Impact of an Innovative HRA-based Wellness & Prevention Demonstration on HRA outcomes, Medicare Utilization and Costs

Research has suggested that risk reduction programs can encourage and help sustain the types of behavioral change that may prevent future health problems. In the Senior Risk Reduction Demonstration (SRRD), Medicare partnered with vendors to implement risk reduction programs for a sample of Medicare beneficiaries. The programs are comprised of health questionnaires, tailored health reports, customized educational materials, health counseling, self-management tools and referrals to national and local community resources. Based on the results of each participant's Health Risk Assessment (HRA), beneficiaries were randomly assigned to one of several treatment arms, which differed in the intensity of the intervention.

The first year of data of this three year intervention have been collected. We used a regression framework to test differences between treatment and controls groups for various Medicare claims and HRA variables. Key findings from this interim evaluation include: for one vendor, participants in the high-intensity treatment arm had $958 lower Medicare expenditures, 14.2% lower probability to be hospitalized and 0.3 fewer days of hospital stay than participants in a treatment arm who simply took an HRA without receiving tailored follow-up. For the other vendor, participants in the low-intensity treatment arm had $822 and $273 higher total and physician Medicare expenditures, respectively. We test the robustness of results using alternative estimators – difference in mean (DIM) and a difference-in-difference (DID). Additional years of data will be used to conduct the final analyses, but these interim results are informative to policymakers given the focus on prevention and wellness under the ACA.