A health and fitness pharmacy match is changing the face of US seniors. Increasingly, they are demanding wellness first, and they've received huge benefits from a recent radical mind-shift in government and industry.
Since 2004, more than five million Medicare members have joined Medicare Advantage plans... at an average rate of 50,000 per month! In 2005 alone, the federal government approved 163 new commercial Medicare Advantage plans.
Why? Because they offer a 'wellness first' approach to living. Health and fitness go together - in that order - with pharmacy in the background to maintain balance and capability.
The revelation has come with the realisation by government and industry that it is cheaper to keep people healthy than it is to fix them when they break down.
And US seniors benefiting from the health and fitness approach are applauding its benefits.
Rising Healthcare Costs
As rising healthcare costs continue to crank up the pressure on insurers and consumers, both are turning to wellness and chronic disease management programs to improve health and longevity at reasonable costs.
The idea of preventative programs rather than remedial programs, has taken hold.
Special gym and exercise programs are being introduced at health and fitness centres around the country, many of them specifically targeting Americans enrolled in the Medicare Advantage plans.
Participation rates are extraordinary, partially because of the social aspects, and convenience. For a start, their health and fitness pharmacy routine gets them out of the house and into a community facility, where they also have access to a variety of fitness and exercise facilities. But they typically also get access to their normal pharmacy providers as well. These pharmacists are generally more focused on the needs of older health-conscious people and the particular considerations required for their fitness regimes and general health,
Private insurers, employers and State and Federal government agencies are also adopting lifelong wellness and disease management programs. Services such as SilverSneakers and chronic disease management programs fit the Medicare requirements, providing a diversity in coverage options. The innovation in health and care support involved has helped spur more older Americans than ever before to join commercial Medicare plans.
A Healthy Cycle!
The growth in Medicare Advantage enrollment mirrors the growth in programs like SilverSneakers. By the end of 2006, more than three million seniors in 42 states at more than 2,400 fitness centers and class sites were eligible for SilverSneakers through their Medicare Advantage health plans. The attraction is that they meet the needs of members at all points on the healthcare spectrum - whether healthy, sick, or like most, somewhere in between.
The "in-between" category of those well enough for daily tasks, but using pharmacy medications and seeing doctors regularly, has never been larger or received more attention. Many of today's seniors enjoy an unprecedented level of health and activity, but they also use more medications and have more complex healthcare situations than previous generations.
Health & Fitness Forecasts
Their unparalleled health status, driven by advances in medicine as well as increased emphasis on nutrition, wellness, prevention and managing illness into old age, is a siren call. In fact, it foreshadows widespread expectations about the level of care and health baby boomers will demand as they move into retirement and beyond.
The challenge of balancing wellness with complex care support and treatment will only grow as America's aging population expands. A Kaiser Family Foundation study found that of the 89 percent of seniors who reported taking prescription drugs in 2005, nearly half took five or more, more than half had more than one doctor who prescribed medicine, and about a third used more than one pharmacy.
The study also found that among older adults with at least three chronic health conditions, nearly three-quarters took five or more medications regularly. And more than half did not take their drugs as prescribed.
Growth In Health Management
The complexity of this care - and the potential to save money by managing it well - is why health plans rely upon companies like Nashville-based Healthways to provide chronic disease management services to their members.
For many seniors, being well doesn't necessarily mean being free from disease. What it does mean is living life to the full. In addition to busy fitness routines, many participate in a disease management program. At Healthways, for instance, the program connects them with nurses who help them manage such conditions as osteoporosis and low back pain, or on the most effective ways to manage acid-reflux.
Behind the scenes, Healthways employs an army of nurses and clinicians who use sophisticated medical, tracking and predictive technology to monitor clients' relations with the healthcare system, medication use and adherence to doctor's orders.
Health education and coaching helps ensure they can continue in programs such as SilverSneakers.
Health, Fitness & Pharmacy Synergy
The combination of managing illness while staying well creates a powerful synergy. In fact, the industry is evolving into a model that embraces a suite of complementary wellness and prevention programs.
Healthways President and CEO Ben R. Leedle Jr said: "The old way of thinking was that you need to be healthy before you can begin exercising And if you need support for your chronic illness, you must be sick. But we know that's not true. Wellness can be achieved at many points on the healthcare spectrum by people of all ages."
Joe Coughlin, PhD, founding director of MIT AgeLab, agreed."This approach looks more like what I - and many others - envision as the future of healthcare. It aligns the interests of consumers, providers and payors - a combination of outcomes-driven disease management with wellness and prevention programs"
Healthways, for instance, provides specialized, comprehensive health and care support to help people maintain or improve their health and, as a result, reduce overall healthcare costs. Programs are designed to provide highly specific and personalized interventions, irrespective of health status, age, or payor, Services are available by phone, mail, internet, and face-to-face.
So where does your life sit right now? Are you waiting to get fit enough to go to fitness class - or are you well enough to embrace wellness right now? Check into your pharmacy and get the medications sorted. Then step out... and grow your health and fitness together!
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