• overweight;
  • older adults;
  • exercise;
  • medical costs;
  • outpatient/inpatient/drug costs


Objective: To examine the influence of physical activity (PA) and BMI on health care utilization and costs among Medicare retirees.

Research Methods and Procedures: This cross-sectional study was based on 42, 520 Medicare retirees in a U.S.-wide manufacturing corporation who participated in indemnity/perferred provider and one health risk appraisal during the years 2001 and 2002. Participants were assigned into one of the three weight groups: normal weight, overweight, and obese. PA behavior was classified into three levels: sedentary (0 time/wk), moderately active (1 to 3 times/wk), and very active (4+ times/wk).

Results: Generalized linear models revealed that the moderately active retirees had $1456, $1731, and $1177 lower total health care charges than their sedentary counterparts in the normal-weight, overweight, and obese groups, respectively (p < 0.01). The very active retirees had $1823, $581, and $1379 lower costs than the moderately active retirees. Health care utilization and specific costs showed similar trends with PA levels for all BMI groups. The total health care charges were lower with higher PA level for all age groups (p < 0.01).

Discussion: Regular PA has strong dose-response effects on both health care utilization and costs for overweight/obese as well as normal-weight people. Promoting active lifestyle in this Medicare population, especially overweight and obese groups, could potentially improve their well-being and save a substantial amount of health care expenditures. Because those Medicare retirees are hard to reach in general, more creative approaches should be launched to address their needs and interests as well as help reduce the usage of health care system.