Miramont Lifestyle Fitness in Fort Collins, CO, is not a typical health club. It offers six-, eight- and 12-week programs that help people with their health issues, such as high blood pressure, diabetes and obesity. One of its four locations has an urgent care and lifestyle medicine practice that is being converted into an employee health clinic where employees will receive medical services along with the opportunity to participate in wellness programs and specific programs for high-risk employees. The clinic offers many services offered by a primary care practice and employs three nurse practitioners, a full-time doctor and a part-time doctor.
All of this came about partly because Cliff Buchholz, owner of Miramont, saw an increasing need to reach out to the non-fitness enthusiast. Fifteen years ago, Miramont and most other clubs marketed primarily to the fit individual who wanted to be fitter, but today, Miramont's market is non-exercisers, many of whom are older and may have health issues, according to Buchholz.
"The market has changed," Buchholz says. "It's not going to revert back to you offering programs just to healthy, fit people. It's going to continue going the other direction, which is good and positive. It is going to reduce health care costs, but it's going to take time."
Buchholz's efforts have positioned Miramont as one of several clubs that already is part of the health care continuum. Positioning within that continuum likely will become even more important when the Patient Protection and Affordable Care Act (PPACA) goes into full effect in 2014.
"One of the reasons we did it was that we felt that wellness and prevention would be a major part of the Affordable Care Act, and there would be emphasis placed on people being more proactive about their health," Buchholz says.
The PPACA could create tremendous opportunities for the health club industry. Because of rising health care costs, many employers and health insurance providers are offering incentives and rewards to individuals who pursue a healthier lifestyle and, consequently, lessen their need for expensive medical treatments. The result could be that individuals, business owners and health providers will look for programs that can assist them in those efforts. With these programs will come a need for coaches, perhaps well-educated and specialized personal trainers, who can guide individuals to make better nutritional, exercise and lifestyle choices.
"Every health club in America is in a perfect opportunity and a perfect place because all the chronic disease risk-related issues can be addressed in part inside the fitness center environment," says Jason Conviser, president of JMC & Associates, a Glencoe, IL-based consulting firm specializing in developing relationships between health care and health clubs.
The treadmill for the obese is the same treadmill as the one for the triathletes, he says. The difference is that individuals dealing with chronic disease need programs and trained staff to help them beyond just the typical definition of customer service. They need help from people who are knowledgeable about their disease state, can assess where they are, educate them on where they need to be and create a roadmap to get them there.
Miramont is not the only club already participating in the health care continuum. The Dedham Athletic Club in Dedham, MA; ACAC Fitness and Wellness Centers in Charlottesville, VA; Gainesville Health and Fitness Centers in Gainesville, FL; and Akron General Health and Wellness Centers in Akron, OH, are just some of the other facilities well-known for their efforts in this area, too.
Executive Health & Sports Club, a 110,000-square-foot club in Manchester, NH, also is preparing for the PPACA. The Executive Health and Sports Club has a full-service spa, an urgent care facility, occupational health services, physical therapy, programming for chronic disease management, a registered dietician along with the standard equipment and programming available in a fitness facility.
"We have completely differentiated ourselves in our market so when people talk about our business, they do not even think we are in the fitness business anymore—they think we are in the wellness business," says Mike Benton, owner of the club.
But Benton has taken his efforts a step further than many, creating the Genavix Wellness Network, which is a network of fitness facility operators that offer a 90-day Commit to Get Fit wellness program for individuals using a comprehensive health-risk assessment, education, wellness programming, coaches and technology. By incorporating the Genavix program into their facilities, these club operators have a client-based business on top of their membership-based business. At the end of the program, 86 percent of the 1,200 participants who have gone through the program at the New Hampshire clubs have joined as members.
The Genavix Network includes nine facilities in New Hampshire and three in Massachusetts with another 20 facilities in New England joining soon, Benton says. He is selecting facilities around the country to expand the network nationwide. These facilities must meet certain qualifications and certifications.
Although the efforts of these regional players are noteworthy, does one of the national chains have the ability and desire to take the lead and show that health clubs can be a successful part of the health care continuum?
"The bigger boys now have a whole different opportunity in front of them if they choose to capitalize on that," says Kevin Steele, a partner with Communications Consultants and someone who has been involved in integration of health care in clubs for 30 years.
Whether 24 Hour Fitness, LA Fitness or Gold's Gym would be able to lead in this area would depend upon whether company executives want to commit to it from a strategic corporate perspective and commit the resources necessary to do it, an industry consultant says. Life Time Fitness could have a large impact in its markets if it commits to this effort, but it is not yet truly national, the consultant adds, and the cost of building its facilities prohibits it from expanding quickly.
So that brings us back to the current leaders in companies such as Miramont, Dedham, ACAC, Gainesville and Akron General as leaders in their areas. Unfortunately, many club operators are not as well-prepared as these facilities to meet the challenges of the PPACA, Steele says.
Anyone who wants to work with corporations and the health care industry will need to look at the issue from a big picture perspective and be willing to take on the required preparations and due diligence to accommodate people who are not fitness enthusiasts into their clubs, Steele says.
"We are really good at providing facilities for people who want to exercise or athletes, but where we really stumble is we don't really understand the mentality of the person or the patients who are going to be referred into these clubs, we don't understand their needs or what the psychological barriers to our industry are," Steele says. "The astute operators who can get into that and really understand that and make the few minor modifications in their facilities will be able to make a huge impact in their local communities."
Health care providers need to be educated about what the fitness industry can offer as part of the continuum of care, and the fitness industry needs to educate itself about protocols that come with being part of that continuum of care, such as the need to comply with federal regulations that cover patient privacy, Steele says.
Ken Germano, CEO of the Medical Fitness Association, agrees that modifications will be required.
"You have to make a fundamental shift in your philosophy and spirit as a facility," Germano says. "Are we this lifestyle of beautiful people, or are we going to be about mainstream and talk about reaching the other 85 percent of the population?"
Buchholz warns that only clubs that are in a position to provide quality programs should pursue this or they risk hurting themselves and opportunities for other club operators.
"You have to have a staff of individuals, of wellness coaches, of nutritionists, of registered dieticians and a marketing team that is willing to do it," Buchholz says. "It is not going to happen without a fair amount of effort."
Program-driven clubs are more likely to be prepared for this challenge than equipment-based clubs, Buchholz says, because equipment-based clubs often are lower-priced clubs that do not have the required staffing.
That does not mean that club operators must change their business models, Conviser says. Instead, operators who have the qualified staff can simply add these short-term programs, especially if their current model is doing well.
"What you are doing is adding a new product and positioning it in a way that people who haven't come before want to buy," Conviser says.
Despite the promises of additional members from the elusive deconditioned market and their accompanying revenue, some club operators may be disappointed that the immediate return on wellness programs is minimal. Miramont's programs are not necessarily its most profitable, but as more emphasis is placed on employees and individuals being proactive about their health, that will change, Buchholz says.
And despite the wait, the programs are worth doing, he says, because they differentiate his facilities, set the foundation for future growth and put Miramont ahead of the curve and going in the direction it needs to go.
"You are preparing yourself for down the road when it can be and will be profitable for you," Buchholz says.
• Assess your human capital and your capability and capacity to deliver programs that help individuals manage chronic disease.
• Assess your current programs to see if they already deliver what you need in a short-term program format. Do you have a medically approved weight-loss program (not just a "Biggest Loser"-style program), a diabetes program, an arthritis and pain management program, and a hypertension program?
• Identify one chronic disease program in which to become an expert. Think about that program in terms of how it changes with the tool of exercise, not with the sale of a membership. Then, use your environment to offer the program but charge a significant premium for offering the use of your facility for a short period of time.
• Identify one person to train as an expert in a chronic disease rather than training every staff member for all these programs. That person must have the right personality: entrepreneurial, parental, scientific, a fitness expert and someone who can talk at the medical and fitness level.
• Learn from your first program, then replicate it with a second one for a different chronic disease. Any additional program is really just a variation on the first program. The main difference is the specifics on the chronic disease.
• Make sure your staff is on board and supportive of these programs.
• Offer tracking and assessment systems as employers want measurements.
• Ensure that your club environment is welcoming to people who are intimidated by health clubs—from the layout to how people are greeted when they enter.
• Create supporting collateral materials and a marketing plan.
• Determine whether these short-term programs will be part of a separate department and a separate budget or in the general ledger.
• Speak to and learn from others who have offered similar programs.
• Establish a network of referrals in the health care market. Start by asking doctors on your membership list to be on your advisory board. Share with them your chronic disease management program plan. Ask them if they would refer at least one of their patients to participate in the program.
For fitness facility operators to be a successful part of the health care continuum, they must change their sales mindset, says Jason Conviser, president of consulting company JMC & Associates, Glencoe, IL. Instead of focusing on selling memberships and personal training, they should focus on selling 12-week programs that help people with specific chronic conditions.
"People are not saying I need a health club membership," Conviser says. "What they are saying is 'I feel like my life is out of control. I'm exhausted. I don't feel good.' The world is coming at them very quickly."
People are willing to participate in short-term programs to treat their chronic conditions even though they do not want to join a health club. The short-term hook gets individuals in the door and gets them results. Once that happens, club operators can discuss re-upping on a 12-week package or converting to a membership, he says.