{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:42:51Z","timestamp":1792665771417,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&R"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Lifestyle medicine (LM) uses evidence\u2010based interventions to reduce chronic systemic inflammation, a driver of chronic diseases and painful musculoskeletal conditions. Medicare beneficiaries represent a high\u2010risk population for chronic systemic inflammation and may benefit from receiving care through an intensive LM program (ILMP).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n 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\u2010ILMP).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Retrospective exploratory study of repository data.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Tertiary orthopedic center.<\/jats:p>\n <\/jats:sec>\n \n Patients<\/jats:title>\n \n 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;\n p<\/jats:italic>\n \u2009=\u2009.040). A third group of 90 Medicare patients with similar conditions received usual care during this same time frame.\n <\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n The ILMP virtually integrates individual and group visits with an interprofessional team, with patient\u2010identified health goals.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n Goal attainment; changes in weight, pain, physical\/mental health, and metabolic labs from program enrollment to completion.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Compared to commercially insured ILMP patients, Medicare ILMP patients were older (70\u2009\u00b1\u20097 vs. 55\u2009\u00b1\u200910\u2009years,\n p<\/jats:italic>\n \u2009<\u2009.001) and had higher rates of \u22652 lifestyle\u2010related chronic diseases (96% vs. 85%;\n p<\/jats:italic>\n \u2009=\u2009.015), hypertension (72% vs. 54%;\n p<\/jats:italic>\n \u2009=\u2009.010), hyperlipidemia (59% vs. 40%;\n p<\/jats:italic>\n \u2009=\u2009.001), and gastroesophageal reflux disease (33% vs. 18%;\n p<\/jats:italic>\n \u2009=\u2009.015) at baseline. Medicare and commercially insured ILMP patients reported similar use of program services, goal attainment, and outcomes. Compared to the Medicare usual\u2010care group, the Medicare ILMP group had similar baseline characteristics but achieved greater weight loss (10\u2009\u00b1\u200914 lbs vs. 1\u2009\u00b1\u20094 lbs;\n p<\/jats:italic>\n \u2009<\u2009.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n An interprofessional ILMP delivered virtually is feasible and effective for Medicare patients with musculoskeletal conditions and lifestyle\u2010related chronic diseases, despite having a greater baseline disease burden compared with commercially insured patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pmrj.70240","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:21:11Z","timestamp":1792664471000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1002","author":[{"given":"Heidi","family":"Prather","sequence":"first","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery New York New York USA"},{"name":"Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan","family":"Bradley","sequence":"additional","affiliation":[{"name":"Ethan Carroll Bradley Consulting, LLC St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4504-2562","authenticated-orcid":false,"given":"Alexandra","family":"Mele","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Leupold","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8458-619X","authenticated-orcid":false,"given":"Jennifer","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Physiatry Hospital for Special Surgery New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.mayocpiqo.2023.11.004","article-title":"Foundations of lifestyle medicine and its evolution","volume":"8","author":"Lippman D","year":"2024","journal-title":"Mayo Clin Proc Innov Qual Outcomes"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1177\/15598276241252799","article-title":"Early outcomes of orthopedic pre\u2010surgical patients enrolled in an intensive, interprofessional lifestyle medicine program to optimize health","author":"Prather H","year":"2024","journal-title":"Am J Lifestyle Med"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","DOI":"10.5888\/pcd13.160174","article-title":"Multimorbidity and functional limitations among adults 65 or older, NHANES 2005\u20132012","volume":"13","author":"Jindai K","year":"2016","journal-title":"Prev Chronic Dis"},{"issue":"21","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph182111632","article-title":"Lifestyle medicine reimbursement: a proposal for policy priorities informed by a cross\u2010sectional survey of lifestyle medicine practitioners","volume":"18","author":"Freeman KJ","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"e_1_2_11_6_1","first-page":"355","article-title":"Care fragmentation, quality, and costs among chronically ill patients","volume":"21","author":"Frandsen BR","year":"2015","journal-title":"Am J Manag Care"},{"issue":"1","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/bja\/aen103","article-title":"Assessment of pain","volume":"101","author":"Breivik H","year":"2008","journal-title":"Br J Anaesth"},{"key":"e_1_2_11_8_1","unstructured":"PROMIS.PROMIS Global Scoring Manual.2017Available at:https:\/\/www.healthmeasures.net\/images\/PROMIS\/manuals\/PROMIS_Global_Scoring_Manual.pdf."},{"issue":"6","key":"e_1_2_11_9_1","first-page":"613","article-title":"An ultra\u2010brief screening scale for anxiety and depression: the PHQ\u20104","volume":"50","author":"Kroenke K","year":"2009","journal-title":"Psychosomatics"},{"issue":"1","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"38","DOI":"10.4278\/0890-1171-12.1.38","article-title":"The transtheoretical model of health behavior change","volume":"12","author":"Prochaska JO","year":"1997","journal-title":"Am J Health Promot"},{"issue":"3","key":"e_1_2_11_11_1","article-title":"Introduction of an area deprivation index measuring patient socioeconomic status in an integrated health system: implications for population health","volume":"4","author":"Knighton AJ","year":"2016","journal-title":"EGEMS (Wash DC)"},{"issue":"2","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/CORR.0000000000002044","article-title":"How should we measure social deprivation in Orthopaedic patients?","volume":"480","author":"Cheng AL","year":"2022","journal-title":"Clin Orthop Relat Res"},{"issue":"1","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1111\/jgs.16902","article-title":"Embedding function into health care","volume":"69","author":"Ling SM","year":"2021","journal-title":"J Am Geriatr Soc"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-017-0692-3"},{"issue":"1","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/0033354916681508","article-title":"A centers for Medicare & Medicaid Services lens toward value\u2010based preventive care and population health","volume":"132","author":"Burd C","year":"2017","journal-title":"Public Health Rep"},{"issue":"12","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.49200","article-title":"Estimated reduction in health care spending associated with weight loss in adults","volume":"7","author":"Thorpe KE","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"7","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/s40273-014-0230-2","article-title":"Savings in medical expenditures associated with reductions in body mass index among US adults with obesity, by diabetes status","volume":"33","author":"Cawley J","year":"2015","journal-title":"PharmacoEconomics"},{"issue":"3","key":"e_1_2_11_18_1","first-page":"354","article-title":"Direct medical costs of obesity in the United States and the most populous states","volume":"27","author":"Cawley J","year":"2021","journal-title":"J Manag Care Spec Pharm"}],"container-title":["PM&R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.70240","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pmrj.70240","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.70240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:21:14Z","timestamp":1792664474000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pmrj.70240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,22]]},"references-count":17,"alternative-id":["10.1002\/pmrj.70240"],"URL":"https:\/\/doi.org\/10.1002\/pmrj.70240","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,22]]},"assertion":[{"value":"2026-03-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pmrj.70240"}}