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Four Ways Health Reform Could Spark Wellness Programs

Les Masterson, for HealthLeaders Media, March 26, 2010

Nearly everyone agrees that prevention and healthy living can help slow the nation's healthcare cost spiral, but actually getting people interested in fitness has always been the problem.

Wellness advocates and population health management officials say Congress took a small step toward a healthier nation by approving health reform.

Here are four ways that health reform could increase and improve wellness programs:

32 million more insured

The legislation will provide health insurance for an estimated 32 million more Americans, which in theory should help improve the health of the currently uninsured. Insurance companies with wellness and disease management programs will enroll the previously uninsured into these programs, which are often run by population health management companies, such as Healthways, Health Dialog, and Alere.

Whether the newly insured can find a primary care physician who can spend time helping them improve their health is in question though.

There are also the issues of how the federal government will implement the broad legislation. Does it invest more in community health centers? Does it invest in demonstration projects and pilots that involve health plans and population health management companies? Or does it fund educational programs?

Though population health leaders are pleased that the legislation could lead to better health and more business, there are still a lot of issues that the feds will have to work out before regulations are implemented.

"This can't be bad, but how will it be shaped in the next round of the process?" says Bob Stone, vice president and co-founder of Healthways. "I would expect people in the [population health management] industry to be fairly active in determining how that gets shaped as it is turned into regulation."

Help for employer wellness programs

The legislation promotes wellness and health promotion activities, including requiring federally qualified health plans to create programs like health risk assessments and allows employers to use more incentives to spark greater employee participation in wellness programs.

Jaan Sidorov, MD, MSHA, FACP, an independent consultant for Sidorov Health Solutions, says reform allows employers to link a higher dollar amount to fitness program participation. Prevention advocates say using that monetary approach can lead to improved fitness participation.

Though he's pleased that many large employers will be able to create more wellness options, Sidorov says he's disappointed that Congress couldn't find ways to help small businesses improve their prevention programs.

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