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Learn the True (Hidden) Cost of Falls for Medicare Advantage Populations
The Exclusive Whitepaper: “Identifying Medical Spend for Older Adults with Injurious Fall Related Claims.”

Executive Summary

Plans face significant challenges in identifying fall-related claims using Medicare data due to inaccurate medical coding completed post point of care, increased comorbidity, and chronic disease prevalence. 

Nymbl recently worked with Wakely, an independent actuarial firm to develop a comprehensive methodology for identifying fall-related medical claims. Through analyzing ICD-10 codes and their application to real world injurious and non-injurious falls (using data from the Medicare Limited Data Set), this new gold standard methodology overcomes limitations in claims assessment. 

This approach improves fall-related claim (FRC) identification and accuracy by over 60%. When applied to a normative MA population, the methodology found an average fall prevalence rate of 21% for years 2017, 2018, and 2019 (based on 20-million member months of claims data). With this alternative methodology, any organization is empowered to reliably understand their fall related claims (FRC) cost of care.

Download the full Whitepaper

Key findings from the whitepaper include:

  1. Fall-related claim (FRC) frequency increases with age.
  2. The Risk Adjusted PMPM for MA members who fall is double that of non-fallers.
  3. FRC beneficiaries experience a ramp up in costs prior to the fall and fail to return to their pre-fall baseline cost.
  4. Over 70% of older adults who fall once will experience a second FRC within 12 months. 

 

Key findings from the whitepaper include:

  1. Fall-related claim (FRC) frequency increases with age.
  2. The Risk Adjusted PMPM for MA members who fall is double that of non-fallers.
  3. FRC beneficiaries experience a ramp up in costs prior to the fall and fail to return to their pre-fall baseline cost.
  4. Over 70% of older adults who fall once will experience a second FRC within 12 months. 



 

 

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In a recent report from AARP, it's clear that older adults are not just catching up with technology—they're embracing it. The report reveals a significant shift in attitudes towards technology among individuals ages 50+, signaling a new era of tech-savviness in this demographic.

On the flip side, nearly two-thirds (64%) of adults ages 50+ feel that today’s technology isn’t tailored to their needs, according to the same AARP report.

Key Takeaways Include:

    1. Tech Adoption on the Rise: Gone are the days when older adults shied away from technology. Today, they're increasingly recognizing the benefits and convenience that tech tools offer.
    2. Changing Mindsets: The report sheds light on the evolving attitudes towards technology among older adults, showcasing a growing willingness to embrace new gadgets and integrate them seamlessly into their daily routines.
    3. Enhancing Life with Tech: From staying connected with loved ones to managing healthcare needs and beyond, technology is viewed as a valuable tool for enhancing various aspects of life for older adults.
    4. A Shift Towards Tech-Savviness: With older adults becoming more adept at navigating the digital landscape, the findings suggest a promising trend towards greater tech fluency in this age group.
    5. Opportunity For a More Inclusive Approach: The findings underscore the need for a more inclusive approach to tech, such as product design, support, and education, to better serve older adults.

Nymbl was created specifically as a digital program for older adults. 

 

Drawing from extensive research and collaborating closely with experts in gerontology, physical therapy, and cognitive science, Nymbl designs exercises and activities that prioritize safety, effectiveness, and enjoyment. 

Programs are personalized to accommodate varying fitness levels and abilities, with a focus on progressions and adaptive challenges.

By integrating evidence-based approaches, Nymbl empowers older adults to maintain or improve balance and mobility while fostering confidence and a sense of accomplishment in their health journey.

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Nymbl exists to remove physical and emotional barriers and help older adults move, live, and be how they want.

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