Hospital-affiliated Wellness Centers on the Rise
By Debra Wood, RN, contributor
November 10, 2010 - What if hospitals were more than just treatment centers, providing ways to help people improve their overall health and avoid getting sick in the first place? That scenario is becoming more common as hospitals and health systems across the country are operating wellness or fitness centers open to the public and their employees in order to improve health in their communities.
“It is a growing trend,” said Stephen Mansfield, Ph.D., CEO and president of Methodist Health System in Dallas, which operates two fitness centers. “While healthcare reform offers some needed changes to insurance and the healthcare delivery system, to truly reduce the costs and impact associated with poor health, the only answer is greater personal accountability for health, and participation in a comprehensive wellness center is an integral part of the process.”
Greg Camp, director of the wellness centers at Lee Memorial Health System in Fort Myers, Fla., estimates about 400 hospitals and health systems around the country have affiliated wellness centers.
“The medical-fitness arena is the fastest growing segment of the fitness industry in the country, and it has to do with baby boomers aging, the preponderance of exercise information out there, and understanding exercise is good for you,” Camp said. “These centers, and ours too, have degreed, certified staff, and [people] feel safer here.”
Focus on prevention
Many hospital officials feel they have an obligation to help people stay well.
“There is a responsibility on the front end to provide services for the community that keep you as healthy as possible,” said Elliot Cohen, spokesman for Health First, a nonprofit health system and health plan provider in Melbourne, Fla., which operates four Pro-Health & Fitness Centers.
Gail Winston, director of The Wellness Center at DeKalb Medical in Decatur, Ga., said, “Throughout the years, our mission statement has included being dedicated to the wellness of the community, and this is one of the ways we demonstrate that.”
Denny Porr, executive director of employee health and safety for Saint Thomas Health Services in Nashville, Tenn., said that while some hospitals do not view prevention as their responsibility, most offer programs, education and other interventions to allow the community members to take a larger portion of the responsibility for their health.
“Any investment in the overall health of the community is or should be an obligation of a healthcare institution,” Porr said. “It is basically a ‘partnership’ with the community the hospital serves.”
Jennifer Hopper, manager of the Piedmont Hospital Health and Fitness Club in Atlanta, added that wellness and exercise is part of the continuum of care.
“When someone in the community needs a physician or treatment and they are already coming to our health and fitness club, they are more apt to look at the hospital as a provider,” Hopper said.
Wellness facilities, screening and other services can serve as tools to advertise healthcare services.
“It’s good visibility for us to demonstrate we are concerned about keeping people healthy,” said Garry Schwall, chief operating officer at Winthrop-University Hospital in Mineola, N.Y. “Also, it promotes Winthrop as a healthcare institution.”
“It sets us apart from other companies that simply operate hospitals,” Cohen added. “That’s an important need, but it’s only one piece of the puzzle when you are talking about community health.”
Many health systems locate reimbursable services--such as physical therapy and cardiac rehabilitation--at their wellness centers, and try to transition patients when those services end to fitness memberships.
“It makes it real easy for them to keep coming,” Winston said.
Catholic Medical Center in Manchester, N.H., has located board-certified physicians offering conventional and complementary medicine, a massage therapist and physical therapy at its Family Health & Wellness Center at Bedford.
“We attract people who normally would not see a doctor,” said Catherine Shanahan, M.D., one of the physicians at the center. “Administration felt it wanted to offer this because other types of practitioners--naturopaths, chiropractors--are out there and not affiliated with the hospital. They indicated they wanted to capture some of that market. They are not separate worlds.”
Insurers cover the physician visits but patients typically pay privately for massage therapy and the hospital’s yoga and exercise classes, which take place in a different building and are subsidized.
Community benefit, not necessarily a revenue producer
Many hospitals, including Health First, Winthrop and DeKalb, operate wellness centers to break even.
“Methodist Dallas Medical Center runs the Folsom Fitness Center at a small loss due to very low membership fees, but this allows for more community and employee participation and is a key part of our mission to improve and save the lives of those we serve,” Mansfield said.
Mansfield added that wellness centers also can serve to help not-for-profit hospitals meet their community-benefit requirements to keep that tax status.
Lee Memorial and Winthrop also consider some of their educational programs as a community benefit for tax-status purposes.
Healthcare attorney William Gregory O of Illinois explained that many hospitals and healthcare systems operate as tax-exempt charities and must provide free public services to maintain tax-exempt status. He said offering public education can be a cost-effective method of delivering such charitable services to the public.
Keeping health premiums down
Winston said wellness centers encourage healthier employees. That, in turn, can keep health premiums down.
Lee Memorial has instituted as part of its benefit package a new program called Healthy Bucks that will screen employees and, hopefully, improve their health. Employees receive $150, which they can spend toward membership at the wellness center or other things.
Nebraska Medical Center in Omaha operates a fitness center exclusively for employees, which it attributes to helping the hospital control healthcare insurance costs. In the last 10 years, the cost of health insurance has gone up more than 27 percent in the United States, while Nebraska Medical’s rates have increased only 4 percent.
As a secondary benefit to employees, Hopper added that staff members work out side by side, promoting collegiality.
“This is positive place for employees to decrease stress and socialize with each other on a different level,” Hopper said.
Partnering or going it alone
Most hospitals are capable of operating their own wellness centers, Mansfield said, although some co-venture with third parties or have a third party manage or operate the venture for the hospital.
Winthrop-University Hospital partnered with Healthtrax Fitness & Wellness, an experienced provider, to operate a fitness center within its Wellness Pavilion, because running such a center is outside its core business, Schwall said.
Nifty after Fifty in Garden Grove, Calif., partners with medical practices and health plans, which allows them to offer older patients and insured people with a customized exercise program.
“We decrease falls and fractures and hospitalizations, so the medical loss ratio is dramatically reduced,” said Sheldon S. Zinberg, M.D., founder of Nifty after Fifty.
Health plan coverage
Health plans do not typically cover the cost of fitness clubs or wellness centers. Health First is an exception. It offers the people it insures, including its employees, free membership in its centers, which gives them access to the fitness equipment and consultations with nutritionists and physical therapists.
“The number one priority is to promote wellness,” Cohen said. “By offering free membership, we hope it encourages people to come in and use the services and stay healthy. If they maintain good health, they are less likely to show up in one of our emergency rooms.”
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