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

Area of Science:

• Gerontology
• Public Health
• Health Economics

Background:

• Fall-related injuries and inactivity pose significant healthcare costs.
• The A Matter of Balance (MOB) program is a widely adopted intervention for older adults to reduce fall risk.
• Community-based wellness programs are being evaluated for their value to Medicare beneficiaries.

Purpose of the Study:

• To examine the effects of MOB program participation on health service utilization and costs for Medicare beneficiaries.
• To assess the economic value of community-based fall prevention programs within the Medicare system.

Main Methods:

• A controlled retrospective cohort study analyzed Medicare data from 2006-2013 and MOB program data from 2007-2011.
• 6,136 Medicare beneficiaries enrolled in MOB were compared to matched controls using difference-in-differences analysis.
• Outcomes included falls, fall-related fractures, health service utilization, and costs, standardized to 2012 dollars.

Main Results:

• MOB participation yielded total medical cost savings of $938 per person within one year.
• Significant savings were observed in unplanned hospitalizations ($517), home health care ($81), and skilled nursing facility care ($234).
• No significant changes in fall or fall-related fracture incidence were detected, indicating savings stem from other mechanisms.

Conclusions:

• The MOB program demonstrates potential for reducing Medicare costs.
• Similar community-based prevention programs may offer economic benefits to Medicare.
• Further research on program delivery costs is needed to support Medicare coverage for preventive benefits.