EnhanceFitness: Reduced Costs and Improved Health Outcomes for Medicare Beneficiaries

In a recent report to Congress, the Centers for Medicare and Medicaid Services (CMS) described promising evidence suggesting that Seattle-based Senior Services' EnhanceFitness Program—a community-based exercise program for older adults—had driven down total healthcare costs, decreased unplanned hospitalizations, and decreased mortality rates for participating Medicare beneficiaries.

EnhanceFitness helps older adults regain and maintain health and physical function. Developed collaboratively by Senior Services, the University of Washington Health Promotion Research Center, and Group Health Cooperative, the program has been implemented at more than 500 sites nationwide, with more than 40,000 participants to date.

"The findings in this report speak to the power of self-efficacy, increased physical activity, and behavior change at any age," states Senior Services Enhance director Susan Snyder.

EnhanceFitness was one of nine other programs retrospectively analyzed as part of an Affordable Care Act requirement under Section 4202(b), which directs the Secretary of Health and Human Services to develop a plan for promoting healthy lifestyles and chronic disease self-management for Medicare beneficiaries. Findings related to EnhanceFitness included:

  • Participation in the program was associated with an estimated total medical cost savings of $945. Specifically, participants in an unplanned inpatient setting saw savings of $545 and those in a skilled nursing facility setting saved $139.
  • Participation in the program helped decrease unplanned hospitalizations; one unplanned hospitalization was prevented during the outcome period for every 20–25 participants.
  • Participants saw a decreased mortality rate; 1.4 percent versus 2.9 percent among controls.

Continuing Assessment

EnhanceFitness, a low-cost, evidence-based group exercise program, helps older adults at all levels of fitness become more active, energized, and empowered to sustain independent lives.

CMS is funding a prospective evaluation of evidence-based wellness and prevention programs in the Medicare population, conducted by research organizations Acumen and Westat. The goal of the study is to assess how wellness programs impact the health and medical expenditures of participating Medicare beneficiaries. This will allow Medicare to consider support for these programs, should they help achieve its overall goals of improving health and lowering health care costs. EnhanceFitness and EnhanceWellness have been identified as some of the high-priority programs for inclusion in this prospective evaluation.

CMS is seeking to assess program effects on Medicare beneficiaries newly enrolling in EnhanceFitness and EnhanceWellness between fall 2014 and 2015. The study involves administration of a participant survey at baseline (prior to first EnhanceFitness class or first EnhanceWellness session), and follow-up surveys at six and 12 months. Data collected at the participant level will be combined with Medicare claims data to examine changes in participant health status and health service utilization. The research team will also be interested in gathering information about participant program attendance and to understand contextual factors by conducting interviews with staff about program operations and implementation costs. The study will offer funding to cover data collection activities associated with participating in the evaluation.

This CMS study presents an exciting opportunity to demonstrate the health and cost benefits offered by EnhanceFitness and EnhanceWellness. The results of these analyses will help inform policies regarding the promotion and support for wellness and prevention activities.

For more information about Project Enhance, visit www.seniorservices.org/wellnessphysicalactivities and www.projectenhance.org. To read the report summary and full retrospective report, click here.

Read contributor Sasha May's article, EnhanceFitness: Endurance, Balance, Flexibility, Strength and Healing, in the May 2014 issue of AgeWise King County. Sasha is assistant director of Project Enhance at Senior Services. She has a wealth of experience managing projects, motivating people, and thinking outside the box.

About Senior Services

Senior Services is the most comprehensive community-based provider of services to older adults in the state of Washington, with a system of integrated programs and senior centers that keep elders food secure and healthy, well-informed, and independent, offering meals, social engagement, information and assistance, health and wellness programs, minor home repairs, caregiver support, and a myriad of activities coordinated through six affiliated senior centers.

Founded in 1967, today the nonprofit agency serves more than 61,000 elders with high-quality services that help them to live independent lives while enabling them to make choices to suit their lifestyle. Services are designed to support seniors emotionally, socially and physically. More than 3,384 volunteers and 250 employees make their mission and vision a reality:

  • To promote the emotional, social and physical well-being of older adults through a network of community connections and services.
  • To form a just society where aging adults and those who care about them can live their best lives.