5 Most-Researched Diagnoses from American Medical Strategies

American Medical Strategies has released its fourth annual list of the five most researched diagnoses in its PredictDx system. Three of the top five spots were held by cancers in 2017.

For the second year in a row, breast cancer was the most commonly researched diagnosis among users of PredictDx. That finding is not surprising, as breast cancer is the most commonly diagnosed non-skin cancer among women. Colon cancer held the third spot and prostate cancer held the fourth spot, reflecting the prevalence and cost of cancer in America.

Chronic renal failure/end stage renal disease (ESRD) was the second most researched diagnoses in 2017. Dilated cardiomyopathy/congestive heart failure (CHF) was fifth.

The list reflected two changes from the previous year. In 2016, colon cancer and CHF didn’t appear in the top five. In that year, the third most searched diagnosis was Non-Hodgkin lymphoma and the fifth was multiple myeloma (cancer of the white blood cells).

AMS included data in its report about the average cost of treatment for each of the top five diagnoses. Of those five, ESRD requires the most expensive treatment. The national average cost for center-based hemodialysis is $338,625 – $420,525, according to the report.

In many of the above cases, the conditions are long-term, taking years of treatment, or they may be chronic, lasting throughout the person’s life. If you have a self-funded plan, ensuring catastrophic care is in place will ensure that if someone in your employee pool experiences one of these ailments, both your organization as well as your employee are taken care of. Your stop loss insurance carrier may also be able to suggest resources that will assist in cost containment for these diagnoses.

At Stop Loss Insurance Brokers Inc. we’re staying on top of trends and insights involving insurance and claims as they relate to stop loss insurance. To learn more on how you can save money while increasing coverage, contact us today.


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    In 2011, the top 5 most expensive medical conditions treated in US hospitals were: Septicemia, Osteoarthritis, Complication of device, implant or graft, Liveborn, and Acute myocardial infarction

    From 2010 to 2013, the number of claims that were individually $1 million or above rose by 1,000%

    In 2017 approximately 18% of the American public will purchase insurance through exchanges, radically transforming the health insurance landscape.

    In 2014, 98% of large firms (= 200 Workers) offer 1+ wellness programs to their employees.

    The most costly 1% of patients account for 20% of national health expenditures – accruing average annual expenses of nearly $90,000 per person.

    6% of firms offering fully-insured plans report they intend to self-insure because of Obamacare.

    In 2014, PPO plans remained the most common plan type, enrolling 58% of covered workers.

    In 2012, 93% of businesses with 5,000+ employees and 80% of companies with 1,000-4,999 employees were self-funded

    Massachusetts has the third-highest prevalence of self-funded insurance in the small-group market (Fewer than 50 employees).

    In 2013, the average deductible was $2,906 for individuals selecting plans from marketplaces. This compares with average deductibles of $1,135 for an individual with employer coverage.

    In 2013, the average annual premiums for employer-sponsored health insurance are $5,884 for single coverage and $16,351 for family coverage, up 5% and 4% respectively from 2012.

    From 2010 – 2013, cancer followed by chronic/end stage renal disease and leukemia accounted for the top 3 costliest illnesses.