The Role of Medical Fitness Centers in the Era of Health Care Reform

In this new era of health care reform and the Patient Protection and Affordable Care Act (PPACA), medical fitness centers must evolve their approach to keep up with the transformational change currently taking place. Hospitals therefore have an extraordinary opportunity to position themselves as facilitators of prevention rather than operating in the previous operational paradigm of disease-care. In these changing times it is clear that medical fitness centers will play a much broader role in the operating models of medical organizations. Americans are coming around to the notion that it is necessary that they actively participate in their own care. Clinicians are realizing that their role is changing as well – from one of ‘expert’ to one of ‘facilitator’.

Health care reform is requiring institutions to shift patient-care models to an upstream approach. In the paradigm preceding the PPACA, medical centers waited downstream for illness to progress to the point that high-cost acute care was necessary. This was supported by reimbursement programs that incentivized this type of methodology. However, as the PPACA gets rolled out and employer-sponsored health benefit plans become more prevalent prevention and self-management will rise to the top as key initiatives for any progressive medical organization[1]. What is the primary conduit for preventive medical care and patient self-management? Medical fitness centers. Care will soon start with the individual instead of the doctor. It will be patient-led instead of provider-led, and it will start in the home or the fitness center instead of the doctor’s office.

Another opportunity for medical fitness centers is an increased effort from coverage payers and providers to influence patient behavior (ex. WellPoint’s Health. Join In. and WellPower initiatives). Through incentives and education payers and employers are working together more than ever before to encourage and influence employees to increase their activity and adopt healthy habits[2]. A reasonable measure of a healthy habit is the consistent use of a fitness facility and this measure – club usage data – is already being used by some organizations as a success metric. The PPACA has also widened the available spectrum of incentives employers can use to reward healthy behavior, such as more attractive insurance premiums, lower deductibles, and other desirable rewards.[3]

Summary: It is clear that the growing trend of patient self-management supported by the PPACA will continue to have a positive impact on medical fitness centers as shared decision-making becomes the norm in health care. Furthermore, hospitals are being pressured to move away from economic models that favor volume and expensive services to models that offer patient value and positive outcomes. This creates an unprecedented opportunity for medical fitness centers to position their offerings as establishing the patient relationship, the relationship that historically was created between the patient and physician at a patient’s time of need. Through better positioning within the wellness continuum, and new economic incentives afforded by health care reform, medical fitness centers not only now have a seat at the table regarding patient care, they will likely play a much bigger role in the relationship a hospital has with their respective patients.

[1] Rosenbaum, Sara. “The Patient Protection and Affordable Care Act: implications for public health policy and practice.” Public Health Reports 126.1 (2011): 130.

[2] Oppenheimer, Karen Pak, and Carol Medlin. “Governors’ Healthy America Initiative.” (2006)

[3] Harrison, Krista, and Anderson, Gerard, “Employee Wellness Incentives.” (2010)