Gregory G Degnan, MD
Medical Director at acac
Christine Thalwitz
Vice President of Marketing at acac
Medical Fitness
• ACA wellness mandates
• AMA’s stance on obesity
• Exercise is Medicine initiative
… the perfect storm
Who we are
low-cost, introductory exercise program
340 average monthly program sales
> 22,000 patients to date
40% convert to annual paying memberships
Average membership > 30 months
$27 million gross/$16 million net
Medical Fitness
Phil Wendel, owner
“Interested inactives”
Of special interest:
• Older adults
• Individuals new to exercise
Target markets
Amenities & programs
acac Albemarle Square
Charlottesville, VA
acac Downtown
Charlottesville, VA
acac Adventure Central
Charlottesville, VA
Crozet, VA
West Chester, PA
Midlothian, VA
Short Pump, VA
Maryland Athletic Clubs
Critical program components
Internal structures and culture
Outreach strategies
Scope & scale
The opportunity ladder
The doc is in …
so we’ll leave plenty of time for Q & A!
Today’s Objectives
Historically, 2 separate entities
Little overlap
Less communication
A few physician champions
A few fitness visionaries
A tale of 2 industries
Surgeon General’s “Exercise is Medicine”
AMA’s declaration of obesity as a disease
Affordable Care Act
Dollars are driving a move toward
prevention
Medical integration
Provider level – private/academic practice
Wellness level – small business owner
Hospital/insurance level – hospital board of managers and vice chair of regional integrated network
Lifelong exerciser –
40 year member
Volunteer medical
advisor
Employed as
medical director
My perspective
One foot in
both worlds
Helps to bridge
the cultural
and “business
model” gap
My perspective
“Prevention” – past
and present
The health of our
nation
Despite technology
and improved
treatment
Obesity and
sedentary lifestyle
Increase in aging
population
State of health care
Driven by:
Rising costs
Affordable Health Care Act
Realization of declining health
Drivers of change
Challenges/weaknesses
Nutrition
Market penetration
20% barrier
60% interested
deconditioned
Training “Attitude”
Training the “fit” and
“trainable”
Drivers of change
Complete Package
Step up our resume
Exercise alone is not enough
Training “attitude”
Embrace our new population
Play to the strength of your trainers
Marketing shift
This population is not direct to consumer
Drivers of change
Not a new concept
On the radar in both
industries
6 presentations on
medical programming
Attorneys, MBAs,
Marketing experts, Fitness
experts, and physicians
Moving forward
Opportunity is apparent …
concrete methods are elusive
Clarity out of chaos
Methods to become involved regardless of club size
Concrete plans for multiple levels of club involvement
Road map for increased membership
Improve community health
Our goal today
Multiple levels of involvement
Provider level
Corporate level
Insurance/ACO/Integrated network level
To consider
Driven by scale of
your organization
Driven by your
health care market
Driven by your
desired level of
investment and
commitment
To consider
Cultural changes
Facilities changes
Marketing and outreach changes
What makes you attractive to the
medical community
The vision
11 years in the making
Started with philosophical commitment
Built a solid basic program – p.r.e.p.
Slowly built a medical model
Physical therapy, nutritionist, nurse, MFA
Vision to reality
Be realistic about necessary changes
Will not succeed with half measures
Seems simple
Many pitfalls
Often seemingly insignificant details
Vision to reality
Organizational
Owners/administrators
You set the tone
You are the key to
success
Changes
Sales
Different population
Different strategies
Not volunteers
Wary of “time share”
Provider concerns
No “hard sell”
Changes
Trainers
Deconditioned participants,
marginally motivated
Special needs/restrictions
Exercise 101
Hand holding 404
Embrace it and change lives
Ignore it and fail
Changes
Comfort Zone
Basic machines
Cardio
Flexibility
Social section (if
(if possible)
Changes
Layout/Exposure
Unfamiliar
Intimidating
Create a “comfort zone”
Use space or scheduling
Varies club to club
Social aspect is important
Changes
Comfort Zone
Handicapped friendly
Maneuvering space
Pool – not necessary but big asset
CPR/AED training
Emergency action plans
Changes
Facilities
Nutrition
Nutritionist vs Trainers
Marketing/Outreach
Key component
Common cause of
failure
Financial commitment
Depends on level of
involvement
Changes
Organizational commitment
Organizational expertise
Basic program – the “Foundation”
A “Team”
“Comfort Zone”
Outreach
The basics
MEMBERSHIPS
Doesn’t cut into your normal population
Don’t need to recruit them away from your comptetitors
Bonus members
The bonus pool is potentially huge
The upside
Foundation and workhorse
Provider referred introduction
to lifestyle
Appropriate for any size club
Data
Least important on the
marketing end
Data for provider feedback is
important
Program levels
Basic program
Team
Facilities
Marketing – a key factor
for success
Be patient
Use physician champions
Program levels
Affordable Care Act
30% premium discounts
Loose definitions of
“wellness program”
Participation vs.
outcomes
Data capture is crucial
at this level
Program levels
Involvement defined by your “bricks and mortar”
On-site, off-site & virtual services
HRA | Biometric screening | Exercise – basics
Nutrition & Education - strong sellers
Remember HIPAA
“Roll over” into corporate memberships
Subsidies based on use or outcomes
Program levels
Ongoing participation – HR’s biggest concern
>40% rollover
On site lectures/video education
Marketing is Key
Capitalize on HR burden/need for assistance
Use basic program as a foundation
Gear towards open enrollment
Program levels
ACOs/Integrated networks/Insurance carriers
New relationship with ill-defined model
Requires significant resources and scale
Largest front end investment
MUST HAVE DATA
Program levels
Requires ongoing programming
Requires metrics based outcomes
Consider small programs for specific
groups ( i.e. Diabetes)
Requires IT support
Requires specialized marketing
Physician champions are key
Program levels
Investment/Risk vs Benefits
Not well defined at present
Front end dollars and rollover
Toughest market with highest
front end
Rules and pathway not yet
well defined
Program levels
Something for everyone
Scope is defined by your
scale/interest/investment
Foundation program is key
Inexpensive, non-intimidating, basic
exercise and nutrition
Everything is built off of this
Seems simple…. It is not
Program levels
Gregory G Degnan, MD
Medical Director at acac
Christine Thalwitz
Vice President of Marketing at acac
acac.com
Thank you