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16-01-2012 | Legal medicine | Article

Medicare plans offer fitness memberships to recruit healthier beneficiaries


Free abstract

MedWire News: Medicare Advantage plans attract healthier patients by including fitness memberships among their insurance benefits, shows research published in The New England Journal of Medicine.

Health insurance market regulations are designed to prevent health insurance plans from engaging in favorable risk selection, explain study authors Amal Trivedi and Alicia Cooper of Brown University in Providence, Rhode Island, USA.

However, "offering a fitness membership does not mean that you are denying people coverage, but you are changing your benefits to appeal selectively to people who are healthy," said Trivedi in a press release. "Policymakers intended for Medicare Advantage plans to compete on the basis of improving quality and reducing costs, rather than on their ability to attract healthier patients. What we found in the study is that offering coverage for fitness membership is a very effective strategy to attract a healthier population."

This was achieved by comparing 11 Medicare Advantage plans offering new fitness-membership benefits in 2004 or 2005 with 11 Medicare plans that did not. The researchers also compared the self-reported health status of people who enrolled after the fitness benefit was added, with the self-reported health status of people who enrolled before this point.

They found that the proportion of Medicare patients who considered themselves to be in excellent or good health increased from 29.1% to 35.1% after the fitness benefit was introduced. Of the people who enrolled before the benefit, 56.1% reported some limitation to their physical activity, but among the group that enrolled after introduction of the benefit, this was reduced to only 45.7%. The proportion of people who had difficulty walking decreased from 33.1% before the benefit was added to 24.1% afterwards.

Self-reported health levels, limitations in activity, and difficulty walking differed only by a maximum of 1.5% between earlier and later enrollees on the control plans.

Eight of the 11 fitness benefit plans enrolled seniors with better overall health, 10 enrolled seniors with fewer physical limitations, and 9 enrolled seniors who had less difficulty walking, after introducing the fitness benefit to the plans. In comparison, the control plans showed only slight differences over the same period of time.

The researchers conclude: "We found that plans offering coverage for fitness memberships may attract and retain a healthier subset of the Medicare population.

"Even with important components in place to promote more balanced risk pools - standard benefits packages, risk-adjusted payment and guaranteed coverage - some Medicare Advantage plans may engage in favorable selection by designing insurance benefits that selectively appeal to healthy persons."

By Chloe McIvor