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Obamacare could cover cost of your spa visits

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Providing services that add value to traditional medical treatments, the spa industry may have a new partner: Obamacare.

The link between obesity and health care costs is strong, and spas with comprehensive fitness and nutrition programs may be well positioned to partner with organizations seeking to lower the overall cost of care for their patients. According to a recent study published in Spa Management Journal, the Patient Protection and Affordable Care Act, also known as the ACA or Obamacare, will cover preventive and wellness services offered at American spas in conjunction with employer wellness plans, health care services, and disease prevention.

Employer Wellness Programs
The ACA furthers the national commitment to employer wellness programs. Wellness programs are established by employers to encourage their employees to learn about or engage in healthy lifestyle choices. One common incentive offered by an employer wellness program is a lower premium on the employee’s health insurance. There are two major types of employer wellness programs:

-Participatory wellness programs in which the employee is not required to satisfy a standard related to a health factor to receive a reward. Instead, the employee is rewarded for participation in a desirable activity. Examples of participatory wellness options include reimbursing employees for fitness center memberships or covering diagnostic tests (without any reward based on the test’s outcome).

-Contingent wellness programs require an enrollee to satisfy a standard related to a health factor. These may be based on the completion of an activity such as a walking or diet and exercise program, or could be dependent upon the attainment or maintenance of a certain health factor.

Coordination of Health Care Services
Additional trends arising from the ACA address coordination of health care services. One well-recognized challenge faced by the American health care system is that physicians and other health care providers often practice independently from one another. Patients, especially those who are elderly or who have multiple chronic diseases, often receive care from multiple physicians. The need to promote greater collaboration and communication within the health care community is viewed as essential to controlling health care costs and avoiding unnecessary or duplicative tests, procedures, and therapies. The ACA creates incentives for health care providers to collaborate and communicate in many different ways, including the creation of new models of care that provide financial incentives to increase quality while lowering costs.

Prevention is cost-effective for insurers

The ACA also places increased emphasis on preventive care, because it is one of the most cost-efficient interventions to improve health outcomes and lower costs. Preventive care seeks to detect, prevent, and mitigate disease at early stages, which avoids more problematic health consequences and more costly interventions (such as hospitalization) down the road.

One significant section of the ACA requires that certain preventive care services be covered by almost all private health insurers without patient cost sharing. This means that patients can access screenings for high cholesterol and diabetes, healthy diet counseling, and tobacco cessation interventions, without paying out-of-pocket.

Spas and resorts might consider aligning with health care providers that actively manage preventive health care services. By offering services that add value to ongoing efforts by traditional medical providers, stakeholders in the spa industry may find innovative opportunities.

One certainty is that the health care system will continue to evolve. By examining the potential opportunities arising from these changes, the spa and resort community may find new ways to serve consumers and their local communities.

Contact:
The authors of this study, Anita Estell, Steven Stranne, and Michael Flood, are attorneys at Polsinelli PC and are located in Washington, DC. Should you have any questions related to this article, contact sstranne@polsinelli.com.

DC Spa Examiner Bernard Burt is senior editor of Spa Management Journal (www.spamanagement.com).

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