Effects of a Community-Based Fall Management Program on Medicare Cost Savings

Published on Dec 1, 2015in American Journal of Preventive Medicine4.42
· DOI :10.1016/J.AMEPRE.2015.07.004
Ekta Ghimire1
Estimated H-index: 1
Erin M. Colligan8
Estimated H-index: 8
(Centers for Medicare and Medicaid Services)
+ 4 AuthorsMichael Packard1
Estimated H-index: 1
(UW: University of Washington)
Introduction Fall-related injuries and health risks associated with reduced mobility or physical inactivity account for significant costs to the U.S. healthcare system. The widely disseminated lay-led A Matter of Balance (MOB) program aims to help older adults reduce their risk of falling and associated activity limitations. This study examined effects of MOB participation on health service utilization and costs for Medicare beneficiaries, as a part of a larger effort to understand the value of community-based prevention and wellness programs for Medicare. Methods A controlled retrospective cohort study was conducted in 2012–2013, using 2007–2011 MOB program data and 2006–2013 Medicare data. It investigated program effects on falls and fall-related fractures, and health service utilization and costs (standardized to 2012 dollars), of 6,136 Medicare beneficiaries enrolled in MOB from 2007 through 2011. A difference-in-differences analysis was employed to compare outcomes of MOB participants with matched controls. Results MOB participation was associated with total medical cost savings of 938 per person (95% CI=79, 1,498) at 1 year. Savings per person amounted to 17 (95% CI=265, 69) for unplanned hospitalizations; 81 for home health care (95% CI=0, 141); and 34 (95% CI=55, 13) for skilled nursing facility care. Changes in the incidence of falls or fall-related fractures were not detected, suggesting that cost savings accrue through other mechanisms. Conclusions This study suggests that MOB and similar prevention programs have the potential to reduce Medicare costs. Further research accounting for program delivery costs would help inform the development of Medicare-covered preventive benefits.
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