Back in 2009 I was particularly interested in the CMS Senior Risk Reduction Demonstration or CMS SRRD when it launched. It is a 5-year nationwide demonstration taking private sector risk reduction programs that focus on reducing health risks for older adults and applying the same methodology to Medicare beneficiaries. It begins with a Health Risk Assessment or HRA, and follows with targeted follow-up to see if application of a private-sector program can reduce health risks and costs to Medicare. I found a report dated February 2012 that summarizes the results of the first year of the demonstration. In short, since this is a 111 page report, there are very positive findings from the demonstration that show how a risk reduction program can reduce costs to Medicare and perhaps improve the health of its beneficiaries, although not all vendor arms of the demonstration showed positive results.
The most positive results were from a vendor that mailed their HRA to targeted moderate to high-risk beneficiaries. Beneficiaries that returned their completed HRAs were enrolled as participants. In the arm that had enhanced or targeted follow-up there were positive results of reduced Medicare payments of $6,634. In the high-risk group emergency department visits were also lower. The report also states that of the 16 HRA-based measures, there were impacts on only two (one per vendor) that were statistically significant at the 5% level, those being one vendor showing 5.3 percentage points less likely to have high/medium polypharmacy risk, and the other showing 3.9 percentage points less likely to have high/medium exercise risk. The lower polypharmacy risk was also the same vendor and arm that reduced Medicare expenditures and ER visits. Hmmm! I wonder if there is a correlation with taking too many medications and poor health outcomes?
All in all, it appears that a low-cost, telephonic health and wellness intervention that is targeted to moderate to high-risk Medicare beneficiaries, combined with health coaching, can lower health care costs and improve health outcomes.