Comparative lifestyle factors and outcomes of an intensive interprofessional lifestyle medicine program versus usual care in Medicare and commercially insured musculoskeletal patients with chronic disease.

BACKGROUND

Lifestyle medicine (LM) uses evidence-based interventions to reduce chronic systemic inflammation, a driver of chronic diseases and painful musculoskeletal conditions. Medicare beneficiaries represent a high-risk population for chronic systemic inflammation and may benefit from receiving care through an intensive LM program (ILMP).

OBJECTIVE

To compare baseline lifestyle factors and outcomes (1) between Medicare and commercially insured patients completing an ILMP, and (2) between Medicare patients completing an ILMP and Medicare patients receiving usual care (non-ILMP).

DESIGN

Retrospective exploratory study of repository data.

SETTING

Tertiary orthopedic center.

PATIENTS: A total of 204 Medicare and 322 commercially insured patients entered the ILMP from May 2023 to May 2025; of these, 101 Medicare and 130 commercially insured patients completed the program and were included in this study (50% vs. 40% completion rate; p = .040). A third group of 90 Medicare patients with similar conditions received usual care during this same time frame.

INTERVENTIONS: The ILMP virtually integrates individual and group visits with an interprofessional team, with patient-identified health goals.

MAIN OUTCOME MEASURES: Goal attainment; changes in weight, pain, physical/mental health, and metabolic labs from program enrollment to completion.

RESULTS

Compared to commercially insured ILMP patients, Medicare ILMP patients were older (70 ± 7 vs. 55 ± 10 years, p < .001) and had higher rates of ≥2 lifestyle-related chronic diseases (96% vs. 85%; p = .015), hypertension (72% vs. 54%; p = .010), hyperlipidemia (59% vs. 40%; p = .001), and gastroesophageal reflux disease (33% vs. 18%; p = .015) at baseline. Medicare and commercially insured ILMP patients reported similar use of program services, goal attainment, and outcomes. Compared to the Medicare usual-care group, the Medicare ILMP group had similar baseline characteristics but achieved greater weight loss (10 ± 14 lbs vs. 1 ± 4 lbs; p < .001).

CONCLUSIONS

An interprofessional ILMP delivered virtually is feasible and effective for Medicare patients with musculoskeletal conditions and lifestyle-related chronic diseases, despite having a greater baseline disease burden compared with commercially insured patients.