title: Body mass index and the impact of a health promotion intervention on health services use and expenditures.
abstract: OBJECTIVE
  To examine the effect of body mass index (BMI) on the impact of a health promotion intervention on health services use and expenditures among Medicare beneficiaries with disabilities.
  
  
  METHODS
  We analyzed data from 452 Medicare beneficiaries who participated in a Medicare demonstration. The intervention included the following components: patient education, health promotion coaching, medication management, and physician care management. We performed the analysis by using generalized linear models (GLM) to examine the impact of BMI and the intervention on total health care expenditures.
  
  
  RESULTS
  The intervention was cost neutral over the 2-year study period. Participants in the intervention group used less home health aide services (p = .03) and had fewer nursing home days (p = .05). The intervention appeared to have smaller effects on expenditures as BMI level increased.
  
  
  CONCLUSIONS
  The findings suggest that a health promotion intervention may achieve better beneficiary outcomes without an increase in resource use in this Medicare population.
authors.affiliation: School of Aging Studies, College of Behavioral & CommunitySciences,University of South Florida, Tampa, FL 33620, USA. meng@usf.edu
authors.forename: Hongdao
authors.initials: H
authors.lastname: Meng
authors.forename: Dianne
authors.initials: D
authors.lastname: Liebel
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Wamsley
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015992:Body Mass Index; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D019468:Disease Management; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000379:methods*; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D006278:Medicare; D011594:Psychometrics; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014481:United States