A Sustainable Wellness Model - Medicare & Prevention

Outcomes outcomes outcomes. Why has wellness been slow to take root ? Outcomes....

Getting on a treadmill does not an outcome make and therefore the theory of how fitness makes people healthier has to date undermined the huge opportunity. Realize that for-profit fitness is $20 Billion a year compared to over $2 Billion a year for traditional medicine, with over 75% of that cost being related to lifestyle oriented diseases. Our health care system cannot afford it and costs must be driven out. Watch the video about how unsustainable our sick care system is.

When the extant fitness industry realizes the motherload of all business opportunities is emerging, value added proven prevention, the shift from membership models will be approaching - but we need the funds shifted from sick care to prevention. . A recent announcement that Medicare will reimburse for the Ornish and Pritikin programs is a step in the right direction. As a recent Blog post by Health Quack of the Healthcare Industry and Policy Community Reported:

Medicare will pay for intensive diet and exercise programs developed under the Ornish and Pritikin brands for reducing cardiovascular event risk, the Centers for Medicare and Medicaid Services announced.

The agency's review of published data on the Ornish and Pritikin intensive cardiac rehabilitation programs found that they effectively slowed or reversed progression of coronary heart disease and reduce the need for coronary artery bypass grafts (CABG) and percutaneous interventions.

Consequently, they are approved for coverage under Part B of Medicare, CMS said. Legislation that went into effect this year established a new benefit for intensive cardiac rehabilitation programs.

Because Medicare will make these programs available to all beneficiaries regardless of income, it expects the decision will "reduce the disparate impact of heart disease in minority populations."

CMS staff reviewed six studies of the Pritikin program and nine on the Ornish version appearing in peer-reviewed publications. Most of these were conducted or sponsored by the Ornish and Pritikin companies -- eight of the nine Ornish studies, for example, had company founder Dean Ornish, MD, as lead or senior author.

Nevertheless, CMS accepted the reported data as valid and adequate to demonstrate the effectiveness of the programs under the agency's statutory and regulatory requirements.