Abstract
This study investigates whether enrollment in Medicare Advantage (MA) promotes increased physical activity among older adults compared to Traditional Medicare (TM). Using nationally representative survey data spanning 2012 to 2022, we implement a fuzzy regression discontinuity design at the Medicare eligibility threshold of age 65. To mitigate selection bias and isolate the causal impact of MA enrollment, we restrict our sample to individuals turning 65 during the study period who were physically active before reaching Medicare eligibility. Additionally, we exclude respondents enrolled in MA before age 65 to ensure valid identification. Our empirical strategy employs reaching age 65 as an instrumental variable for MA enrollment, enabling us to estimate the local average treatment effect (LATE) on the frequency of weekly vigorous physical activity. We find robust evidence that enrolling in MA increases vigorous physical activity by approximately 2.7 days per week compared to TM enrollment. This effect aligns with the wellness incentives frequently offered in MA plans, such as gym memberships and fitness program access. As a robustness check, we use doubly robust inverse probability weighting estimator to address potential self-selection into MA among physically active older adults. The results consistently confirm the primary findings in both magnitude and direction, strengthening our conclusions. Overall, this study provides novel insights into how public insurance program structures can effectively shape health behaviors among seniors. Our findings suggest that Medicare Advantage’s fitness-oriented benefits significantly encourage active lifestyles, offering valuable implications for policymakers interested in designing health programs to promote healthy aging.
Details
Presentation Type
Paper Presentation in a Themed Session
Theme
Public Policy and Public Perspectives on Aging
KEYWORDS
Healthy Aging, Public Insurance, Physical Activity
