Key Takeaways

  • Roughly 80% of older adults have one chronic condition, where many struggle to manage their symptoms.  

  • About two-thirds of all health care costs go toward treating chronic illnesses.  

  • Chronic disease self-management programs can empower individuals with chronic conditions to manage their own care and improve their quality of life.  

Diabetes, arthritis, hypertension, lung disease, and other chronic conditions like these can make life difficult to manage for millions of older adults, often forcing them to give up their independence.  

The Challenges of Chronic Disease

Every day, millions of people with chronic conditions struggle to manage their symptoms.  

  • About 80% of older adults have one chronic condition. 1  
  • 68.4% of Medicare beneficiaries have two or more chronic conditions, and 36.4% have four or more. 2 
  • Chronic diseases can affect a person’s ability to perform important activities, restricting their engagement in life and their enjoyment of family and friends. 3  

The Cost of Chronic Conditions

The traditional medical model of caring for people with chronic conditions—which focuses more on the illness than on the patient—is expensive and often ineffective. 

  • More than two-thirds of all health care costs are for treating chronic illnesses. 3
  • 95% of health care costs for older Americans can be attributed to chronic diseases. 3   
  • Yet less than 1% of health care dollars are spent on prevention to improve overall health. 4  

National Council on Aging's Role

Addressing chronic conditions requires new strategies to delay health deterioration, improve function, and address the problems that people confront in their day-to-day lives.  

NCOA, the Self-Management Resource Center, and other program developers have collaborated for nearly a decade to disseminate proven programs in-person and online that empower individuals with chronic conditions to manage their own care and improve their quality of life.  

Probably the best known and most highly regarded self-management program for people with chronic conditions is the Self-Management Resource Center's  suite of Chronic Disease Self-Management Programs (CDSMP).  

Through a partnership with the U.S. Administration for Community Living, NCOA promotes CDSMP and its variants through community-based workshops. CDSMP is also supported in communities by grants from the Centers for Disease Control and Prevention (CDC) and other funders. Since 2006, more than 300,000 people have participated in these impactful programs.  

We also remain committed to research and development work on evidence-based self-management and patient engagement. 

What Is CDSMP?

CDSMP is a low-cost program that helps adults with chronic conditions learn how to manage and improve their health. Interactive workshop sessions focus on problems that are common to individuals dealing with any chronic condition. Topics include pain management, nutrition, exercise, medication use, emotions, and communicating with doctors.  

Workshops are led by two trained facilitators, at least one of whom has a chronic condition. Fifteen hours of content are covered during weekly sessions held over a six-week period. Throughout the program, approximately 10 to 15 participants focus on building skills to manage their conditions by sharing experiences and providing mutual support.  

What Does CDSMP Do?

  • Helps people with medical conditions such as diabetes, arthritis, and hypertension develop skills and coping strategies to manage their symptoms.
  • Employs action planning, interactive learning, behavior modeling, problem-solving, decision-making, and social support for change.
  • Is offered via two venues—online and in-person—and are held in community settings such as senior centers, churches, community health clinics, and libraries.
  • Has disease-specific variants for diabetes, chronic pain, cancer survivors, and HIV/AIDS.
  • Is available in Spanish for the chronic disease and diabetes self-management programs, and the CDSMP trainer manual is available in over 19 different languages. 

How Effective Is CDSMP?

Based on a national study of CDSMP, the program resulted in significant, measurable improvements in the health and quality of life of adults with chronic conditions. CDSMP also appears to save enough through reductions in health care expenditures to pay for itself within the first year.  

Health Benefits  

  • Improved self-reported health.
  • Improved health status: fatigue, shortness of breath, depression, pain, stress, and sleep.
  • Improved health-related quality of life.
  • Improved communication with doctors, medication compliance, and health literacy.  

Cost Savings  

  • $714 per person savings in emergency room visits and hospital utilization.
  • $364 per person net savings after considering program costs of $350 per participant.
  • Potential savings of $6.6 billion by reaching 10% of Americans with one or more chronic conditions.  

For more information:  

This project was supported in part by grant number 90CR2001-01-00 from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy. 

  1. Centers for Disease Control and Prevention. Healthy Aging at a Glance 2011. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2011. Lochner KA, Cox CS. Prevalence of Multiple Chronic Conditions Among Medicare Beneficiaries, United States, 2010. Prev Chronic Dis 2013. 
  2. Centers for Disease Control and Prevention. The State of Aging and Health in America 2013. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. 
  3. The State of Chronic Disease Prevention: Hearing Before the Committee on Health, Education, Labor, and Pensions. (6) 2011. 
  4. Ory, M. G., Ahn, S., Jiang L., Smith, M. L., Ritter, P., Whitelaw, N., & Lorig, K. (2013). Successes of a National Study of the Chronic Disease Self-Management Program: Meeting the Triple Aim of Health Care Reform. Medical Care, 51(11), 992-998.