The shift in healthcare services is moving from a fee-for-service model to one of value and quality.  Healthcare providers and hospitals are on the hook (i.e. risk sharing) for producing better health outcomes for the patients (i.e. health consumer), and thus their compensation and reimbursements are more closely tied to those outcomes.  This financial ‘buy-in’ could be a watershed moment for the fitness industry in respect to becoming a partner in the delivery of healthcare.


Working for a major healthcare system in New Jersey for the last 4 years has afforded me an interesting perspective on healthcare reform and how the dynamic changes currently taking place may impact the fitness industry for years to come.

On the consumer end, accountability particularly in Employer-sponsored healthcare plans is skyrocketing. Why is this important to know?

Because a majority of Americans receive their insurance through Employer-sponsored health insurance. Employees are being asked to take better care of themselves by participating actively in “Healthcare Consumerism”.  Healthcare consumerism looks at healthcare as most other products a consumer would be buy including a car, home, etc.  You shop around ,look for best value and purchase/participate in the best plan that fits your needs.

Tied into the patient accountability trend are Consumer Driven Health Plans (CDHPS).  These plans attaches a Health Savings Account (HSAs) to a High Deductible plan.  Consumers with these plans are inherently driven to keep themselves healthier due to the fact they could pay more out of pocket.  Driving the cost shifting, in part, may be the pending implementation of the Cadillac Tax, a tax placed on health plans that exceed certain cost thresholds.

Where do fitness professionals fit into this equation?

Healthcare providers AND consumers are looking for credible resources in the community to provide professional fitness guidance.

What’s changed is the compensation model on the healthcare side is shifting; this is driving the need for services centered around keeping our population healthy.  Doctors and hospitals are being compensated to keep patients OUT OF THE HOSPITAL; employees are incentized through their benefit plan design to take control of their health with lower healthcare premiums, contributions to their HSAs, etc.

There are many health resources available on the internet, yet I truly believe there is no substitute for in-person professional guidance.  TRAINERS are experts on exercise and physical activity.  Trainers will become part of the healthcare delivery system thus needing to understand not only program design principles but have basic understanding of chronic diseases, behavior modifications principles, etc.

We’ve been hearing this for years, but society’s health woes are still trending in the wrong direction with respect to obesity, chronic disease, etc.

The tipping point has arrived.  Behaviors will change in the general population because the cost (and pain) of NOT being active will outweigh that of being active, thus driving consumers to engage their health more aggressively.

Recommendations for Trainers:

  • Get out in Front of the Business: attend local networking events through your chamber of commerce, offer to present for organizations in your community, submit complimentary articles you’ve written to your local paper or publication, BE VISIBLE!
  • Become a Referral Source-Market your Services to the Medical Community: Visit your local Healthcare System’s Website.  Search for ‘Medical Groups/Providers’ with specialties in Primary Care, Cardiology & Orthopedics, for example.  Also, look for the system’s Accountable Care Organization (ACO).  These two groups mostly likely are EMPLOYED and/or financially incentivized to track their patients’ health outcomes. Considering many healthcare systems don’t have an integrated fitness component on-site for general populations you can become a great referral source in the community.
  • Employers: reach out to your local companies.  Share your marketing materials, offer free lectures, etc.  Many benefit plan designs now offer an incentive either cash or incentives to become and stay active. Most companies, particularly small to medium size, do not have the resources to offer an on-site fitness center.  You can fill that void.
  • Cost Effective Product: Small Group Training, Partner Training, condition-focused sessions are cost-effective services you can offer to healthcare systems and employers.  Packages or membership option could be offered.
  • Education: read up on disease management, medical conditions/contraindications, etc.  ACSM, Medical Exercise Training Institute, NSCA, are 3 great organizations that come to mind when thinking of high quality education.  Please note, THERE IS NOT SUBSTITUTE FOR WORK EXPERIENCE.  All the certifications and formal education won’t make up for hands on work experience with clients.

Key Takeaways:

  • Healthcare Industry Buy-in: more providers are employed and now incentivized to KEEP PATIENTS out of the hospital
  • Disease Management vs. Disease Prevention: fitness professionals ARE health providers.  You are the Front line of prevention.
  • Integrated System of Care: Fitness professionals should consider themselves part of an ‘Integrated System of Care’.
  • Scope of Practice: know your role in the healthcare management chain. You are a trainer not a doctor or therapist, but arguably you will potentially have the greatest impact on a client’s health over the course of their lifetime.
  • Educator: you are an educator and teacher to your clients.  Teach them the basics of health and fitness they can do on their own.
  • Niche vs. General Population: we all have our niche…sports, geriatrics, etc.  Keep in mind 80-90% of your business will come from the general population, particularly if you work in a commercial or community based fitness setting.  Keep refining your skills in the core skills generally associated with training: program design, nutrition, lifestyle modification, assessments, etc.

Have a great 2016!  I hope this ‘peek’ into how to bridge the gap between healthcare and fitness will help you kick start your business.

Feel Free to reach out for a chat.

Best, William Smith

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