Currently, the rehabilitation community is feeling the frustration in dealing with the many HMO's in this country5. While some aspects of the current market-driven health care reform are disturbing, other elements seem to be more favorable for health promotion. A program at in Arizona is changing the 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 9 regional clubs3. The components include: smoking cessation, weight management, stress reduction, senior and youth fitness, physical therapy, therapeutic exercise, and aquatic rehab. 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 in place, room for conversion (ie: racket ball courts converted into health promotion facilities), and the ability to work with special population groups.
With these relationships comes another opportunity for a relationship between health promotion and rehabilitation. Current reviews suggest both the efficacy of health promotion as part of the medical model, and the need to implement more types of preventive health into current medical practices7,9. Physical Therapists will refer patients for post rehab, and they will establish relationships with clubs and fitness professionals who have experience in rehab, and this working relationship will fuel one of the future trends in the fitness profession.
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 unecessarily4. The next year and a half will be critical times for establishing relationships with insurers, and other health/health care professionals5,8. The result may be a new version of health care delivered to Americans that is long term, truly multi-disciplinary, unique, and cost effective. We strive to make this a reality.
1. Banja, J.D. Ethics, outcomes, and reimbursement. Rehab Management. 1994, Dec./Jan. pp. 61-65.
2. Bly, J.L, Jones, R.C., Richardson, J.E. Impact of worksite health promotion on health care costs and utilization. JAMA. 1986. 256:3235-40.
3. Burrough, D.J. Insurer and health clubs form partnership. Phoenix Business Journal. pg. B-1, Jan., 1995.
4. Chenoweth, D.H. Health Care Cost Management. 2nd edition. 1993, Brown and Benchmark, Dubuque, IA.
5. 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.
6. Eckenhoff, E. HMO's may prevent patients from receiving necessary therapy and equipment. PT Bulletin. pg. 7, May 5, 1995.
7. Fries, J.F., Green, L.W., Levine, S. Health promotion and the compression of morbidity. Lancet. 1989, March 4, pp. 481-83.
8. LaForge, R. Health reform and the future of fitness and health promotion. ACE Insider Newsletter. 1993, 3;3:1-4, Winter.
9. Leaf, A. Preventive Medicine for our ailing heath care system. JAMA. 1993. 269;5:616-18.
10. Pelliter, K.R. A review and analysis of the health and cost-effective outcome studies of comprehensive health promotion and disease prevention programs. American Journal of Health Promotion. 1991, 5;4:311-15.
11. 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 editor of the Fitness TherapistTM course.