title: Managed-Medicare health club benefit and reduced health care costs among older adults.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, HSB T602A, Box 357266, Seattle, WA 98199, USA. HQN@u.washington.edu
authors: Huong Q
authors: HQ
authors: Nguyen
authors: Ronald T
authors: RT
authors: Ackermann
authors: Matthew
authors: M
authors: Maciejewski
authors: Ethan
authors: E
authors: Berke
authors: Marsha
authors: M
authors: Patrick
authors: Barbara
authors: B
authors: Williams
authors: James P
authors: JP
authors: LoGerfo
mesh_terms: D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D016001:Confidence Intervals; D017046:Cost Savings; D005260:Female; D020446:Fitness Centers / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007342:Insurance Benefits / Q000191:economics*; D008297:Male; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D020398:Medicare Part C / Q000191:economics / Q000458:organization & administration*; D015999:Multivariate Analysis; D010809:Physical Fitness; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States