Evaluation of the Senior Risk Reduction Demonstration (SRRD) Under Medicare- First Year Report

Abstract: This report is an interim evaluation of the Centers for Medicare & Medicaid Services' (CMS), Senior Risk Reduction Demonstration (SRRD) Under Medicare. SRRD began on May 1, 2009 and will end on April 30, 2012. Following CMS' approval, two SRRD vendors, referred to as "Vendor A" and "Vendor B," adapted health risk reduction programs available for commercial populations to the Medicare population. In this report, we examine the impact of the first year of the demonstration on various outcomes, using data from health risk assessments (HRA) collected yearly (and at baseline) as well as Medicare claims data obtained yearly (and at baseline).We found that Vendor A's national enhanced intervention (Arm 2) reduced key Medicare utilization rates and expenditures: On average, Vendor A's participants (i.e., Medicare beneficiaries who filled out an HRA) that were randomly assigned to Arm 2 (i.e., eligible to receive enhanced tailored follow-up services), cost Medicare $958 less and were 14.2 percent less likely to be hospitalized than Vendor A's participants that were randomly assigned to Arm 3 and thus were not eligible for any tailored follow-up services. Both impacts are statistically significant at the 5 percent level. These are significant program impacts provided that the impact of the control intervention (HRA + generic health advice) is minimal. We did not find any statistically significant impact of Vendor B's national enhanced intervention. However, we did detect some impacts of Vendor B's national standard intervention. The impact of Vendor B's national standard intervention (Arm 1) net of its control intervention was to increase total and carrier Medicare expenditures by $822 and $273, respectively. However, the impact on total Medicare expenditures was less precisely estimated (significant at the 10 percent level). This first-year report offers early learning experiences in terms of policy and the potential impact of Section 4103 of the Affordable Care Act: Medicare Coverage of Annual Wellness Visit Providing a Personalized Prevention Plan. SRRD is similar to the intervention that was instituted under Section 4103 except that it is administered outside of physicians' offices.