In 1989, Steve Dietz arrived at Pro-Health and Fitness in Melbourne, FL, to find a medical fitness center that was floundering. The 50,000-square-foot center, owned by hospital system Health First, Rockledge, FL, had been open since 1983 to serve the community, but it was losing the hospital money.

That’s when the CEO of the hospital, Mike Means, charged Dietz with turning around the facility in hopes that the not-for-profit health care system could expand and add additional Pro-Health and Fitness medical centers at its other hospitals. Dietz went to work, improving programming, staff training, marketing and integrating other departments of the hospital with this facility. Today, Health First has four medical fitness centers, the latest opening two years ago in the planned community of Viera, FL, despite being in the midst of a recession in a county with unemployment at 11 percent. The four facilities serve 40,000 members and are profitable departments of the hospital group, Dietz says.

Health First is not the only health care system adding medical fitness centers. Statistics show that the number of these types of facilities is growing despite the recession. The growth stems from the obesity epidemic, increased health care costs and the federal government’s Affordable Care Act.

These trends create an opportunity—and some might say an obligation—for hospitals to open medical fitness centers to improve the health of their community and for fitness management companies to add more medical fitness centers to their portfolios.

In 2009, the United States had 5,008 hospitals, and 1,214 reported having medical fitness centers, according to the American Hospital Association. A 2010 report from the Medical Fitness Association (MFA) identified 1,083 U.S. medical fitness centers, serving an estimated 3.3 million members. (The difference in figures stems from varying definitions of a medical fitness center.) The number of these types of facilities has increased by 6 percent per year since 2003, and membership numbers are expected to exceed 4 million by 2015, according to the MFA.

The biggest growth in this market occurred in the late 1990s and early 2000s, say many people in the industry, but they add that they see stirrings of growth again.

“Clearly this area of wellness prevention is growing,” says Doug Ribley, vice president, health and wellness services at Akron General LifeStyles, a department of Akron General Health System, Akron, OH. “You just look at our organization, for example. We have two multi-million dollar centers, one on each side of town. We broke ground on a third $35 million center in the southern part of our county and just announced our fourth—which is a partnership with a local municipality in the northern part of our county. Our medical center will be surrounded by our outpatient delivery health and wellness center model.”

Health Care Reform

Much of the expected growth in medical fitness is due to the Affordable Care Act. Debra Siena, president at Proactive Partners, a division of TCA Holdings, Chicago, calls the act a “momentum changer.”

“Employers, employees and health systems all realize that no matter how this health care reform act evolves in the next five years, they are going to be affected,” says Siena, whose company develops and manages both corporate and medical fitness centers. “The best way to get ahead of it is through prevention.”

Ribley says health care reform is motivating health care systems to change.

“We clearly understand that we need to be in the business of prevention going forward,” Ribley says. “As more and more health care organizations through health care reform are going to have to accept responsibility for and accept the risks of various populations and groups through health care reform, it only makes sense that rather than waiting for people to have a physical train wreck, we need to be in the business of helping to prevent that train wreck from occurring.”

Ribley estimates that within the next 10 to 15 years, every health care organization will have a facility and program dedicated to the prevention and treatment of lifestyle-related disease, illness and injury. To do so requires adding a fourth component to the continuum of care that had traditionally only included diagnosing issues, treating them and rehabilitating patients. That new component is prevention.