This proposal envisions a new way forward for the United States healthcare system, creating a true focus on preventive health by leveraging existing resources to provide the most impactful yet cost effective interventions possible. Our vision is for a healthier population with fewer chronic health conditions, cancers, and disability. This proposal will require cooperation from many entities, from local, state, and federal governments, foundations & large corporations, as well as health insurance companies. This plan will be based on education and consistent reinforcement that will be necessary to combat a sea of misinformation concerning health and how to achieve it.
This preventive health framework can be accomplished by providing 5 main interventions:
The 5 major interventions are detailed below.
What is needed?
Creation of a preventive health resource for patients provided by a licensed, wellness-oriented health professional (Chiropractor, PT, MD) to exist in parallel with the standard medical system. This resource is envisioned as a first option intervention requiring primary care physician referral although direct access is anticipated for those with health seeking behaviors. Insurance reimbursement will likely be dependent on primary care referral.
Why is this needed?
Standard in-office counselling has not worked as demonstrated by ever increasing rates of obesity and reversible, chronic health conditions. It is commonly suggested that people know how to exercise and eat correctly but don’t have the willpower to do it. This is entirely inaccurate! For example, with exercise, most people have no idea what to do or where to start even if they are willing! In addition, many patients have existing health conditions and/or musculoskeletal limitations that require professional guidance.
Barriers to patient wellness knowledge:
Referral based on need:
Referral made by primary care physicians:
Referral made for:
Program synopsis – What will this in-person preventive health resource consist of?
This resource will consist of 3 entities with a major focus on leveraging existing resources and systems that are already in place throughout the State & Country.
An ideal situation would be the licensed wellness health professional able to maintain a small office space or to simply have use of a small area or room at a local gym location (YMCA, small town community wellness center, etc.) Gyms & wellness centers usually already have personal trainers and instructors who could be utilized at lower cost to work under the direction of the wellness health professional. Individual, group, or family personal training would be only for educational purposes, would last for approximately 4 weeks with a major focus on strength training (progressive resistance exercise), with a smaller focus on teaching proper shorter duration cardiovascular activity. Exercise efficiency and effectiveness will be stressed.
Role of the licensed wellness health professional.
Any supplementation advice would fall to the primary care physician. This is a strictly wellness, non-pharmaceutical, non-supplement, resource.
Licensed wellness health professional requirements and responsibilities
The practitioner MUST:
Why focus on strength training as a primary exercise intervention?
After age 30, adults lose approximately 3-8% of lean muscle mass every decade with this rate of decline even higher after age 60. The loss of lean muscle mass means not only decreased strength, balance, and mobility over time, but also a consistently decreasing metabolism making it extremely difficult to maintain a healthy weight. Strength training (progressive resistance exercise), maintains and increases lean muscle mass, strength, and bone density. In addition, strength training produces anabolic hormones naturally - growth hormone, insulin like growth factor, and testosterone which maintains and builds healthy muscle, organ, and connective tissue. This aids in maintaining a healthy body hormone balance which may prevent some cancers and generally keeps our bodies as cellularly healthy as possible. Going further, proper strength training ensures a balanced, strong, musculoskeletal system which prevents back pain, neck pain, shoulder, knee, and other joint pain. For those who have chronic back or neck pain, a simple, regular strength training routine is all that is needed for a more curative solution negating the need for expensive symptom treatment by various health professionals. In addition, strength training provides cardiovascular benefit.
Efficiency & effectiveness prioritized.
The main reason patients provide for not exercising is that they do not have time in addition to not really knowing what to do. This education provided will teach effectiveness in the shortest amount of time possible.
Exercise is the most important yet most misunderstood aspect of health. A short talk with patients leads to the realization that most think they know what to do, which usually consists of the patient getting on a treadmill long enough until they have burned off enough fat! Misinformation and poor exercise understanding is so prevalent among the public as to be considered a public health emergency!
After over 30 years of personal strength training & exercise experience as well as over 20 years of professional in-office experience as a Chiropractor and Registered Nurse, Dr. Christopher May has developed a simple, yet extremely effective progressive resistance exercise routine.
This is a detailed full body routine that utilizes compound exercises with resistance. There are generally only 4 main exercises for the upper body and 4 for the lower body that will ensure strength, balance, mobility, and musculoskeletal health. This routine may be broken down into upper body one day and the lower body the next day. Details are provided with our full preventive health framework guide.
Cardiovascular exercise is taught to increase understanding of the big picture – namely, how to stress the heart, lungs, and vascular system in the most efficient, effective way. Effective cardiovascular exercise can usually be accomplished in less than 10 minutes.
Consistency is the key for effectiveness, not volume, and this is what will be taught. It is important that this framework be maintained across the country as patients are already confused enough as it is concerning exercise and wellness. For those who want to do more, there is much to explore, but this program will focus on the basics which is all most patients require.
Education provided for both wellness facility and home exercise.
Strength training and cardiovascular exercise will be taught for two separate scenarios - those who wish to exercise at home and for those who prefer to exercise at a gym location. There will be value in learning both as personal situations and preferences can change over time. Even if a patient does not continue following the program, they will know what to do if they decide to make a change in the future.
Senior at-home preventive health resource
Over 125 billion dollars are spent on home health in the United States yearly with that entire amount provided only after a person is sick, injured, or disabled. Zero dollars are spent on true preventive health interventions that could negate the need for home health services to begin with! The in-person preventive health benefit would provide seniors with the ability to choose an in-home wellness intervention instead of the wellness center-based option.
This intervention, while initially adding extra cost, would be anticipated to save a significant amount of money not only by preventing falls and chronic health conditions but may also limit the need for unnecessary primary care visits as a longer, in-person, in-home visit is much more efficient and effective in discovering patient needs that can be relayed to the primary care physician negating the need for unnecessary office visits.
Role of the primary care physician
Benefits to the primary care physician
Role of the personal trainer
Benefits to the personal trainer
Role of the wellness facility
Benefits to the wellness facility
This resource will serve as reinforcement for the in-person preventive health resource as well as providing medically and science based preventive health education for those with health seeking behaviors to combat a sea of misinformation that currently predominates online and across all media in advertisements. This resource will further serve as support for all other hospital and community-based health programs.
Exercise Education
Nutrition Education
General Health Information
To facilitate a substantial move toward better health in the United States, constant reinforcement will be necessary. We envision public health commercials that focus on the need for daily body / health maintenance. Some of the same material that will be provided with in-person and online educational resources will be highlighted including the physiology of both detrimental and positive habits and behaviors.
Funding
This resource will likely be the most expensive of all the interventions but one of the most important. As this preventive health endeavor will benefit everyone, it is anticipated that almost everyone can be a possible donor for this intervention.
Content
All previously discussed in-person and online health education ideas are possibilities for publication. This is an area with many possibilities to become creative with content.
Partners
Partners for this intervention may include local and national video creation professionals. Many entities already have vast experience with video and audio production which will be leveraged. College students would be a great creative, low or no cost resource when provided with content direction. Film studios who are already on set may be willing to partner as well.
Google, Microsoft, Meta, Amazon, and many others already provide support to 501c3 nonprofit organizations.
Current primary school health education in the United States continues to teach the old mainstays of discussing calories, protein, carbohydrates, fats as well as sex education. While nutrition is taught on a remedial level, exercise education is almost nonexistent and must be taught from a medical perspective to give kids the best chance to prevent disease and maintain a healthy weight for a lifetime.
Need
Historically in most public and private schools, health education is typically taught by an athletics coach who may not have sufficient education to provide the best instruction. Well-made, interesting video material, sourced from a health professional, can easily bridge the gap to provide kids with the best education possible.
Cost Effective
A one-time production cost will create needed educational material that can be freely provided to all schools across the United States. Much of the material that will be created for the online health resource can also be shared with schools.
Topics needed
Unfortunately, with drug use and overdoses becoming an ever-bigger problem in the United States, teens need to see the effects. Behavioral health hospitals are full of low functioning adults who experience permanent psychosis from drug use. Hospitals are regularly forced to have end of life conversations with parents of teens who have overdosed causing brain death. Experimentation is part of the human experience, so every teen should realize the dangers and stakes before making decisions. This material would not villainize recreational drug use, but rather give a full, realistic picture of modern-day drug use.
Commercial health insurance companies and Medicare participation is vital. These entities already have reimbursement claim systems in place to provide reimbursement for in-person preventive health interventions. Initial preventive health funding can be provided by governments and other donors to minimize the start up impact on insurance companies, however, cost savings are likely to be realized very quickly. The addition of this preventive health framework will likely save insurance companies billions of dollars, paying for itself very quickly.
Reimbursement
Specific preventive health counseling and personal training CPT codes to be created for reimbursement through existing digital claims systems.
It is anticipated that public and private gym facilities may hire, train, and provide preventive health personal trainers for this program where reimbursement would be provided directly to the facility. This would combine the facility charge and the personal training fee to ensure cost effectiveness of this program. By leveraging this existing resource, which exists even in small towns across the country, a faster rollout with no facility overhead costs will be realized.
Preventive health professional resource
An announcement can be made by local and state government, insurance companies, and provided in local media of the opportunity for specific, licensed health professionals to provide this in-person preventive health resource. Specific requirements will need to be met for participation with final candidates chosen by Preventive Health Initiative, Insurance companies, or local government. Once chosen, preventive health framework training will be required. It is anticipated that this will be one of the most sought-after jobs in healthcare as there is no greater job satisfaction than being able to help a patient become healthy and having the resources to accomplish this. This will be an independent contractor role with reimbursement provided through the claims process.
Local wellness / gym facility participation
Initial contact with facilities may be made by Preventive Health initiative, insurance companies, or government agencies to assess the desire to participate in this program. It is anticipated that most facilities will want to be a part of this program as there will be multiple benefits for participation. Equipment and facility criteria will need to be met to be considered for participation.
Health insurance incentives
A comprehensive preventive health resource will create the opportunity to provide monetary insurance premium incentives for those who maintain vital signs, weight, and lab values within normal limits. This will create further incentive for the public to realize better health.
Insurance companies are already spending hundreds of millions of dollars on various wellness initiatives that have not worked as demonstrated by health statistics. They already maintain staff who oversee current wellness initiatives, so these employees may either be redirected or will not be needed which will provide additional savings.
Local government role
Local government will be recruited to help in many aspects of program initiation as this will be a community endeavor. They will have the ability to publicize the existence of this new resource and to provide facilities or seek cooperation of other local gym/wellness facilities and local primary care physicians.
Local governments can also play a vital role in supporting the message of better health through local advertising, assisting with the addition of preventive health audio visual resources to middle and high school students, and assisting with other local organizations participation.
State government role
State governments will have a responsibility to notify local governments of this initiative and to help with the rollout across the State. Some funding may be provided by the State at their discretion, and they may also choose to include this preventive health initiative in Medicaid and other State health programs. State government can also play a major role in bringing all participating entities together to ensure program success.
Federal government role
As this will require a nationwide effort, we anticipate federal government funding as well as participation by Medicare. This will require Congressional support, so our organization intends to seek the help and participation of State Congressmen and Senators.
Initial rollout
We anticipate this preventive health initiative to initially be administered at the County and State level. If an insurance company partner would prefer a smaller demonstration project, we are open to a more locally provided resource as insurance company support is a necessity.
Summary
This framework should be considered a working guide with further details developed in consultation with all involved parties. Development of this preventive health framework has taken into consideration many factors, including ease of administration, cost effectiveness, health impact, and sustainability. Everything will be structured to maintain consistency and effectiveness.
