Oral

Medicare has primarily been “sick-care” since most of its benefits are designed for beneficiaries in need of medical care. The innovative Senior Risk Reduction Demonstration (SRRD) is a randomized controlled trial that examines whether health promotion and health management programs that have been developed and used in the private sector can also be tailored to Medicare beneficiaries. The goal of the SRRD is to improve beneficiary health and reduce avoidable health care utilization. The cornerstone of this demonstration is conducting a participant Health Risk Assessment (HRA) to identify health risk factors. Risk factors are then prioritized and participants receive customized wellness and prevention programs. The evaluation of the SRRD is timely as the Accountable Care Act of 2010 introduced the new Medicare benefit of a “Wellness Visit” in 2011 that covers an annual visit during which the beneficiary completes an HRA and then receives customized wellness and prevention plans for the next 12 months. This symposium includes five papers that were developed based on SRRD activities completed after the first year of this three year demonstration. The symposium will include topics such as the design and implementation of this demonstration; findings from studying the implementation of the demonstration; an analyses of vendors' recruitment strategies, including an examination of how participants differ from non-participants; the interim impacts on Medicare utilization, costs and HRA outcomes; and an analyses of the HRAs of both vendors, assessing them for external validity and comparing the vendor-constructed risk scores with those used by Medicare.

Session Objectives: 1.Describe the rationale for SRRD and the evidence supporting its implementation 2.Explain the evaluation design for the demonstration 3.Identify the risk factors targeted for the demonstration 4.Discuss the implications of the demonstration for healthy aging among Medicare beneficiaries 5.Inform the interpretation of study findings by understanding the specific context in which the SRRD operates 6.Learn how existing risk reduction programs available in the private sector can be adapted for the Medicare population 7.Describe recruiting strategies used in Medicare’s Senior Risk Reduction Demonstration (SRRD). 8.Analyze participation rates, retention rates, and participants’ characteristics across vendors and intervention arms. 9.Assess the interim impact of a randomized controlled trial using alternative estimators including linear regression and difference-in-difference after the first year of a three-year demonstration. 10.Compare the Medicare utilizations, costs and health risk assessment outcomes between a treatment group receiving a health risk assessment and follow-up risk reduction services and a control group receiving only a health risk assessment after the first year of a three-year demonstration. 11.Describe the contents of health risk assessment (HRA) instruments used for a wellness intervention for Medicare beneficiaries. 12. Assess the internal validity of the HRAs by examining correlations among HRA variables. 13. Evaluate the external validity of the HRAs by examining the concordance between the HRA data and national benchmarks and Medicare claims.

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH) , Masters Certified Health Education Specialist (MCHES)