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The Hidden Costs of Care Gaps

Beyond the challenges of administration, incentives and systems, care gaps remain one of healthcare’s most critical blind spots. These gaps occur when patients miss preventive screenings, lack proper chronic condition management, or experience poor transitions of care from hospitals back to their homes. The consequences of these gaps create both healthcare issues and financial burdens for patients, doctors, hospitals, and insurers. Understanding and fixing these gaps is essential to build a healthcare system that works for everyone and remains affordable.

Missed Critical Screenings

It’s a textbook example of a care gap: a patient misses a crucial appointment or fails to receive timely care, and a disease that might have been caught early progresses to a more advanced stage. Emergency departments across the country feel the downstream effects acutely. A 2024 Johns Hopkins study found that 55% of emergency department visits are for non-emergent or primary care–treatable conditions, and approximately 30% of those patients have not seen a primary care physician in the past year. Many of these visits stem from conditions that could have been managed more effectively and at a lower cost in outpatient settings if care gaps had been addressed earlier. With roughly 140 million ED visits annually (and rising since the CDC’s last survey in 2021), and ED spending growing faster than any other area of healthcare, a course correction is urgently needed.

Chronic Disease Costs

The financial impact is most evident in the management, or mismanagement, of chronic conditions. Diseases like diabetes, heart disease, and chronic obstructive pulmonary disease (COPD) require consistent monitoring and care to prevent costly complications. The CDC (Centers for Disease Control and Prevention) has highlighted the scale of this challenge, noting that chronic and mental health conditions account for 90 percent of the $4.5 trillion the United States spends annually on healthcare. When patients fall through the cracks of care coordination, costs rise exponentially as preventable complications lead to hospitalizations, emergency interventions, and long-term disability.

Hidden Operational Burdens

Beyond direct financial impacts, care gaps create significant operational burdens that often go unrecognized. Doctors, nurses, and support staff find themselves treating preventable complications rather than focusing on proactive care. This rising workload contributes to professional burnout, high turnover rates, and ultimately, reduced quality of care. 

Resource allocation presents another hidden challenge. Hospital beds, specialized equipment, and medical staff represent finite resources in our healthcare system. When these resources are consumed by preventable hospitalizations resulting from care gaps, they become unavailable for patients with unavoidable conditions. This misallocation creates inefficiencies throughout the system. It extends wait times, delays procedures, and increases operational costs in ways that affect all patients.

Widening Disparities

While financial calculations can quantify many aspects of care gaps, their human toll extends far beyond dollars and cents. Even worse, the pain is felt more severely by some than others. Underserved populations, including racial and ethnic minorities, rural communities, and those with lower socioeconomic status, consistently face more significant care gaps. These disparities stem from complex factors including geographic isolation, transportation challenges, financial barriers, and systemic inequities in healthcare access and delivery. 

The Economic Impact

Care gaps also create a dual economic burden that extends well beyond healthcare facilities. When chronic conditions worsen due to missed care, patients often cannot work, removing productive individuals from the workforce. Simultaneously, family members must step in as caregivers, joining the 48 million caregivers in the US already providing $600 billion in unpaid care labor annually. Employers face costs from both the absent sick employee and the distracted or absent family caregiver. This workforce reduction hits businesses directly through increased employee absenteeism, reduced productivity, and higher disability claims. These interconnected losses ripple throughout the economy, having negative impacts on productivity and consumer spending.

Closing the Gap

The organizations poised to succeed will be those that understand both the critical blind spot these care gaps represent and the need to embrace innovative approaches that bring healthcare directly to patients. Mobile, community-integrated care models overcome traditional barriers by meeting patients where they are. These solutions eliminate transportation challenges, reduce time away from work, and bring critical preventive services to communities with limited access.

Countless innovators are creating a future of care delivery beyond clinic walls: mobile healthcare organizations like Sprinter Health, telehealth accessibility platforms like Teladoc, AI-powered diagnostic tools like IDx-DR for diabetic screenings, and remote monitoring companies like Dexcom. With more than 30 specialized care gap closure services, DocGo stands out as particularly well-positioned to lead the industry forward. It integrates the best facets of multiple approaches (mobile, telehealth, remote patient monitoring, diagnostics), transforming care delivery while simultaneously addressing healthcare’s most persistent challenge.

Closing care gaps starts at the patient-level, where a single missed appointment can start a domino effect. When a patient skips a screening, they might end up in the ER months later with a preventable crisis. This creates unnecessary costs, takes up hospital beds, and contributes to burn out doctors and nurses can experience due to the increased need to treat preventable complications. This burden falls hardest on disadvantaged communities, creating a cycle where poor health leads to missed work, financial strain, and even worse outcomes. By addressing these blind spots and closing critical care gaps, we can create a healthcare system that truly works for everyone: improving health outcomes, reducing costs and building stronger, healthier communities.