Community exercise program use and changes in healthcare costs for older adults

Background: Regular exercise is associated with many health benefits. Community-based exercise programs may increase exercise participation, but little is known about cost implications. Methods: A retrospective, matched cohort study was conducted to determine if changes in healthcare costs for Medicare-eligible adults who choose to participate in a community-based exercise program were different from similar individuals who did not participate. Exercise program participants included 1114 adults aged greater than or equal to65 years, who were continuously enrolled in Group Health Cooperative of Puget Sound (GHQ between October 1, 1997 and December 31, 2000 and who participated in the Lifetime Fitness (exercise) Program(R), (LFP) at least once; three GHC enrollees who never attended LFP were randomly selected as controls for each participant by matching on age and gender. Cost and utilization estimates from GHC administrative data for the time from LFP enrollment to December 31, 2000 were compared using multivariable regression models. Results: The average increase in annual total healthcare costs was less in participants compared to controls (+$642 vs +$1175; p=0.05). After adjusting for differences in age, gender, enrollment date, comorbidity index, and pre-exposure cost and utilization levels, total healthcare costs for participants were 94.1% (95% confidence interval [CI], 85.6%-103.5%) of control costs. However, for participants who attended the exercise program at an average rate of greater than or equal to1 visit weekly, total adjusted follow-up costs were 79.3% (95% Cl, 71.3%-88.2%) of controls. Conclusions: Including a community exercise program as a health insurance benefit shows promise as a strategy for helping some Medicare-eligible adults to improve their health through exercise.