From 2007 to 2018, claim lines with diagnoses of Lyme disease increased nationally 117 percent, according to a new white paper from FAIR Health, a national, independent nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information. Comparing Lyme disease to other tick-borne diseases, the study draws on data from FAIR Health’s comprehensive repository of over 29 billion private healthcare claim records–the largest in the country.


A bacterial infection transmitted through the bite of blacklegged ticks, Lyme disease historically has been associated more with rural than urban areas. But the new study shows that the growth in claim lines from 2007 to 2018 was more pronounced in urban locations. In urban areas, the increase was 121 percent, compared to 105 percent in rural areas–a difference perhaps attributable in part to people seeking care for the disease in or around their urban homes or work environments notwithstanding having contracted Lyme in a rural setting.

The white paper originated as an invited presentation to the Tick-Borne Disease Working Group’s Subcommittee on Training, Education, Access to Care and Reimbursement. Congress established the Tick-Borne Disease Working Group as part of the 21st Century Cures Act of 2016.

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Among the white paper’s other findings:

  • Predominance. Claim lines for Lyme disease accounted for 94 percent of claim lines for tick-borne diseases in 2018.
  • Geographic spread. In 2007, the five states with the highest number of claim lines with Lyme disease diagnoses as a percentage of all medical claim lines by state were all in the Northeast, but in 2018, one (North Carolina) was in the South.
  • Gender. In both rural and urban areas in 2018, more claim lines with Lyme disease diagnoses were submitted for females than males.
  • Other diagnoses. In 2018, the 10 most common “other diagnoses” found in patients who had been diagnosed with Lyme disease were, in order from most to least common, general signs and symptoms, dorsopathies (disorders of the spine), soft tissue disorders, other joint disorders, disorders of the thyroid gland, anxiety and other nonpsychotic mental disorders, osteoarthritis, skin and subcutaneous tissue symptoms, dermatitis and eczema, and mood (affective) disorders. All were more common in patients with Lyme disease than in all patients.
  • Age. In both rural and urban areas in 2018, individuals aged 51 to 60 held the largest share of the age distribution of claim lines with Lyme disease diagnoses. The age group 41-50 held the second largest share in both rural and urban areas.
  • Monthly distribution. In 2018, July was the month with the highest share of the distribution of claim lines for Lyme disease. The month with the lowest share was December.

FAIR Health President Robin Gelburd commented: “FAIR Health is pleased to use our unequaled data repository to help fill the gaps in knowledge about Lyme disease. Our study provides a foundation to advance the work of other researchers.”