Helping Medicare Patients Reap the Benefits of Exercise

In a September 14th letter to the Centers for Medicare & Medicaid Services (CMS), PAA offered several recommendations to the proposed Calendar Year 2027 Medicare Physician Fee Schedule. PAA is asking that CMS:

• Make physical activity assessment a routine part of annual wellness visits;

• Make it easier for doctors to refer people to qualified exercise professionals and community programs;

• Support health and wellness coaching;

• Incorporate physical activity into programs for diabetes, obesity, and cognitive decline (when clinically appropriate); and

• Create better ways for doctors and community providers to share information about a person’s progress through follow-ups.

“Our goal is to make sure physical activity is considered earlier and more often, not just after someone develops a serious condition or reaches the point where they need a highly structured medical program,” Goscinski explains. “We want policymakers to understand that fitness facilities and the professionals working in them can be an important part of that solution.”

An Opportunity for Fitness Facilities

With the adoption of these recommendations, operators and fitness professionals could become part of the referral pathway by providing qualified professionals and evidence-based programs in community environments.

The scale of the chronic disease epidemic requires the US to leverage more of its existing healthcare infrastructure, according to Mike Stack, president of PAA. “Traditional healthcare settings are already bursting at the seams. Fitness centers can provide capacity to meet demand.”

But fitness facilities must meet higher expectations in order to be considered a trusted referral source, he adds.

“Facilities will need to employ qualified professionals and ensure the high standards of safety and cleanliness you’d expect from healthcare settings,” Stack adds.

PAA also calls for Medicare to preserve options for individuals to choose qualified professionals and programs across clinical and community settings.

“For one person, the right option might be a medically supervised program,” Goscinski says. “For someone else, it might be working with a qualified exercise professional, joining a community program, or going to a fitness facility where they feel comfortable.”

Preparing for a Role in Healthcare

The potential evolution of the healthcare–fitness relationship requires operators to reconsider their approach, Stack points out.

“For industry leaders that want to be part of the healthcare system, it can no longer just be about getting fit. The mindset shift has to be to that of a healthcare provider who works with individuals with chronic disease to treat and/or prevent their condition(s).”

That means fitness professionals need to understand chronic disease and the needs of aging adults, communicate effectively with healthcare providers, and demonstrate clinically meaningful outcomes.

“This work won’t transform Medicare overnight, but it helps establish the building blocks for where we believe healthcare needs to go,” Goscinski says. “HFA and PAA have an opportunity to ensure that physical activity stays front and center, and that fitness facilities, qualified exercise professionals, community programs, and consumer choice are part of the solution as healthcare evolves.”