According to a study published this week in the September/October 2011 issue of the American Journal of Health Promotion (Vol. 26, No. 1, pp. 56-60), people with consistently high health care costs experienced a 28 percent cumulative decrease in physician fees after an average of five years practicing the stress-reducing Transcendental Meditation technique compared with their baseline. Both between and within group comparisons were statistically significant. This study has major policy implications.
In most populations, a small fraction of people account for the majority of health care costs. In the U.S., the highest spending 10% in the general population incurred 60% to 70% of total medical expenditures annually. In the Medicare population, the highest spending 5% incurred 43% of total Medicare costs, and the highest spending 25% of seniors accounted for 85% of total expenses. A large number of these people have consistently high medical bills over many years.
Chronic stress is the number one factor contributing to high medical expenses. Stress reduction may help reduce these costs.
This new study compared the changes in physician costs for 284 consistent high-cost participants-142 Transcendental Meditation practitioners with 142 non-practitioners, over five years in Quebec, Canada. The non-TM® subjects were randomly selected from Quebec health insurance enrollees with the same age, sex, and region to match the TM participant profiles. The TM participants decided to begin the technique prior to choosing to enter the study. In the year before the intervention began, there were no significant differences between the groups in payments to physicians.
During the five-year assessment period, the TM group’s annual rate of change in payments declined significantly (p = 0.004), while the comparison group»s payments showed no significant changes. After the first year, the TM group decreased 11%, and after 5 years, their cumulative reduction was 28% (p = 0.001).
The primary measure for assessing the effectiveness of TM practice in decreasing medical costs was the fees paid by the Quebec health insurance agency to private physicians in all settings for treating study participants. In Canada and U.S., physician payments have been 20% of national health expenditures. This study’s results are important because doctors’ decisions determine most medical expenses: tests, prescription drugs, hospitalization, surgery, and other treatments.
This study’s findings were similar to earlier ones. In a previous Canadian study, the TM group exhibited reduced medical expenses between 5% and 13% relative to comparison subjects each year for 6 consecutive years.
In a subsequent Canadian study of senior citizens, the TM group’s five-year cumulative reduction for people aged 65 years and older relative to comparison subjects was 70%. In a sample of American health insurance enrollees, the TM participants had reduced rates of illness in all disease categories. An eleven-year, cross-sectional study in Iowa found that subjects age 45 and over who practiced the TM technique had 88% fewer hospital days compared with controls. Their medical expenditures were 60% below the norm.
Other studies, including randomized clinical trials, indicate the TM technique can improve physical and mental health, decrease tobacco use, reduce substance abuse, and decrease other unhealthy habits and risk factors that lead to chronic disease and costly treatments. “Almost no intervention for cost containment has decreased medical expenditures by 28% over 5 years from a baseline,” said Dr. Robert Herron, the study’s author. Now, it may be possible to rescue Medicare and Medicaid by adding coverage for learning the Transcendental Meditation technique.”