title: Healthcare cost differences with participation in a community-based group physical activity benefit for medicare managed care health plan members.
abstract: OBJECTIVE
  To determine whether participation in a physical activity benefit by Medicare managed care enrollees is associated with lower healthcare utilization and costs.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Medicare managed care.
  
  
  METHODS
  A cohort of 1,188 older adult health maintenance organization enrollees who participated at least once in the EnhanceFitness (EF) physical activity benefit and a matched group of enrollees who never used the program.
  
  
  METHODS
  Healthcare costs and utilization were estimated. Ordinary least squares regression was used, adjusting for demographics, comorbidity, indicators of preventive service use, and baseline utilization or cost. Robustness of findings was tested in sensitivity analyses involving continuous propensity score adjustment and generalized linear models with nonconstant variance assumptions.
  
  
  RESULTS
  EF participants had similar total healthcare costs during Year 1 of the program, but during Year 2, adjusted total costs were $1,186 lower (P=.005) than for non-EF users. Differences were partially attributable to lower inpatient costs (-$3,384; P=.02), which did not result from high-cost outliers. Enrollees who attended EF an average of one visit or more per week had lower adjusted total healthcare costs in Year 1 (-$1,929; P<.001) and Year 2 (-$1,784; P<.001) than nonusers.
  
  
  CONCLUSIONS
  Health plan coverage of a preventive physical activity benefit for seniors is a promising strategy to avoid significant healthcare costs in the short term.
authors.affiliation: Department of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana 46202, USA. rtackerm@iupui.edu
authors.forename: Ronald T
authors.initials: RT
authors.lastname: Ackermann
authors.forename: Barbara
authors.initials: B
authors.lastname: Williams
authors.forename: Huong Q
authors.initials: HQ
authors.lastname: Nguyen
authors.forename: Ethan M
authors.initials: EM
authors.lastname: Berke
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Maciejewski
authors.forename: James P
authors.initials: JP
authors.lastname: LoGerfo
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003153:Community Health Services / Q000191:economics / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D004185:Disability Evaluation; D015444:Exercise; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D007342:Insurance Benefits / Q000191:economics; D016018:Least-Squares Analysis; D008297:Male; D008329:Managed Care Programs / Q000191:economics*; D006278:Medicare / Q000191:economics*; D012189:Retrospective Studies; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data; D014861:Washington