Tag: chronic illness

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.

 

Chronic Care Management

Check out this company. Recently in the Science Section of The New York Times, an article on chronic care management got my attention because of this company, Health Quality Partners, and the success they’ve had in lowering Medicare patients’ healthcare costs. (The rest of the article wasn’t too optimistic.) Medical Fitness Centers ought to be doing this, if they’re not already. We have a similar approach that we’ve used with some of our clients.