Delivering Prevention and Wellness under ACA

The Affordable Care Act moves into high gear Oct 1. with the ability for the uninsured to enroll in federal and state health insurance exchanges. For the first time, a one-stop competitive marketplace for health insurance will exist. No longer will pre-existing conditions be a reason for denial of coverage, and lifetime caps on benefits will be a thing of the past. Government subsidies will reduce the premium costs for many.

The 2010 Census estimates there are 48 million uninsured, which is 15 percent of the population. Interestingly, this number is roughly the same number that IHRSA estimates as being healthclub members (50 million). I have to wonder how many uninsured are using their healthcare dollars for membership fees.

With the Act’s emphasis on prevention and wellness, it will be interesting to see what impact it will have on the health and fitness industry and especially, medical fitness centers. I believe it could be huge and that is the reason that clubs, medical facilities, and Ys should be taking the lead in promoting and educating the public and their members about their state’s enrollment process. I would even go so far, as to suggest we offer a free month’s membership incentive to anyone who enrolls in a health-insurance exchange and who provides appropriate documentation as to eligibility. Also, the health and fitness industry should be using its marketing clout to run public service announcements in the local media. Many states have decided not to participate providing a need for greater local activism.

In my opinion, these new enrollees will be a game changer for our industry. For many with chronic health issues, there will be a new emphasis on managing their health. We should be part of the new delivery mechanism of insurers, physicians and health systems. With so many new consumers in the system, communicating and managing health for many will create new opportunities and a new sub-industry. The health and fitness industry must be part of “getting the message out” if its 30,000-plus locations are to have a place at the table.

 

  • kevinconlon

    Excellent insight and a fresh approach to how medical fitness centers and YMCA’s can impact the ACA! I would like to see further discussion or consulting by Mr Greene on how facilities can implement the health-insurance exchange fitness promotion properly.
    Hospital Administrator’s and Healthcare Executives have been preaching on the need to help manage their community members health, but no real and immediate solution like Mr. Greene proposes has ever been discussed!

  • donnafjarmusz

    Exploring the development of wellness centers/medically-based health & fitness centers should be considered as part of healthcare providers strategic planning processes. Health & wellness is definitely part of their core business and gives them the opportunity to develop a retail versus third party payer relationship with their patients/consumers. These facilities can be used as tools to reduce readmissions, manage population health and create positive experiences for community members while assisting them in taking more responsibility for their own health. If developed properly, they serve as positive revenue generators for healthcare systems.