Medicare's Fitness Benefits Draw Healthier Members

Published Online: Monday, January 30, 2012
Follow Pharmacy_Times:
Fitness benefits help keep patients—and Medicare’s bottom line—healthy. 

A new study published in the New England Journal of Medicine looked at enrollees in Medicare Advantage, sometimes called Part C plans, and examined the effects of adding a fitness membership benefit on patients’ self-reported health statuses.
The researchers found that enrollees in Medicare Advantage after fitness membership benefits were added reported significantly better general health. They were more likely to engage in moderate activities, walked better, and better overall health as measured by a 12-item survey. Greater activity and fewer walking limitations (but not perception of good health) persisted over a 2-year follow-up period. The proportion of enrollees reporting excellent or very good health was 6.1% higher among the 755 new enrollees in plans that added fitness benefits than among the 4097 earlier enrollees.
The study authors suggest that adding fitness membership benefits encouraged healthier beneficiaries to enroll in plans. Other studies have similarly found that a fitness membership benefit encourages participation from healthier beneficiaries. Having healthier enrollees is appealing for benefit providers because it lowers the financial risk for those plans. Combinations of benefits can lead to a more diverse risk pool and also balance costs.
Previous studies have shown that dental benefits have also been associated with selection by healthier individuals. Other predictors of this phenomenon, called selective enrollment, include prescription drug and vision benefits. These types of benefits differ significantly from fitness benefits, however, in that they are associated with the enrollment of less healthy individuals and increased financial risk.

Related Articles
Bipartisan legislation introduced in the U.S. House of Representatives today would formally designate pharmacists as healthcare providers under Medicare Part B. Supported by the National Association of Chain Drug Stores, the bill would amend The Social Security Act of 1935 to enable pharmacists to provide to Medicare patients in underserved communities services that pharmacists already are providing for other patients under state law.
Leaders of Senate and House committees with health care jurisdiction should hold oversight hearings to examine the issues that plagued approximately 50,000 beneficiaries who are covered by Aetna Medicare Part D drug plans.
Community pharmacists are most concerned about below-cost reimbursement for certain generic drugs as well as exclusionary Medicare drug plans according to a survey conducted by the National Community Pharmacists Association that asked its members to help identify the organization’s 2015 priorities.
Provider status would recognize pharmacists as a valued part of the health care team.
Latest Issues
  • photo
    Pharmacy Times
    Health-System Edition
    Directions in Pharmacy
    OTC Guide
    Generic Supplements
  • photo
    Pharmacy Careers
    Specialty Pharmacy Times