Managed-Medicare health club benefit and reduced health care costs among older adults

Abstract

Introduction: Our study was undertaken to determine the association between use of a health plan-sponsored health club benefit by older adults and total health care costs over 2 years.

Methods: This retrospective cohort study used administrative and claims data from a Medicare Advantage plan. Participants (n = 4766) were enrolled in the plan for at least 1 year before participating in the plan-sponsored health club benefit (Silver Sneakers). Controls (n = 9035) were matched to participants by age and sex according to the index date of Silver Sneakers enrollment. Multivariate regression models were used to estimate health care use and costs and to make subgroup comparisons according to frequency of health club visits.

Results: Compared with controls, Silver Sneakers participants were older and more likely to be male, used more preventive services, and had higher total health care costs at baseline. Adjusted total health care costs for Silver Sneakers participants and controls did not differ significantly in year 1. By year 2, compared with controls, Silver Sneakers participants had significantly fewer inpatient admissions (-2.3%, 95% confidence interval, -3.3% to -1.2%; P < .001) and lower total health care costs (-$500; 95% confidence interval, -$892 to -$106; P = .01]. Silver Sneakers participants who averaged at least two health club visits per week over 2 years incurred at least $1252 (95% confidence interval, -$1937 to -$567; P < .001) less in health care costs in year 2 than did those who visited on average less than once per week.

Conclusion: Regular use of a health club benefit was associated with slower growth in total health care costs in the long term but not in the short term. These findings warrant additional prospective investigations to determine whether policies to offer health club benefits and promote physical activity among older adults can reduce increases in health care costs.

Figure.

Adjusted total health care costs of Silver Sneakers (SS) participants in 2003 dollars, by mean number of health club visits per week for 2 years (top) and year 2 cost differences between categories of visits per week (bottom). SS participants (n = 4766) were categorized according to the mean number of health club visits per week over 2 years: fewer than 1 visit per week (n = 2778), 1 to fewer than 2 visits per week (n = 819), 2 to fewer than 3 visits per week (n = 593), and 3 or more visits per week (n = 576). Error bars indicate standard errors.