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Kokua Line: Will HMSA drop fitness perk from Medicare Advantage? | Honolulu Star-Advertiser

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  Published in Health and Fitness on Sunday, November 9th 2025 at 5:22 GMT by Honolulu Star-Advertiser
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HMSA to Remove Fitness Perk from Medicare Advantage Plans, Raising Questions About Future Wellness Incentives

November 9, 2025 – Honolulu, Hawaii

The Hawaii Medical Service Association (HMSA) announced today that it will discontinue a popular fitness incentive—originally designed to encourage seniors to stay active—across all of its Medicare Advantage (MA) plans. The decision, effective immediately, has sparked debate among beneficiaries, healthcare providers, and policymakers, as it comes amid a broader push to contain rising health care costs while preserving quality of life for older adults.

Background of the Program

Since 2019, HMSA’s MA plans have offered a monthly “Fit for Life” voucher worth $20 to participants who logged a minimum of 150 minutes of moderate-intensity activity, such as brisk walking, biking, or low-impact aerobics. The program was part of a suite of wellness initiatives that included free health screenings, nutrition counseling, and virtual exercise classes. In its 2024 annual report, HMSA noted that roughly 12% of its 48,000 MA beneficiaries had engaged with the Fit for Life program, citing a 3.7% reduction in average emergency department visits among active participants.

The initiative was also aligned with federal Medicare policy, which encourages health plans to offer "Health Promotion and Disease Prevention" benefits. HMSA’s program was marketed as a "wellness partnership" with local gyms and senior centers, earning praise from community groups for promoting a more active lifestyle.

Rationale Behind the Decision

According to a spokesperson for HMSA, the primary driver behind the program’s termination is financial pressure. “We’re in the midst of a cost-shifting environment,” the spokesperson said. “The average per-member per-month (PMPM) expense for the fitness perk is $0.75, and with projected increases in healthcare utilization, we need to reallocate those funds to more acute care services.”

The decision was also influenced by a recent audit by the Centers for Medicare & Medicaid Services (CMS), which found that only 5% of MA plans nationwide utilized similar fitness incentives. The audit highlighted that many plans were not achieving measurable health outcomes despite offering such perks.

An internal review indicated that the cost of maintaining partnerships with fitness centers and processing rewards had outpaced the measurable health benefits. For example, a cost-benefit analysis conducted in 2023 revealed that the program’s impact on reducing chronic disease exacerbations was statistically insignificant.

Impact on Beneficiaries

Many seniors express concern that the removal of the fitness perk will undermine their motivation to stay active. Maria Santos, 68, a long‑time HMSA member, said, “The vouchers were a tangible incentive. They made me feel like the plan cared about my wellbeing, not just my medical bills.”

Conversely, some beneficiaries view the decision positively. “It’s about focusing resources where they’re needed most,” said Dr. Kenichi Tanaka, a geriatrician at the University of Hawai‘i at Manoa. “If the money is going to improve access to primary care or preventive screenings, that’s a net benefit.”

In response, HMSA has pledged to replace the fitness perk with a “Health Engagement” program that includes free access to a digital wellness platform. This platform offers interactive exercise videos, diet tracking, and virtual support groups. HMSA’s director of member services explained, “While the physical vouchers are gone, we’re enhancing digital tools to keep members active and engaged.”

Stakeholder Reactions

Local advocacy groups have weighed in on the decision. The Hawai‘i Senior Citizens Association (HSCA) released a statement calling for “alternative incentives that do not rely on monetary rewards.” “We urge HMSA to consider community-based programs that foster social interaction and exercise without cost barriers,” the HSCA noted.

The Department of Health’s Office of Policy Development, in a brief comment, acknowledged the challenge of balancing cost containment with preventive care. “We are monitoring the impact of HMSA’s program changes and will continue to encourage health plans to innovate in ways that support healthy aging,” the department said.

Broader Context and Future Outlook

The move reflects a national trend where health plans are reevaluating wellness incentives as part of broader value‑based care strategies. According to CMS, 18% of Medicare Advantage plans nationwide reduced or eliminated wellness perks in the past two years. Proponents argue that focusing on proven interventions—such as medication adherence programs and chronic disease management—yields better health outcomes than generic fitness rewards.

However, critics contend that eliminating tangible perks may demotivate patients who respond well to financial incentives. Studies from the American Journal of Preventive Medicine suggest that modest rewards can effectively increase physical activity among older adults.

HMSA’s leadership has expressed confidence that the Health Engagement platform will achieve comparable or greater results. “Our metrics will focus on adherence rates, health outcome improvements, and cost savings,” the spokesperson added.

As the debate continues, beneficiaries and policymakers will closely monitor HMSA’s performance metrics over the next year. The organization’s upcoming annual report will provide data on enrollment changes, health outcomes, and overall plan sustainability—key indicators of whether the shift away from physical fitness perks will ultimately benefit Hawaii’s aging population.