Wellness Programs Aren’t Generating Medicare Savings

February 27, 2018

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Source: Modern Healthcare

Seniors in wellness programs targeting obesity, falling and chronic conditions are not sparking healthcare spending decreases, according to a federal analysis released Friday.

The Affordable Care Act required the CMS conduct an independent evaluation of wellness programs that targeted various health conditions experienced by Medicare beneficiaries, and that study found no evidence of cost savings.

“Utilization and expenditures actually increased among (chronic-care management) program participants,” the report said.

The findings are based on spending data for Medicare enrollees in fall prevention, weight loss and chronic care initiatives. The CMS followed beneficiaries one year after they joined a wellness program.

The results mirror those found in the corporate world, where companies are increasingly funding wellness programs meant to improve employees’ health.

Corporate wellness spending hit $8 billion in 2016, up from $1 billion in 2011, according to researchers The Harris School of Public Policy at the University of Chicago.

Researchers have also found that these efforts have aided in employee retention, but not changes in employee behavior or cuts in healthcare spending.

Although the wellness programs didn’t save money, the CMS found that Medicare enrollees in wellness programs were more aware of their mental health needs and had increased engagement with physicians and ancillary services.

“So, while it didn’t reduce healthcare expense or utilization, it seems to have had a positive impact,” said Steve Wojcik, vice president of public policy at National Business Group of Health. These programs “prevented or delayed normal deterioration that comes with age.”

Wellness initatives also take time to become successful, according to Cheryl Larson, president and CEO at Midwest Business Group on Health.

Wellness programs “may or may not result in short-term outcomes, but if it helps identify one case of cancer or diabetes in at-risk populations, they can achieve positive outcomes down the road,” Larson said.

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