Covering Gym Fees Might Be Money Saver for Medicare
Medicare Advantage plans that do so lure healthier members, study suggests
By Maureen Salamon
WEDNESDAY, Jan. 11 (HealthDay News) -- Paying the gym-membership fees of seniors joining private Medicare supplemental insurance plans -- which by law cannot deny coverage based on illness -- attracts healthier adults, potentially saving the U.S. insurer money, a new study suggests.
Analyzing 22 Medicare Advantage plans, including half that added fitness club memberships and half that didn't, Brown University researchers found that plans with fitness benefits had 6 percent more seniors who reported being in excellent or very good health. The number of new enrollees in such plans reporting activity limitations was 10.4 percent lower, and those reporting difficulty walking was 8.1 percent lower than in plans not offering gym memberships.
"Insurance companies are at risk for paying for all covered services, so there's a strong financial incentive to enroll people who are healthy rather than those who are sick," said study co-author Dr. Amal Trivedi, an assistant professor of health services, policy and practice at Brown.
"Obviously, covering gym memberships costs money, so there's a calculus between [that] versus attracting healthier enrollees," Trivedi added. "What this suggests is that offering gym memberships is an attractive business proposition."
The study is published Jan. 12 in the New England Journal of Medicine.
Medicare is the U.S. government's health insurance program for people 65 and older. Medicare Advantage plans, which are administered by private insurers approved by Medicare, offer coverage for extra services such as vision, hearing, dental and/or prescription drugs. The plans must accept all applicants, but individual premiums are risk-adjusted based on pre-existing medical conditions. Sicker applicants, therefore, pay higher premiums than healthier ones.
Coverage of fitness clubs jumped significantly in the past decade. Looking at 101 Medicare Advantage plans from 2002 to 2008, the researchers found that the number offering gym memberships jumped from 14 to 58.
"That's a fourfold rise, which I suspect is even higher now," said Trivedi, noting that more than 300 total Medicare Advantage plans are currently available. "I think the magnitude of the effect was surprising to us, and this is a topic that was not studied before."
Trivedi, who also practices at the VA Medical Center in Providence, R.I., and co-author Alicia Cooper also obtained data from the Medicare Health Outcomes Survey -- which collects information such as health, social and demographic status from a random sample of beneficiaries. The sample included nearly 5,000 Medicare Advantage beneficiaries ages 65 and older in 11 plans that added fitness-membership benefits in 2004 or 2005 along with 11 plans that did not.
Dr. Tamara Kuittinen, director of medical education in the department of emergency medicine at Lenox Hill Hospital in New York City, said some private insurance plans covering all ages also offer gym memberships, which she compared to a "carrot on a stick to living healthily."
"Aging is a complicated process, but I think [this practice is] a positive incentive for those who, say, need to join a gym or talk to their doctor about staying healthy," she said. "Studies show if you're active in your senior years, you live longer. It improves mental health as well as physical health."
Learn more about Medicare Advantage plans.SOURCES: Amal Trivedi, M.D., M.P.H., assistant professor, health services, policy and practice, Brown University, and physician at Providence VA Medical Center, Providence, R.I.; Tamara R. Kuittinen, M.D., director, medical education, department of emergency medicine, Lenox Hill Hospital, New York City; Jan. 12, 2012, New England Journal of Medicine Related Articles
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