Chronic disease accounts for approximately 75 percent of the nation’s aggregate healthcare spending, according to the Centers for Disease Control and Prevention (CDC). In terms of public insurance, the treatment of chronic disease constitutes 96 cents per dollar for Medicare and 83 cents per dollar for Medicaid.
More than 50 percent of Americans report a chronic musculoskeletal (MSK) condition in any given year. Nearly one in five healthcare visits are tied to a musculoskeletal issue. Total spending on musculoskeletal conditions alone in the United States exceeds $200 billion annually with an average cost of $7,800 per person.
Astonishingly, a majority of these cases and associated costs are preventable. Countless studies have proven that regular physical activity can profoundly impact fighting chronic diseases and lowering the rate of MSK injuries. However, it takes a coordinated and integrated effort between multiple stakeholders to effectively evoke change.
Efforts to integrate healthcare with the fitness industry has existed for years. A vision of a seamless continuum of care and training has provided great inspiration for the multiple stakeholders involved:
- Insurers seek ways to keep their members healthy and reward those that do
- Healthcare providers seek ways to deliver cost-efficient care and provide services beyond their allotted reimbursable time
- Club owners yearn to tap into the other 80 percent of the population that isn’t intrinsically motivated to say healthy
- Patients and members desire convenient, coordinated and cost-effective ways to stay healthy and active
Despite these aspirations, there historically have been insurmountable barriers to achieve this vision:
- Insurers battled with the administrative burden tied to keeping track of member activities
- Healthcare providers didn’t receive incentives through traditional fee-for-service reimbursement models
- Club owners struggled to find meaningful ways to provide operational value to the healthcare system
The Acceleration of Change
Over the years, these barriers began to lower. Technology advanced to automate the administrative burden, and reimbursement expanded to value-based care offering new models to deliver health services. Even with these advancements, there was still a challenge of inducing operational change to implement this vision. Then came COVID-19.
COVID-19 instantaneously brought organizations to a halt. Doors closed, revenue stopped and everyone struggled to hold on and figure out what it will mean to run a business on the other side of this pandemic. Although we’re still in a deep battle with the virus, thought leaders have come together to collaborate, plan new innovative models and adapt services to the new norm. Ironically, this horrific pandemic has accelerated the path to implementing this long-standing vision of connecting the healthcare and fitness industries.
A Vision Realized
Rapid advancements in technology and the reinvention of business models have unlocked an opportunity to implement a new model that provides advantages for everyone. The evolution of smart equipment, sensors, wearables, cameras and facility check-ins has created a plethora of data to track physical activity and deliver care or training. We’ve also seen advanced digital “piping” constructed to consolidate all these data sources into one digestible stream for efficient consumption and connectivity, leading to new opportunities:
- Health Insurers now have the digital infrastructure to provide activity-based rewards such as lower premiums or gift cards to help incentivize people to stay active and healthy.
- Healthcare providers can deliver medically driven protocols in remote facilities, such as commercial clubs, to reduce costly in-clinic visits and provide more accessible, long-term care to patients
- Club operators can digitally connect with insurers and providers expanding revenue models and increasing membership from the other 80 percent.
The biggest winner through this collaboration is the patient or member. A once-fragmented and inconvenient system has now evolved into a cohesive, coordinated and engaging experience to ensure long-term health and wellness.
Our world is in a unique moment in time. The advancements of technology, the evolution of business models and an induced catalyst of change from COVID-19 is providing breakthrough opportunities to deliver next-generation care and training. Although the present is challenging and daunting, the future is bright, inspiring and tangible.
Ryan Eder is CEO and founder of IncludeHealth. With a passion for design and an unwavering commitment to lowering the barriers in health and performance, Eder leads the growth and success of IncludeHealth, a next-generation musculoskeletal platform that pairs HIPAA-compliant cloud software with connected equipment, sensors and data to drive better outcomes at lower costs. He leads a team of innovators that focus on empowering the health, performance and fitness industries through connectivity, data and analytics. With more than 15 years of experience designing products across a variety of industries, Eder has received more than 40 innovation and design awards including winning Gold and Best in Show twice (2007 and 2016) in IDSA’s International Design Excellence Awards.