Medicare Wellness Programs Promise Better Health Outcomes

February 28, 2018 - Medicare wellness programs have the potential to improve physical and mental health for beneficiaries with chronic conditions, according to a new report from the Center for Medicare and Medicaid Innovation (CMMI).

Medicare members that participated in wellness programs reported improved fitness levels, were less likely to be injured in a fall, and were able to maintain their physical health better than members who did not participate in wellness programs.

Additionally, the team found that participation in chronic disease management, fall prevention, and physical activity programs led to positive mental health effects like improved overall confidence.

“All three program types were associated with small positive effects in different areas of mental health,” the team said.

“This is an unexpected finding given that the intended impacts of these programs are primarily medical and physical in nature. An important secondary benefit of participation appears to be enhanced mental well-being, which may result from both lifestyle changes and knowledge gained from programs, or from the social aspects of program participation.”

An early evaluation of wellness programs shows a mix of positive outcomes within each type of program.

Strength and flexibility improved by 14.4 percent and aerobic activity improved by 7.7 percent after completing physical activity and nutrition wellness programs. Beneficiaries in physical activity programs also improved social and mental functioning by 2.4 percent.

Chronic disease management programs helped drive a 5.9 percent increase in confidence in balance, a 2.7 percent improvement in emotional health, and a 1.7 percent improvement in overall health.

Beneficiaries participating in fall prevention programs improved their emotional health by 4 percent and their physical health by 1.9 percent.

Medicare beneficiaries are more likely to participate in a wellness program if they were in a younger age group within Medicare (aged 66-74), had awareness of a wellness program in the community or online, or received a provider recommendation.

Adding social outreach and addressing the social determinants of health could increase participation in Medicare wellness programming. Lower education levels and transportation access hindered participation in wellness programs, the team found.

“Those without a high school degree and those with transportation difficulty had lower levels of readiness,” the researchers said.

“Interestingly, social support was slightly lower among those who were ready. This may signal additional social needs among those who were ready for behavior change and program participation, or it may suggest that those with more social support had their wellness needs met outside the context of a wellness program.”

Large healthcare organizations spend between $100 to $500 per patient to operate a wellness program, according to the study. CMMI plans to study the potential return of Medicare programs on spending, costs, and beneficiary health outcomes.

“Future reports will include results of the impact of participation in wellness programs onthese same self-reported health outcomes and behaviors at twelve months and will address program impacts on other health outcomes, service utilization, and cost,” the team concluded.

“In addition, the team will conduct a global assessment of program impacts and operations based on the combined quantitative and qualitative findings of specific program effects on health status, behavior, resource use, demand in the Medicare population for wellness programs, and program operational costs.”