Counties with greatest well-being for seniors cost Medicare thousands less, study finds

Communities with the greatest well-being cost Medicare less. (Getty Images/rawpixel)

Improving well-being among seniors could translate into big savings for the Medicare program, according to a new study in JAMA Network Open.

The study defined well-being as “a holistic assessment of the overall health of [a] population comprising interrelated domains.”

To measure well-being, it used data from the Gallup-Sharecare Well-Being Index, which asks about not only physical health, emotional health, access to care, and behaviors like diet and smoking, but factors such as job satisfaction, housing and optimism.

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The study found Medicare spent $992 less per fee-for-service beneficiary in counties that scored in the top 20% of well-being compared to counties at the bottom.

Moreover, the program spent $1,233 less per beneficiary in counties with the greatest access to basic needs compared to counties with the least access to basic needs.

Although the researchers expected this association, it was stronger than they anticipated, according to Carley Riley, M.D., lead author of the study.

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Although the study could not attribute this trend to any particular cause, it listed a few possibilities. Positive environmental and social conditions could cause widespread wellness and good health. For example, elderly people with a lot of social support may be better positioned to receive care at home than in a hospital; at-home care also costs less.

Alternatively, wellness could be contagious: Living among healthy, happy individuals could make someone feel healthy and happy, too—bringing down the entire community’s healthcare costs. The study cited multiple other studies supporting both of these theories.

Despite their need, most existing programs to promote wellness are not targeted toward seniors specifically, Riley said.

“That said, there is evidence that increasing rates of volunteering, programs that foster social connectivity, and aging in place are beneficial for well-being among older adults,” she added.

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Riley also said the Centers for Medicare & Medicaid Services (CMS) could promote well-being among Medicare beneficiaries by expanding their Accountable Health Communities program, which addresses social determinants of health.

CMS could also partner with other agencies, such as the Department of Housing and Urban Development, the Environmental Protection Agency, the Substance Abuse and Mental Health Services Administration or the Department of Transportation, she said.

Riley said her team hopes both federal and local public agencies provide more support for programs that promote well-being "in the very near future to prevent even greater spending on healthcare."

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