How to tackle the chronic condition trifecta 

Cardiovascular disease, obesity and diabetes form a powerful — and costly — trifecta of chronic conditions that continue to drive long-term health plan expenses and quietly erode workforce productivity. As many as 51.4% of adults — representing roughly 130 million people — report multiple chronic conditions, underscoring the scale and urgency of this issue. These conditions rarely occur in isolation, are deeply interconnected and often compound one another, creating a cycle of escalating health risks, diminished quality of life and rising employer health care costs.

For employers, the stakes are high — and brokers play a pivotal role in helping organizations evaluate risks, navigate the vendor landscape and build a benefit strategy that aligns clinical realities with business priorities. Traditional approaches — such as one-size-fits-all wellness programs, siloed disease management and reactive interventions — simply have not delivered sustainable, long-term improvements. What's needed instead is a more integrated, strategic approach that recognizes the complexity of these conditions and aligns benefit design, vendor strategy and employee support programs around prevention and whole-person care. 

Obesity remains one of the most significant risk factors for cardiovascular disease and type 2 diabetes. At the same time, diabetes increases the risk of heart disease. When an employee is living with two or more of these conditions, severity rises, complications multiply and costs increase exponentially. Addressing these conditions separately — through multiple, disconnected vendors or programs — misses opportunities for coordinated treatment that is more effective and supportive for the individual. Brokers are uniquely positioned to guide employers away from fragmented solutions and toward integrated models that streamline care, reduce confusion and improve outcomes.

At MBGH member meetings, employers continue to underscore the value of taking a more holistic, long-term approach. One large blue-collar manufacturer advises benefits leaders to formally recognize obesity as a chronic medical condition and to reject "quick fixes" or fragmented solutions that ignore root causes. Their guiding principle — "Do the right thing to improve lives and protect plan sustainability" — has driven them to challenge misaligned systems that prevent employees from receiving evidence-based care.

Another large government employer has doubled down on the basics, emphasizing that lifestyle choices account for more than 70% of risk factors associated with diabetes, hypertension and obesity. They are integrating lifestyle-based interventions directly into benefit design, embedded into the structure of care rather than offered as optional wellness add-ons that often fail to gain traction.

For employees, the lived experience of managing multiple chronic conditions can be overwhelming. Conflicting nutritional advice, inconsistent messages between providers, limited education about medications and widespread misinformation all create confusion and disengagement. Many feel siloed between specialists without a clear, coordinated plan that helps them understand how their conditions interact — or what steps they can take to better manage them.

Prevention, integration and engagement

To help employers address these concerns, MBGH is working closely with member organizations to shift benefit strategies toward prevention, integrated care and meaningful engagement. This shift begins with ensuring access to solutions backed by science — ones that address the root causes of obesity and related conditions, remove barriers to care and provide consistent support.

Employers looking to break the cycle of chronic disease progression with the help of their benefit advisers should consider adopting a more strategic, evidence-based approach featuring the following steps:

• Elevate primary care: Encourage every employee to have a primary care provider who can serve as the hub for coordinating care. This becomes particularly important as weight changes may affect medication needs for diabetes, hypertension and other conditions.
• Leverage data: Using claims data, biometrics and predictive modeling helps identify high-risk populations earlier and tailor interventions before complications occur.
• Coordinate care: Partner with adaptable, evidence-based vendors who can support integrated care models that treat the whole person — not isolated symptoms.
• Engage members deeply: Move beyond passive wellness programs. Personalized outreach, digital coaching, incentives tied to meaningful actions and culturally tailored communication can all drive sustained behavior change.
• Support mental health: Stress, depression, anxiety and emotional well-being are inseparable from physical health. Employers should ensure mental health resources are easy to access, destigmatized and embedded in chronic condition programs.

Clinicians working with MBGH offer several key recommendations to support employers as they redesign benefits:

• Cover supportive programs: Nutrition counseling, health coaching and wraparound services should be covered benefits rather than optional add-ons.
• Avoid overreliance on GLP-1s: While GLP-1 medications can be highly effective for some employees, they are not first-line treatments for everyone and come with safety, cost and compounding considerations.
• Strengthen the basics: Incentivize small, sustainable lifestyle changes — such as adding a cup of vegetables daily, which can reduce diabetes risk by 35% — and reinforce nutrition education within the care delivery system.
• Treat obesity as a chronic disease: As with hypertension or diabetes, stopping treatment often leads to relapse. Long-term or lifelong therapy may be appropriate for many individuals.

Driving better outcomes and cost control

Many existing programs fall short for employees with multiple chronic conditions. These individuals often disengage when programs focus on only one condition while ignoring the interconnectedness of their health challenges. Integrated solutions — those that combine medication guidance, lifestyle support, behavioral health and data-driven insights — produce stronger engagement and more durable outcomes.

Employers that adopt this holistic approach are already seeing improvements: better control of chronic conditions, increased workforce resilience and meaningful reductions in total health care spend. Virtual chronic care platforms, nutrition support and targeted coaching are helping organizations address the trifecta head-on.

What was once primarily a clinical challenge is now a clear business imperative. By shifting from reactive treatment to proactive, coordinated care, benefits leaders can protect plan sustainability while improving quality of life for employees and their families.