Essential changes within the healthcare system are creating a potential tsunami of economic shift amongst the medical, government, insurance and corporate sector. With the uncertainty regarding the sustainability and future of the healthcare system due to rising costs, many of these industries are looking for business opportunities to be a disruptive solution to the healthcare crisis.

    In the medical arena, hospitals, physicians, private medical practices, and health and fitness professionals are beginning to see unique opportunities to collaborate. Most medical professionals and administrators understand the impact healthy eating and exercise can have in the management and prevention of chronic disease. However, the integration of these two professions have mainly remained segregated up to this point.

    The obesity epidemic and the incidence of chronic disease and injury have forced the need for a preventable, medically-integrated, and outcome-based model of medical fitness. Our nation has thrived in traumatic care and with communicable disease but has failed miserably with chronic disease and pain management. Several economists have predicted a shortfall of government funding to keep pace with the rising obesity rates and related healthcare costs.

    Clifton Leaf, ( has predicted self-aggregation where large corporations will create large self-organized health systems within their walls as they believe they can provide care at lower costs. Recently Apple replicated Amazon into a self-aggregated healthcare model. Apple is opening health clinics for employees and their families this spring, CNBC reports. CEO Tim Cook recently told shareholders that Apple could make a “significant contribution” to the healthcare industry. Prior to this announcement Amazon, Berkshire Hathaway and JPMorgan Chase released a joint healthcare initiative for their corporations.

    Self-insured corporations are investing in corporate wellness and fitness programs as well as preventive, holistic and non-surgical orthopedic medical services to reduce healthcare-related spending. Self-insured companies are those that pay directly for employee care and may elect to add any medical or health service to their insurance plan. Offerings of wellness, training, functional and regenerative medicine led programs are aimed to reduce or better manage disease, prevent surgery and chronic disease, workers compensation claims, sick time while providing attractive employee benefits.

    Recently, we have met progressive efforts of all insurance sectors to reduce the total cost of healthcare and more specifically the root cause of obesity related disease. In 2018, Centers for Medicare and Medicaid Services (CMS) released the Diabetes Prevention Program (DPP) after years of initial trials aimed at adding wellness and preventative services to help combat the rising cost of health care and as a solution to better manage and prevent chronic disease.

    The Diabetes Prevention Program was a major multicenter clinical research study aimed at discovering whether modest weight loss through dietary changes and increased physical activity or treatment with the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in study participants. At the beginning of the DPP, participants were all overweight and had blood glucose, also called blood sugar, levels higher than normal but not high enough for a diagnosis of diabetes—a condition called prediabetes. The DPP found that participants who lost a modest amount of weight through dietary changes and increased physical activity sharply reduced their chances of developing diabetes.

    The DPP's results indicate that millions of high-risk people can delay or avoid developing type 2 diabetes by losing weight through regular physical activity and a diet low in fat and calories. Weight loss and physical activity lower the risk of diabetes by improving the body's ability to use insulin and process glucose. Additionally, DPP participants who took the oral diabetes medication metformin also reduced their risk of developing diabetes, but not as much as those in the lifestyle intervention group. The DPP's impact continues as new research builds on the study's results to find the best ways to delay, prevent, and treat diabetes.

    The National Institute of Diabetes and Digestive and Kidney Diseases supports a wide range of research related to the DPP, such as studies that assess cost-effective methods of delivering lifestyle modifications in group settings and over the Internet, as well as methods to sustain behavior change and weight loss. Other researchers are testing interventions like those used in the DPP to help prevent the development of or treat existing type 2 diabetes in children and youth. (National Institute of Diabetes and Digestive and Kidney Diseases / NIH).

    Beginning in 2018, the Centers for Medicare and Medicaid Services announced Medicare coverage for Diabetes Prevention Programs (DPPs). This supports the much-needed efforts to prevent diabetes in seniors. Soon, there will be a huge demand for qualifying DPP suppliers to meet the needs of 54 million Medicare beneficiaries nationwide, half of whom are estimated to have prediabetes. (Natalie D. Ritchie, PHD).

    Within the private insurance sector, there’s legislation aimed at passing the Personal Health Investment Today Act (PHIT). Individuals with health savings accounts or flex dollars can use their tax-deferred contributions towards preventative lifestyle approved services. It’s a health-related tax incentive to help encourage movement and reduce lifestyle related disease. In the new healthcare reform legislation, it’s one of the few acts to receive bipartisan support.

    Medical centers like Rejuv Medical and John Hopkins Weight Management provide patients with medical assessment, supervision, exercise programing, behavioral and nutritional therapy, and individualized medical services. These are all services the typical personal training client cannot find at a gym. People who seek out (or are referred to) medically-supervised programs require more of a complex approach than the simple training or weight loss ideologies of years past. A significant rise in preventive and functional medicine centers employing health coaches, nutritionists and fitness professions has begun to create and abundance of integration opportunities.

    Health and fitness professionals may explore several options to engage patients who need medically integrated or supervised programs:

    • Become employed with an integrated medical system
    • Serve as an independent contractor for independent medical practices owners
    • Partner with a physician/medical group
    • Own a medical fitness facility and lease space to medical professionals
    • Offer retirement and nursing home recreational, fitness and nutritional programing
    • Create online fitness programs partnered with medic biometric-based outcome tracking technology for personal or corporate wellness program delivery

    The goal of medical fitness is to combine the science of medicine, and the physiology and endocrinology of the body to develop a healthcare model that creates permanent changes, heals degenerative conditions, and restores health and vitality to patients.

    Persons with obesity, diabetes, high cholesterol, inflammation, pain or injury is now the common. This population will not just be coming to centers with medical supervision; they are at every fitness club in America so professionals must be equipped to handle this growing population. It’s estimated that in the next 10 years every healthcare organization will have a facility and program dedicated to the prevention and treatment of lifestyle related disease. (Pamela Kufahl, Editor-in-Chief | Club Industry, Jun. 1, 2011).