Currently, the rehabilitation community is feeling the frustration in dealing with the many HMO's in this country. While some aspects of the current market-driven health care reform are disturbing to practitioners, other elements may be very favorable for health promotion. A program in Arizona is changing the current thought process on the role of the health club as a health care provider. The Fitness Network has negotiated with Metra Health, Inc. for a contract for health promotion and rehabilitation programs for their nine regional clubs. The components include: smoking cessation, weight management, stress reduction, senior and youth fitness, physical therapy, therapeutic exercise, and aquatic rehab. The same type of program is happening in Colorado, where the Fitness Therapy Network has a membership of over 40 health clubs, and is negotiating with insurers in a five-state region to bring health promotion and exercise services to this group of providers.
This programming is appealing to insurance companies because it is the 1990's version of health care "one stop shopping". Health clubs represent a unique aspect of tomorrow's health care, because of their size, OSHA regulations that are already in place, room for conversion (ie: racket ball courts converted into health promotion facilities), and the ability to work with special population groups.
There are other trends that will help create major changes within tomorrow's health care arena. They include: Licensure for clinical exercise professionals. This is now a reality on one state (Louisiana), and will probably set guidelines for other states to adopt minimal standards for health promotion, as well. Secondly, expanded services for clients Ð such as mind/body fitness (yoga, t'ai chi, Qigong, etc.) will be an integral part of stress reduction programs, in addition to the classic programs that are in existence today. Third, health promotion will take its place as a health care provider by virtue of expanding their services to fit many medical clients, providing outcomes data that measure program success to insurers and physicians, and their ability to negotiate with payers for contracts on local, regional, and national levels.
As health care issues change with rapid regularity, those professionals willing to establish relationships in growth areas will certainly profit, whereas those who are set on continuing "business as usual" and complain about why things are not going well may struggle unnecessarily. The next year and a half will be critical times for establishing relationships with insurers, and other health/health care professionals. The result may be a new version of health care delivered to Americans that is long term, truly multi-disciplinary, unique, and cost effective. Health promotion proponents will strive to make this a reality.
References
1. Burrough, D.J. Insurer and health clubs form partnership. Phoenix Business Journal. pg. B-1, Jan., 1995.
2. Chenoweth, D.H. Health Care Cost Management. 2nd edition. 1993, Brown and Benchmark, Dubuque, IA.
3. Durak, EP, Shapiro, AA. The Ins and Outs of Medical Insurance Billing: A Resource Guide for the Fitness and Health Professional. Medical Health and Fitness, Santa Barbara, CA 1994.
4. LaForge, R. Health reform and the future of fitness and health promotion. ACE Insider Newsletter. 1993, 3;3:1-4, Winter.
5. Leaf, A. Preventive Medicine for our ailing heath care system. JAMA. 1993. 269;5:616-18.
6. Shephard, R.S., Corey, P., Renzland, P, et al. The impact of changes in fitness and lifestyle upon health care utilization. Canadian Journal of Public Health. 1983. 74:51-54.
Eric Durak is a clinical exercise physiologist and health educator. He is special populations advisor to the International Sports Sciences Association, author of "The Ins and Outs of Medical Insurance Billing", and is the director of the Fitness Therapistª certification course.