CONTENT BROUGHT TO YOU BY: GENAVIX.
Over the last two years, our country has been in the process of rolling out healthcare reform. During this process, the employer has emerged as the new payer in managing healthcare costs. Many companies with more than 200 employees (and, in some cases, with just more than 100 employees) are moving to the self-insured ranks.
The companies can now buy healthcare plans that offer reinsurance on the back end of their healthcare policies. This is a direct by-product of insurers wishing to keep employer-based healthcare intact and employers wishing to exit the Affordable Care Act. These new self-insured employers are now looking to reduce healthcare claims by offering pervasive wellness programs that are engaging to their employees. Yet they also offer low cost, high value and outcome-based reporting for better health and wellbeing.
A good part of the Affordable Care Act focuses on preventative care and all preventative care services, such as nutrition counseling. Other services no longer require a physician’s referral or a co-pay. In short, a massively growing preventative care market has emerged and exists in our country today. Most importantly, if you own a successful membership-based business, this opportunity may be available to you. However, you must be willing and able to evolve and establish a wellness practice and to address the needs of families, providers, brokers and employers in the community you serve. A wellness practice will grow your membership as a community outreach offering as it targets individuals and families that never would have had the need to visit your facility.
We want to grow as an industry. Yet, on average, we fight over the same 17 percent of our community market share. The other 83 percent are in need of our services; however, we only offer membership as our primary product offering. Wellness assessments, wellness programming and one-on-one wellness services are more lucrative, carry higher retention rates and provide more customer satisfaction while increasing new market share, but as an industry we need to evolve or we will lose this growth opportunity to others. The preventative care market is a virtually untapped industry. As of March 2016, it is now funded by the federal government for reimbursement as well as many of the major healthcare insurance plans.
Imagine a world where health insurance providers are pre-qualifying pre-diabetics and sending them to your facility for support and help. That would be a good world to operate in and to grow your businesses. It would be a perfect world if they sent us the same prequalified individuals and reimbursed for our services to meet their health and wellbeing needs. That world is here now, and in early 2017, Medicare and other national plans will be reimbursing for pre-diabetes programs based on the Centers for Disease Control's Diabetic Prevention Program (DPP).
However, Weight Watchers, the healthcare sector and others are now mobilizing to establish pervasive delivery capability. Our industry has not been as proactive as others. Yet we possess all of the key performance metrics for success. We may lose this opportunity to others because we are unable to add the additional human capital, programs and business practices that make up this emerging entity called a "wellness practice." Insurance carriers have already started the deployment of preventative care offerings as differentiation and support to their customers looking for a healthier workforce and insured families.
Our industry addresses the needs of the family not just the employee. So, by default, we could and should be a key resource for the delivery of these services. But are we ready? Many insurance plans are starting to roll out reimbursement for preventative care in support of employer-based healthcare. Now is the time to evaluate your capabilities to establish a wellness practice in your four walls and to build a new profit center using the same resources on top of your successful membership-based business.
Here are the key questions you should ask and evaluate prior to spending more time on this topic:
- Do you have the desire or capability to sell outside your four walls to employers, brokers, providers and municipalities? (The Business to Business vs. the Business to Customer selling model)
- Do you have the desire or the ability to set up the proper assessment area (typically, no less than a 12x12 room and no more than 700 square feet)?
- Do you have available time in your group exercise schedule or do you have additional space or conference rooms to run group programming at your facility no earlier than 5 a.m. and no later than 7:30 p.m.?
- Are you willing to hire or certify additional personnel to deliver assessments, wellness programming and one-and-one services as well as group wellness training?
- Are you interested in creating a real differentiation versus your club competitors and actually do so with an attractive ROI result for this wellness direction?
If the answers are "yes" to the above questions, then you are a possible candidate to establish a wellness practice and to deliver preventative care as a corporate wellness provider. There are resources to help guide you in your evolution as a wellness and preventative care provider. This fall, the Club Industry Show will be dedicating educational tracks to this topic, and many leaders in our industry will be there to help guide you to a successful launch.
Mike Benton is the president and CEO of GENAVIX. The GENAVIX Wellness Network is currently in eight states with more than 35 facilities and more than 100 certified wellness coaches. If you feel you are a good candidate to offer outcome-based preventive care programs and services that are reimbursed by health insurance plans, the federal government and employers, then you should speak to GENAVIX. Please contact GENAVIX at 603-232-4894 or www.genavix.com and select “Contact Us” for more information on GENAVIX and the GENAVIX Wellness Network. It is a proven success for existing service-oriented health clubs.