Thursday, March 6, 2008

Healthways News, Cigna and Interesting Data on Silver Sneakers

Should help preserve some cash flow. 1.2 million persons' worth.

Does the uptick have any relationship to the Cigna announcement? You be the judge!

But enough about the shekels already. Let's don our academic spectacles and check out the latest Centers for Disease Control's Preventing Chronic Disease. There's a manuscript examining Silver Sneakers' impact on claims expense in a cohort of elders from Group Health Cooperative of Puget Sound. Thankfully free of odds ratios (touched on in my March 4 entry), the study showed that Silver Sneakers participants had a statistically significant difference of $500 in yearly expense (including the additional cost of the health club benefit) versus an age-gender matched control group.

I like the study because the analysis

1) was on an intention to treat basis. Selecting out participants is a classic source of bias and can inflate an observed difference.

2) took the time to look at the dose response. If there is a correlation between the intensity of the intervention and the degree of outcome, that is further evidence that the intervention is responsible. That was the case here.

3) showed no increase in year 1 of the study; the $500 showed up at year 2. This makes sense that the benefits of exercise would not appear immediately. As an aside, the bulk of the costs seemed to be from avoided hospitalizations.

4) had authors who were explicitly honest about the very real shortcomings of the study. There could have been residual confounding or selection bias, there were drop outs in year two and the impact of non-Silver Sneakers exercise programs was not captured.

5) None of the authors were employees of and the study was NOT funded by Silver Sneakers or Healthways.

6) Isn't Group Health the home of the MacColl Institute for Healthcare Innovation? Home of the Medical Home?

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