single chronic condition, who are also higher care utilizers.
These patients pose a major financial challenge for providers due to their unfavorable payer mix. Specifically, Vizient found that 72% of inpatient admissions for those with multiple chronic conditions were covered by Medicare and another 10% by Medicaid.
That combination of unfavorable reimbursement rates and increased demand is an albatross on operating margins that will worsen as the population ages, warned Erika Johnson, vice president of strategic research at Vizient.
“Capacity constraints compound the issue, especially as inpatient beds and ED space remain finite,” she wrote in the group’s analysis. “When lower acuity chronic demand fills those resources, systems risk crowding out the high-acuity tertiary and quaternary cases that sustain academic distinction and margin. Chronic care strategy is now inseparable from enterprise strategy.”
To head off the issue, Vizient advised systems to address care fragmentation, or the friction patients face as they visit different providers and interact with different systems.
Citing 2025 consumer survey data, about three in five patients with multiple chronic conditions said they visit five or more specialists in a year. Half said they have difficulty with securing appointments, with almost a third of those who do have commercial insurance reporting that they left their prior provider due to such circumstances.
Vizient also noted that Medicare patients with multiple chronic conditions incur about 30% higher annual spend when receiving their care across multiple health systems.
Johnson and Vizient’s suggestion: redesigning care systems from disconnected specialty clinics and uniform access channels for integrated continuous care models dedicated to these high-risk patients. That means allowing patients of services during a single in-person care visit, bolstered information sharing and care plan coordination between clinicians, and a heightened focus on their other access needs like home-based services (cited as important by 86% of survey respondents).
"Access strategies must shift to meet the distinct needs of patients with multiple chronic conditions," Johnson told Fierce Healthcare. "Health systems should create integrated access models that allow coordinated multi-specialty visits in a single encounter, alongside on-demand urgent care options that address unplanned needs early—reducing delayed care and avoidable emergency department use,"
“Organizations that proactively redesign care models around this cohort will be better positioned to improve outcomes, protect margins and sustain long-term growth,” Johnson said.