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Health care use and costs associated with use a health club membership benefit in older adults with diabetes

¹Department of Biobehavioral Nursing and Health Systems, University of Washington
²Center for Health Services Research in Primary Care, Durham VA Medical Center and Division of Pharmaceutical Outcomes and Policy, School of Pharmacy, University of North Carolina at Chapel Hill
³Global Health Economics, Amgen Inc. Thousand Oaks, CA
⁴Center for Health Studies, Group Health Cooperative
⁵Health Promotion Research Center (HPRC), University of Washington
⁶Department of Health Services, Global Health and HPRC, University of Washington

HQN{at}u.washington.edu

ABSTRACT

OBJECTIVES: To determine whether elective use a health plan-sponsored health club membership impacted health care use and costs among older adults with diabetes.

RESEARCH DESIGN AND METHODS: Administrative claims for 2031 older adults with diabetes enrolled in a Medicare Advantage plan were obtained for this retrospective cohort study. Participants (n=618) in the plan-sponsored health club benefit (Silver Sneakers^®, SS) and controls (n=1413) matched on SS enrollment index date were enrolled in the plan for at least one year prior to the index date. Two year health care use and costs of SS participants and controls were estimated in regressions adjusting for baseline differences.

RESULTS: SS participants were more likely to be male, had a lower chronic disease burden, used more preventive services, and had a lower prevalence of arthritis (p05). SS participants had lower adjusted total health care costs than controls in the first year after enrollment [–$1633, (95% Confidence Interval, CI, –2620, –646), p=.001] and adjusted total costs in year two trended lower [–$1230, (95% CI, –2494, 33), p=.06]. Participants who made on average 2 SS visits/week in year one had lower total costs in year two [$2141 (95%CI, –$3877, –$405; p=.02)] compared participants who made <2 visits/week.

CONCLUSIONS: Use of a health club benefit by older adults with diabetes was associated with slower growth in total health care costs over two years; greater use of the benefit was actually associated with declines in total costs.

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