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Does investing in pop health and social determinants work? New study finds link to lower Medicare spending

Correlative research finds that Medicare spent nearly $1,000 less per member in counties with a high well-being ranking.

Jeff Lagasse, Associate Editor

Proponents and skeptics not convinced that investing in population-level interventions and social determinants of health, take note: New research finds that the overall well-being of a population on a county level is associated with lower healthcare spending for each Medicare fee-for-service beneficiary.

The findings suggest that certain population health and social determinants programs, such as interventions that improve access to populations for basic resources, including access to healthcare, or improve social connection and emotional health for populations, may not only increase well-being but also result in reduced healthcare spending. Researchers are quick to point out, however, that the study demonstrates an association between Medicare spending and well-being, not a causal relationship.

Led by a physician at Cincinnati Children's Hospital Medical Center, the study shows that Medicare spent $992 less per fee-for-service beneficiary in counties with the highest well-being compared to those in counties with the lowest well-being.

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"Populations with higher well-being are likely to result from and/or create positive environmental and social conditions that result in lower healthcare spending," says Carley Riley, MD, a physician at Cincinnati Children's and lead author of the study. "One possible explanation may be that behaviors and emotional states spread from person to person in a population, so that living with people who have higher well-being can confer health-related benefits that lead to lower healthcare spending." 

This association was maintained even after accounting for median household income, the degree to which the county was urban, as well as healthcare system capacity and the inverse between well-being and Medicare dollars spent was stronger in counties with higher household income and greater capacity in the healthcare system. 

Riley led the study with a team of researchers from Yale University and Tivity Health to assess 2,998 counties, with data from the Gallup-Sharecare Well-Being Index.

Twitter: @JELagasse
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