title: Effects of a Community-Based Fall Management Program on Medicare Cost Savings.
abstract: BACKGROUND
  Fall-related injuries and health risks associated with reduced mobility or physical inactivity account for significant costs to the U.S. healthcare system. The widely disseminated lay-led A Matter of Balance (MOB) program aims to help older adults reduce their risk of falling and associated activity limitations. This study examined effects of MOB participation on health service utilization and costs for Medicare beneficiaries, as a part of a larger effort to understand the value of community-based prevention and wellness programs for Medicare.
  
  
  METHODS
  A controlled retrospective cohort study was conducted in 2012-2013, using 2007-2011 MOB program data and 2006-2013 Medicare data. It investigated program effects on falls and fall-related fractures, and health service utilization and costs (standardized to 2012 dollars), of 6,136 Medicare beneficiaries enrolled in MOB from 2007 through 2011. A difference-in-differences analysis was employed to compare outcomes of MOB participants with matched controls.
  
  
  RESULTS
  MOB participation was associated with total medical cost savings of $938 per person (95% CI=$379, $1,498) at 1 year. Savings per person amounted to $517 (95% CI=$265, $769) for unplanned hospitalizations; $81 for home health care (95% CI=$20, $141); and $234 (95% CI=$55, $413) for skilled nursing facility care. Changes in the incidence of falls or fall-related fractures were not detected, suggesting that cost savings accrue through other mechanisms.
  
  
  CONCLUSIONS
  This study suggests that MOB and similar prevention programs have the potential to reduce Medicare costs. Further research accounting for program delivery costs would help inform the development of Medicare-covered preventive benefits.
authors.affiliation: Acumen, LLC, Burlingame, California. Electronic address: eghimire@acumenllc.com.
authors.forename: Ekta
authors.initials: E
authors.lastname: Ghimire
authors.affiliation: the Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation, Baltimore, Maryland.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Colligan
authors.affiliation: CVS/Caremark, Cumberland, Rhode Island.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Howell
authors.affiliation: Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University, Stanford, California.
authors.forename: Daniella
authors.initials: D
authors.lastname: Perlroth
authors.affiliation: Lewin Group, Falls Church, Virginia.
authors.forename: Grecia
authors.initials: G
authors.lastname: Marrufo
authors.affiliation: Acumen, LLC, Burlingame, California.
authors.forename: Emil
authors.initials: E
authors.lastname: Rusev
authors.affiliation: Department of Economics, Georgetown University, Washington, District of Columbia.
authors.forename: Michael
authors.initials: M
authors.lastname: Packard
mesh_terms: D000368:Aged; D019058:Community Networks; D017046:Cost Savings / Q000379:methods*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics*; D012189:Retrospective Studies; D014481:United States