Nguyen, HQ, Maciejewski, M, Gao, S, Lin, E, Williams, B, LoGerfo, JP
Diabetes Care, 2008


Objective: The purpose of this study was to determine whether elective use of a health plan– sponsored health club membership had an impact on health care use and costs among older adults with diabetes.

Research and Methods: Administrative claims for 2,031 older adults with diabetes enrolled in a Medicare Advantage plan were obtained for this retrospective cohort study. Participants (n 618) in the plan-sponsored health club benefit (SilverSneakers®) and control subjects (n1,413) matched on SilverSneakers enrollment index date were enrolled in the plan for at least 1 year before the index date. Two-year health care use and costs of SilverSneakers participants and control subjects were estimated in regressions adjusting for baseline differences.

Results: SilverSneakers participants were more likely to be male, had a lower chronic disease burden, used more preventive services, and had a lower prevalence of arthritis (P 05). SilverSneakers participants had lower adjusted total health care costs than control subjects in the first year after enrollment ($1,633 [95% CI $2,620 to $646], P 0.001), and adjusted total costs in year 2 trended lower ($1,230 [$2,494 to $33], P 0.06). Participants who made on average 2 SilverSneakers visits/ week in year 1 had lower total costs in year 2 ($2,141 [$3,877 to$405], P0.02) than participants who made 2 visits/week.

Conclusions: Use of a health club benefit by older adults with diabetes was associated with slower growth in total health care costs over 2 years; greater use of the benefit was actually associated with declines in total costs.

Key Takeaways:

  • SilverSneakers can help control health care costs for older adults with diabetes
  • SilverSneakers participants with diabetes had$1,633 lower average health care costs than the control group after one year in the program
  • Year two costs were $1,230 less for SilverSneakers participants than the control group and significantly fewer participants were hospitalized
  • Higher program participation was associated with greater savings. Participants averaging two or more fitness center visits declined in cost over two years and had savings of $2,141 in year two relative to those with lower participation

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