Article Series

Health Care Reform and Wellness – A Real Element in the Health Care Equation

Submitted by Eric Durak, MS - Wellness @ Home Workshops and The Cancer Wellness Company. For more information about Eric Durak visit: www.MedHealthFit.com

A lot of debate has surrounded the New Health Care Reform Act. However – in looking at the reform from a global perspective – the main concern for those in health care is to reduce costs – and one of the biggest changes is to reduce hospital re-admission rates for persons suffering from acute or chronic diseases. Last year that total was over $17 billion dollars.

Many healthcare organizations feel they are uniquely qualified to address this concern. One large company – Philips Lifeline (home care products) states that they can address this need through developing better home care products for their patient base. They state that the aim of developing products to reform health care is three fold:

  1. Improving population health (in their case – seniors)
  2. Reduce per-capita costs (per illness or injury)
  3. Improve the experience of health care (patient satisfaction)

One of the items they mention in reducing health costs is the application of health and wellness within the patient education paradigm. The aim of providing health and wellness in terms of companies like Philips is to manage chronic disease states better.

Most large health care companies are also looking to accountable care organizations (ACOs) to health them manage health care delivery systems. ACOs look at the services (and products) being delivered, and try to find the most efficient way to get them to the market. ACOs then share in the cost savings with the health care companies.

Wellness and Evidence-based Medicine

Another model that is at the top of everyone’s health model is Evidence-based medicine – which in theory is supposed to improve quality outcomes, reduce costs, and contribute to patient satisfaction. In using evidence-based approaches, health care organizations see what the “best practice” is for a particular service, and strive to meet that cornerstone. This all has to do with improving quality of care.

But – if we look at the value of wellness, from return on investment (ROI), which is almost all health promotion studies runs from $2 up to 8.5 dollars return for every dollar invested, wellness is a great product / service to provide for patients / staff, etc. Also, wellness programs of ANY kind cost much less than traditional medical interventions, such as diagnostics, therapies, counseling, etc., and in most cases, lasts longer. The average physician visit is less than 13 minutes; the average amount of physical therapy is 10 fifteen minute sessions, the average amount of counseling sessions is approximately 10, then looking at wellness programs (smoking classes, fitness classes, relaxation programs, on the job stretching) which may be permanent programs lasting for years, then we again see the value of wellness based on the relatively small cost to start, maintain, and grow such programs.

Remember too that as health care reform is broadened in its scope, health institutions may be penalized for not improving their outcomes. An example would be hospital re-admissions. Under the current plan, there is a 1% penalty in 2012-13 for increases in re-admissions, a 2% penalty in 2014, and a 3% penalty in 2015. So institutions want to implement programs that are cost effective, and also will decrease the amount of re-admissions, thus causing penalty payments for themselves. These types of penalties are also placed on equipment purchasing (such as value-based purchasing – if you buy things at a discount, or bulk, you may save money through incentives).

Wellness and True Quality of Care

Wellness is a key for quality care. Actually – what a person like me thinks of as quality care and what a doctor thinks of as quality care are much different. Let’s look at back pain. Most physicians will prescribe opioids for pain, and also recommend surgery for specific types of back pain. However –from a wellness standpoint, there are literally dozens of procedures that may be effective for reducing back pain, and lessening total lost days for an employee. Some of these include:

  • Stretching program
  • Pilates or yoga specific to back care
  • Massage therapy
  • Acupuncture
  • Strength training
  • Water therapy
  • Reiki work
  • Relaxation therapy
  • Decompression / inversion therapy
  • Chiropractic
  • Health coaching / personal training

When applied in specific situations, these wellness programs are both cost effective, and have been shown to be very effective in reducing back pain symptoms in a variety of people. The trick is to match the “best practice” wellness program to the person to see if it is the most effective. This may be the only drawback with wellness. With so many good types of programs – people may get too involved and not be placed into the best situation for their healing process.

Wellness and Prevention

From a standpoint of preventing both orthopedic and metabolic diseases (primary prevention), and lessening the burden of chronic illnesses (secondary prevention), wellness programs can stand toe to toe with other types of prevention programs. One key element discussed in the health plan is hospital-acquired conditions (staff infections, MRSA, air borne illnesses, pneumonia, etc.). Through prevention programs, persons will not be admitted to the hospital in the first place, and the incidence of these types of conditions will not exist in the first place. Wellness has been shown to reduce the incidence rate of development of type 2 diabetes by close to 60%, and many types of cancers (breast, prostate, and colon) by up to 40%. Exercise has been shown to reduce the incidence of depression and anxiety and panic disorders, prevent and actually reverse the elements of arthritis, and improve hormone function in a variety of metabolic conditions. There are many reports that state persons who exercise regularly can have a biologic age up to 20 years younger than their chronologic age. Fit persons have less health care claims, lower overall health care costs, and recover faster from many types of medical procedures.

Conclusions

In speaking with health care organizations – their goals for dealing with the new health care reform act include reducing costs (through prescribing their products), improving quality (by having patients use their products regularly), improving the patient experience, and having seniors especially stay at home longer – reducing the admission or re-admission to hospitals. By using their products – a patient may forgo the need for medical attention, or if a situation arises when they need assistance, new technologies give them assistance quicker, and improve their outlook for recovery.

By using ACOs and bundling of services, most health care organizations hope to save money. By using wellness services for a variety of conditions – research has shown time and again that most conditions are either prevented entirely, or their effects are lessened over time through its application.

As we look for the best methods to reduce disease burden in the US, and maintain the tenets of the Health Reform Act – it is clear that wellness activities may finally be viewed as the holy grail in terms of their application to the masses, their ability to reduce costs, and improve satisfaction of the majority of persons who take part in the variety of wellness activities that are available in this country to date. With over 16,000 health clubs, YMCAs, and recreation centers in the US, there are plenty of opportunities to take part in wellness. We are interested to see if health care professionals now can answer the call.

References

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  2. Philips Technologies. Increasing Lifeline Awareness Series. Conference Call series – August 8, 2012
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  10. Burton, W. McCallister, T, Chen, C-Y, Edington, DW. Fitness Centers: Productivity Measures among Fitness Center Members and Non-Members. Journal of Occupational and Environmental Medicine. 47(4) 343-351. 2005
  11. Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary atherosclerosis? The Lifestyle Heart Trial. Lancet. 1990;336:129–133.
  12. Wilson, MG, Holman, PB, Hammock, A. (1996) A Comprehensive Review of the Effects of Worksite Health Promotion on Health-related Outcomes. American Journal of Health Promotion: July/August 1996, Vol. 10, No. 6, pp. 429-435.
  13. Pelletier, KR (1996) A Review and Analysis of the Health and Cost-effective Outcome Studies of Comprehensive Health Promotion and Disease Prevention Programs at the Worksite: 1993–1995 Update. American Journal of Health Promotion: May/June 1996, Vol. 10, No. 5, pp. 380-388.

About the Author

Eric Durak is the President of Medical Health and Fitness in Santa Barbara, CA. He is the director of the Wellness @ Home program for home care professionals, and has worked his entire career in clinical exercise and The Cancer Wellness Company. Eric has produced award winning programs for wellness and fitness in diabetes, cancer, bariatrics, arthritis, and renal disease.

- Visit Erik Durak’s website: www.MedHealthFit.com

© 2012, All Rights Reserved by Eric Durak, Medical Health & Fitness

Posted January 2013 on www.SeniorsResourceGuide.com