Seeking a Seamless Relationship

It’s Time to Move aims to make physical activity assessment, prescription, and referral a standard part of care. Whitsel describes a seamless handoff from clinic to community.

“We want to take the friction out of that referral and get people as quickly as possible into those community-based resources,” she says. “We want to see reimbursement and coverage for that supervised exercise where patients need a little extra support.”

Early on, Whitsel explains, clinician champions reported that simply adding assessment questions and a referral pathway to their health system’s electronic health record (EHR) took two or three years.

Then came payment. In last year’s physician fee schedule, Whitsel says, the Centers for Medicare and Medicaid Services “revised a code to cover physical activity assessment, to pay clinicians for actually asking the questions and talking to their patients. So that’s a huge accomplishment.”

The next goal is coverage for the referral and follow-through. Cardiac and pulmonary rehabilitation and the National Diabetes Prevention Program already have pathways, Whitsel notes.

“We need to expand these pathways for many other types of conditions and diseases and risk factors,” she says.

A PAA review of the research literature found a return on investment when these services are paid for, giving advocates a message for payers: “It’s worth paying for,” she adds.

A Long Runway

It’s Time to Move is one of several PAA efforts. Under a memorandum of understanding with the Department of Health and Human Services, the alliance supports the federal Physical Activity Guidelines for Americans. Goscinski says he and Whitsel are drafting comments that seek to strengthen recommendations about strength training and steps.

PAA is also updating its National Physical Activity Plan, which lays out strategies and tactics across 10 sectors. “It’s a roadmap for implementing the guidelines,” Whitsel says. The updated plan is due in 2028.

Asked for a 30-second pitch to federal policymakers, Whitsel says: “We’re trying to see a physically active nation, make physical activity accessible, affordable, and a standard for all.”

Goscinski frames the urgency of the challenge, which is supported by data from the Centers for Disease Control and Prevention (see below). Depending on the numbers, he says, only 24% to 26% of Americans who can be physically active are.

“How do we get that next 5%?” he asks.

PAA has set its impact goal out to 2050. “This is a long runway,” Whitsel admits, “but we’re excited to do this together.”

Where HFA Members Come In

The most direct opening for HFA members is PAA’s new national implementation collaborative, which brings health systems, payers, and community partners together to put It’s Time to Move into practice.

“We would love for members of the health and fitness club industry to come and join us,” Whitsel points out, “because that’s where they can connect with health systems and payers and others in this work.”

She offers a concrete example: a federally qualified health center in Texas that wants to adopt the implementation guide and is looking for community partners to handle follow-through.

“I hope that [a] fitness club will be ready to work with that federally qualified health center to be programming evidence-based programming for their patients. These are the kinds of relationships you want to help catalyze.”

Operators interested in participating can contact Goscinski directly through HFA.