The offer of a fitness club membership is helping insurers including UnitedHealth Group Inc. and Humana Inc. draw healthier and less costly patients to their Medicare programs, said researchers reporting in the New England Journal of Medicine.
The study found 35.3 percent of new enrollees in a fitness membership benefit plan reported “excellent” or “very good” health, compared with 29.1 percent in the group without the benefit. The number of plans offering the memberships rose to 58 in 2008 from 4 in 2002, the researchers said.
The five largest insurers are looking to expand their roles in offering government-subsidized health plans as the number of Americans covered by them grows under the 2010 U.S. health law. In doing so, the companies may try to “cherry pick” members who are more likely to be healthy using the fitness memberships, said Amal Trivedi, an assistant professor of community health at Brown University in Providence, Rhode Island, and the author of the report released yesterday.
“In general, the government’s goal is to have plans compete on their value to Medicare beneficiaries, and not on their ability to cherry pick the healthiest patients,” Trivedi said in a telephone interview. “They have still found a way to do that in a market that’s very regulated.”
Researchers compared about 5,000 people using 11 Medicare Advantage plans offering fitness-club memberships with those who didn’t receive the benefit. The research by Trivedi and Alicia Cooper was based on patient self-reporting, and the groups weren’t randomly assigned to plans.
Medicare Advantage is a U.S.-supported program in which managed-care health plans are sold by commercial insurers. The plans cover and help coordinate medical services, physician fees and hospitalizations and offer benefits not offered by traditional Medicare plans. The U.S. prescription drug program for the elderly is regulated so companies can’t deny coverage for high-risk members.
Cigna Corp. has a Medicare Advantage HMO plan in Arizona that offers a program that reimburses $200 for fitness classes, said Leigh Woodward, a spokeswoman for the Philadelphia-based company, in an e-mailed response to questions.
“The Golden Vitality program isn’t part of a strategy to get a healthier risk pool, but part of our overall health and wellness strategy, which aligns with Cigna’s mission to help the people we serve improve their health, well-being and sense of security,” she said.
Humana’s program “is very popular with our members,” said Jim Turner, a spokesman for the Louisville, Kentucky-based insurer, in an e-mail. “The main reason is to help our members stay physically active and live healthier lives.”
Advantage programs are required to offer benefits that aren’t part of the traditional Medicare plans, said Tyler Mason, a UnitedHealth spokesman. “We work hard to combine a benefit package that offers value to our members. This includes gym memberships when possible,” he said in an e-mail.
Cynthia Michener, an Aetna Inc. spokeswoman, said in an e-mail that the company provides health incentives in programs besides Medicare and government programs, and is not reacting to regulation. Jill Becher of WellPoint Inc. didn’t return a request for comment.
The government has added standard benefits packages, risk-adjusted payment and guaranteed coverage to balance the industry, said Trivedi, whose study was sponsored by the National Institute on Aging.
The commercial business accounts for less than half of the combined revenue for insurers for the first time in at least two decades, according to a Bloomberg Government report. Quarterly revenue from Medicare, the U.S. program for the elderly and disabled, increased by one third, to $16.4 billion, from the third quarter of 2008 to the same period in 2011 for the four largest insurers that reported figures.
Advantage plans may produce a $10 billion increase in revenue by 2015 as more baby boomers retire, industry analysts have said.