The Role of Medical Fitness Centers in the Era of COVID-19

[UPDATED May 2020] In this new era of COVID-19, 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, but they will also likely play a much bigger role in the relationship a hospital has with their respective patients.

 

The Role of Fitness in Medicine

When experts try to elucidate the increase in global obesity the explanation is usually marred because they use a reductionist approach to explain the phenomena. Obesity has been blamed on the transition from strenuous work to the more heuristic work of our current information age. Other researchers have pointed to modern urban design and advances in transportation that decrease the need for physical activity. Sometimes nutrition is the culprit ranging from increases in dining plate circumference, as well as increases in portion size, to the strides made in food science that have created energy-rich, ready to eat products that make over-indulging easy and inexpensive.  In reality, we are likely where we are today because these events (and others) converged around the same time probably in the early 1970s creating a powerful force that would not be recognized as harmful until decades later. However, I’m optimistic that a convergence of a different kind is upon us today that will help correct this current trajectory and get us back on track. These convergent forces should open up new opportunities for health clubs as health care continues to be steered towards prevention and away from treatment.

One trend is the increasing acceptance that exercise is potentially as effective as many drugs used to control diseases. Our industry has anecdotally known this for years but recent empirical findings from the Stanford University School of Medicine, London School of Economics, and the Harvard Pilgrim Health Care Institute at Harvard Medical School have brought these facts to the forefront.  Advances in wearable technology that effortlessly track activity and other health metrics continue to improve and become more ubiquitous. Peripheral hardware to accomplish these tasks is quickly beginning to be consolidated and replaced by sensor-loaded smartphones and (soon) smartwatches, which will lead to even wider adoption. In parallel, the Affordable Care Act is motivating physicians with monetary incentives to deliver positive patient outcomes, in contrast to previously being rewarded for treatment volume. However, this paradigm shift in the way doctors are compensated has yet to affect their patient load. Therefore, primary care physicians are increasingly going to look to allied health professionals to aid with the continuum of treatment strategies outside office visits. This is not simply conjuncture, it’s supported by the strides that the American College of Sports Medicine has made through ‘Exercise is Medicine’ and Kaiser Permanente adding exercise as one of their ‘Vital Signs’.  As this trend collides with the deluge of data made available from the advancement and adoption of consumer health technology, electronic medical records (EMRs) will be populated with more data from exercise and activity modalities than medical visits. This will likely expand the scope of practice of many traditional health club roles as the concept of care is shifted from doctors to the empowering the individual. It will be more patient-led in contrast to provider-led, and it will start at the health club instead of the doctor’s office. As health clubs embrace this new role and evolve from the equipment rental business to becoming more of a partner in the well-being of their members the potential for increased opportunity is substantial and imminent.

This is the extended version of an article written for Club Business International, Fourteen in 2014. An original version of the Fourteen in 2014 article is available here.