Better well-being linked to lower Medicare spending

Medicare spending per fee-for-service beneficiary is likely to be lower in counties where people have the highest well-being — defined as physical, mental and social health — as well as access to basic needs, according to a study published in the Journal of the American Medical Association Network Open.

The study — led by Carley Riley, MD, a physician at Cincinnati Children's Hospital Medical Center — found that Medicare spent $992 more per fee-for-service beneficiary in counties with the lowest well-being than in counties with the highest well-being. Researchers said the association continued after accounting for population characteristics, including median household income, as well as factors such as urbanicity and healthcare system capacity.

Among well-being components, access to basic needs, such as food, healthcare and shelter, was associated with the largest difference in Medicare spending: Medicare spent $1,233 less per fee-for-service beneficiary in counties with the greatest access to basic needs compared with those with the lowest access.

Dr. Riley, along with researchers from Yale University and Tivity Health, examined 2,998 U.S. counties to compare Medicare fee-for-service spending per beneficiary with well-being data from the Gallup-Sharecare Well-Being Index in 2010.

In a prepared statement, Dr. Riley said the study suggests that investing in interventions that improve people's access to basic resources, including healthcare, or improve people's social connection and emotional health, may lead to increased well-being and reduced healthcare spending.

"In this U.S. national study, the overall well-being of a geographically defined population was inversely associated with its healthcare spending for people 65 years and older," she and the other authors concluded. "Identifying this association between well-being and healthcare spending at the population level may help to lay the foundation for further study to first illuminate the mechanisms underlying the association and to study interventions aimed at creating greater well-being and lower healthcare spending at the population level."


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