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Health Care Use and Costs Associated With Use of a Health Club Membership Benefit in Older Adults with Diabetes

¹ Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington
² Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina, and the Division of Pharmaceutical Outcomes and Policy, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
³ Global Health Economics, Amgen Inc., Thousand Oaks, California
⁴ Center for Health Studies, Group Health Cooperative, Seattle, Washington
⁵ Health Promotion Research Center, University of Washington, Seattle, Washington
⁶ Department of Health Services, Global Health and Health Promotion Research Center, University of Washington, Seattle, Washington

Corresponding author: Huong Q. Nguyen, hqn{at}u.washington.edu

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 DESIGN 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 (Silver Sneakers [SS]) and control subjects (n = 1,413) matched on SS 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 SS participants and control subjects were estimated in regressions adjusting for baseline differences.

RESULTS—SS 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). SS 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 SS visits/week in year 1 had lower total costs in year 2 ($2,141 [–$3,877 to –$405], P = 0.02) 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.

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