According to the Centers for Disease Control and Prevention (CDC), each year,
one in every three adults age 65 and older falls.[
]1[] Very often
these falls can cause moderate and severe injuries, such as hip fractures and
head traumas, and can even increase the risk of early death. The CDC also notes
that 2.2 million non-fatal fall injuries among older adults in 2009 were
treated in emergency departments, and more than a half-million of those
patients were hospitalized.
These injuries have a direct medical cost impact on the U.S. health care system
to the sum of billions of dollars each year. Additionally, many people who
fall, even if they are not injured, develop a fear of falling. This fear may
cause them to limit their activities, leading to reduced mobility and loss of
physical fitness, which in turn actually increases their risk of falling.
[
]Fall intervention[
]
There?s good news though, as there are several things older adults can do to
help prevent dangerous falls. One of the best preventive measures is living an
active lifestyle, which is known to help decrease the risk of falling by
improving strength and balance. Exercise recommendations in the 2010 guidelines
from the American Geriatrics Society (AGS) specify programs that include
balance, gait, and strength training, such as tai chi or physical therapy, in
group programs or as individual programs at home.[
]2[]
AGS states further that, because a large body of evidence supports the
recommendation that exercise in the form of resistance (strength) training,
balance, gait, and coordination training, is effective in reducing falls, these
types of exercises should be included as part of a multifactorial or
multi-component intervention to prevent falls in older persons and may be
considered as a single intervention. In most positive trials, the exercise
program was longer than 12 weeks (one to three times per week) with variable
intensity.[
]2[]
Additionally, a new requirement by the Centers for Medicare & Medicaid Services
(CMS) requires all community health centers to provide a detailed review of
fall risk for all patients who are Medicare members 65 years of age or older.
This requirement falls under the category of Managing Chronic Conditions, which
includes how often members with different conditions get certain tests and
treatments to help them manage their condition.
A health plan?s CMS star rating is based on the percentage of patients who had
a fall or had problems with balance or walking in the last 12 months
(denominator) who were seen by a practitioner in the past 12 months and who
received fall-risk intervention from their current practitioner (numerator).
Keystone 65 HMO (at 68 percent) and Personal Choice 65[
]SM[] PPO (at 63 percent) both currently have a 4-star
rating for this measure.
[
]The SilverSneakers[]?[] Fitness Program[
]
The Healthways SilverSneakers Fitness Program is available to IBC Medicare
Advantage HMO and PPO members to help them stay active and maintain their
independence. SilverSneakers offers activities that increase flexibility,
strengthen muscles, and improve coordination, reducing a patient?s risk of
falling. Eligible members receive a fitness membership at any SilverSneakers
location, with access to all basic amenities plus SilverSneakers signature
group exercise classes. There are more than 11,000 SilverSneakers locations in
all 50 states, Washington, D.C., and Puerto Rico.
SilverSneakers classes, which typically consist of no-impact cardiovascular and
muscular strength activities, can help patients get the physical activity they
need. By keeping active, they will not only make their bones stronger and
joints more flexible, but they will feel safer performing daily activities.
SilverSneakers is perfect for those patients looking to start an exercise
program for the first time, or for those who are already active and looking for
additional opportunities and support. Are you recommending SilverSneakers to
your patients?
[
]Note[]: SilverSneakers is offered to Keystone 65 HMO and Personal
Choice 65 PPO members at no cost. To enroll in the program, members can simply
bring their SilverSneakers ID card to any participating SilverSneakers
location. For a complete list of locations, members can visit the [
]SilverSneakers website[] or call
[
]1-888-423-4632[].
[
][]1[][]www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html[]
[]2[] []www.americangeriatrics.org/files/documents/health_care_pros
/JAGS.Falls.Guidelines.pdf[]
This is not a statement of benefits. Benefits may vary based on Federal
requirements, Benefits Program (HMO, PPO, etc.), and/or employer groups.
Providers should call Customer Service for the member?s applicable benefits
information. Members should be instructed to call the Customer Service
telephone number listed on their ID card.
SilverSneakers is a registered mark of Healthways, Inc., an independent
company.[
]