SummaryAvalere conducted a retrospective observational analysis to examine differences in healthcare outcomes among Medicare beneficiaries enrolled in Medicare Advantage (MA) and participating in the Silver Sneakers healthy aging program.
The goal of the study was to assess and quantify the potential value and benefit to participants and providers of programs designed to promote physical activity and social engagement in seniors.
MA encounter data, including all medical and pharmacy claims, were linked to MA members with a minimum of 12 months of participation in the fitness program who were continuously enrolled in their MA plan during the same time period. We used a previously validated dual study design to limit the likelihood that the observed relationships between program participation and the measures of interest were confounded by differential selection into the program. Two study cohorts were constructed to examine differences in utilization, costs, and quality outcomes among: 1) MA members before and after the first date of program participation; and 2) program participants vs. comparable MA non-participants identified using a strictly applied propensity score matching approach.
- MA members had significantly lower healthcare utilization after joining the program as well as when compared with similar MA non-participants, including consistently lower inpatient hospitalizations and emergency department visits.
- Participation in the fitness program was also associated with significantly lower costs, driven primarily by lower inpatient expenditures.
- Cost savings stratified by key member characteristics revealed several results that may be counterintuitive to some: the largest cost savings were among fitness program members age 80+ (not among younger, healthier Medicare beneficiaries), among those with 3 or more chronic conditions (versus those with 1 or 2 conditions), and among members enrolled in Medicare due to disability (versus those who joined Medicare at age 65).
- Program participants had better performance on key measures of quality, including greater adherence to hypertension and cholesterol medications both after joining the program and compared to similar non-participants; lower rates of 30-day all-cause hospital readmissions compared to non-participants; and higher rates of vaccination and disease screening. Several of these results were associated with higher ratings on triple weighted measures included in the Centers for Medicare and Medicaid Services Medicare Advantage Plan Five-Star Rating system.
Results from the pre/post and the matched-cohort analyses were largely consistent, suggesting that the study’s findings reflect real-world improvement. This study’s findings are also consistent with previous analyses of senior fitness programs that found decreased healthcare utilization and costs. Importantly, this study expands the evidence base by using a large national sample of program participants linked to their complete medical and pharmacy claims for a full 12 months. External validity was further increased by including a diverse set of MA plans. This study also adds new evidence related to important measures of quality and access, and examined differences by age group, chronic disease burden, and disability status.
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