Proactive Living: A Unique Model for the Promotion of Lifestyle Medicine

Abstract

Lifestyle medicine (LM) is a growing field focused on maintenance of health and reversal of chronic diseases; however, it is still unfamiliar to many as it lacks a mechanism to set itself apart from other medical specialties, which focus primarily on management of established diseases and their symptoms. Given that employers have many incentives to maintain and improve the health of their employees, the corporate wellness space (corporate wellness) represents a considerable opportunity for LM. Proactive Living, a company at the confluence of LM and corporate wellness, promotes and connects LM practitioners with employers and employees through a mobile app (PAL App). The app is designed to improve health literacy, encourage healthy lifestyle behaviors, and engage individuals in their own health, while simultaneously helping LM practitioners market LM and grow their practice.

‘Employers must manage the health of their workforce and rein in health care costs—both of which can be accomplished through a comprehensive LM program.’

Proactive Living®, Inc, is a digital health and well-being company, and its tagline, “Empower to Transform™,” signifies signifies its mission to empower individuals to transform their lives. Proactive Living believes the intersection of corporate wellness and lifestyle medicine (LM) represents a unique opportunity to help individuals engage in their health while reducing health care costs and growing the field of LM. Employers must manage the health of their workforce and rein in health care costs—both of which can be accomplished through a comprehensive LM program. The Proactive Living App (PAL App^™) is a mobile interface that utilizes social networking and community engagement to increase interest in well-being. The interface is specifically designed to bring LM to the fingertips of the user via a tailored experience that allows them to connect with credentialed LM physicians and other practitioners within the geographic area of their choice.

Scheduled to launch phase one in June 2017, the PAL App will be offered by employers to employees as a wellness benefit. LM practitioners will be invited to register with Proactive Living in order to become members of the Proactive Living Network (PAL Network^™). This gives them access to connect content they may produce—such as online courses, videos, podcasts, blogs, and articles—to the PAL App. They will also be provided opportunities to deliver webinars to PAL App users. The PAL App will therefore provide the LM professionals direct-to-consumer access to market their LM services.

Proactive Living will specifically engage with only those LM practitioners who are trained or certified in LM, behavior modification, or a related field. In this manner, Proactive Living will create a beneficial situation for all stakeholders. Employers will be able to improve health literacy and encourage healthier behaviors among employees. Employees will have access to experts from whom they can learn about important health and wellness topics, and LM practitioners will be able to reach more people and grow their practices.

This article shares key insights on the early stages of Proactive Living, Inc, its evolving product offerings, and how it is poised to expand the reach of lifestyle medicine while helping employers create healthier workforces.

Background: Lifestyle Medicine

Lifestyle medicine is a growing field focused on the use of evidence-based lifestyle interventions for disease prevention, treatment, and reversal in a clinical setting either alone or in conjunction with other therapies. ¹ LM addresses the root causes of disease rather than focusing on symptom management. This fresh approach to medical care addresses a gap in practice and training. Increasing numbers of health care providers, allied health professionals, psychologists, health coaches, and researchers are seeking additional training and networking in LM. ² The American College of Lifestyle Medicine (ACLM), the professional medical association devoted to advancing the mission of LM, is the primary source for this training. In recent years, ACLM and the American College of Preventive Medicine (ACPM) partnered to create and expand an LM curriculum for all levels of health professional education. ³ More recently, the American Board of Lifestyle Medicine (ABLM) was established to administer national board certification examinations. ⁴ As more providers train and certify in LM, the demands will continue to grow for not only patient education resources and practice tools but also for technology innovations, sustainable financial practice models, and marketing strategies to support and expand the demand for LM services.

The Problem

The treatment of obesity and related chronic diseases in the existing fee-for-service model is considered to be a key contributor to rising health care costs in the United States.^5,6 This model rewards volume and provides little incentive for achieving and maintaining health or preventing disease. It is currently more lucrative for most in the health care industry when the consumer remains unhealthy. ⁷ As a result, LM providers struggle to find appropriate reimbursement through traditional channels; many have opened practices that rely on out-of-pocket payments for LM services either in stand-alone practices or as adjuncts to primary care practices. ⁸ Certain models, such as Accountable Care Organizations (ACOs), are financially incentivized to keep their patient populations healthy. Accountable Care Organizations reduce cost by improving efficiency and coordination of care. However, much work lies ahead if LM is to be broadly incorporated into ACOs.

Unfortunately, LM services are not widely covered under health insurance plans, resulting in many health care consumers being unaware of the field’s existence. Behavior change is complex and inherently difficult to compare in value to a pill or procedure so consumers find it hard to grasp. Without easily identifiable “products” to sell, LM has had difficulty competing in the current fee-for-service health care payment model. As a result, a physician who opens a new LM practice, or incorporates LM into their existing practice, has few ways to distinguish it from more traditional models of care. There are no mechanisms currently in place for an LM practitioner to market his or her practice in a way that not only sets them apart from the competition but also begins to garner the kind of attention in the market that is needed for them to flourish.

The Solution

Proactive Living believes that working with employers to expand employee access to LM services and tools is the most efficient way to gain mainstream acceptance and recognition for LM. Health care costs represent one of the major expenditures for employers; in 2016, the average cost of health coverage offered by employers was over $18 000 for a family plan with the employer covering approximately 72% of this amount on average.^9,10 This cost is expected to increase by 6% in 2017 with specialty pharmacy benefits, high-cost claimants, and specific high-cost diseases and conditions being the top 3 cost drivers. ¹¹ For these reasons, employers spent an average of $693 per employee on wellness-based incentives in 2015, up from $594 in 2014. ¹² While some large forward-thinking corporations, such as Cummins, have worked to address this by giving their employees access to physicians and other professionals who focus on providing comprehensive health and wellness care,^13,14 most employers are either unaware of or lack access to similar LM services. Proactive Living aims to change that by making LM and other wellness services easily accessible to all employers and employees. Proactive Living offers a mechanism through its mobile app and partnerships with employers to highlight the benefits of LM, both to their employees and their bottom line.

Proactive Living’s main product is the PAL App that employers can offer as a wellness benefit to their employees. The PAL App leverages social networks, builds communities for social engagement to promote healthy behaviors, and serves as a way for employers to engage their employees in activities that promote well-being. LM practitioners, such as physicians, can pay a monthly or yearly subscription fee to register with Proactive Living and become members of the PAL Network, whereby they appear within the PAL App. Members of the PAL Network have the ability to create unique profiles that highlight their qualifications, services, and overall LM philosophy. Credentialed LM professionals who are members of the Proactive Living Network are also invited to give webinars and connect online LM educational materials that they may have to the PAL App. This allows LM providers to connect directly to employees interested in their services, essentially providing a new way to market themselves and build recognition for their practice.

As a result of this process, the brand recognition of the physicians accessible through the PAL App will be higher than other physicians in a given community who are not part of the PAL Network. Inevitably, when an employee is in need of physician services, these physicians will be familiar to the employees because of the positive interactions that they have had with them through the PAL App. The app also allows the employee to do a simple name, specialty, or zip code search to find and review physician profiles and, when available, set up an appointment for a clinic visit. As the preliminary and informal relationship between the employee and physician has already been established through the PAL App, it makes for a more meaningful interaction during the clinic visit. The connection will lead to higher levels of patient activation, further facilitating behavior changes and LM interventions. ¹⁵ In this way, the PAL App becomes an extension of the LM practice not only for marketing purposes but also for the development of anenhanced patient experience and, over time, improved health outcomes. Future plans include offering some PAL App functionalities to the general public as well. Mainstream access to the app would be expected to further accelerate the growth of LM.

Proactive Living also benefits health insurance companies and LM professional organizations such as ACLM, ACPM, and ABLM. As the user base for Proactive Living grows, LM physicians will become increasingly in demand by employees. The type of care these physicians provide will lead to better health outcomes and care experiences, and health care cost savings over time. ¹⁶ The successes of LM physicians will subsequently attract new health care professionals to seek certification in LM, as they recognize the utility and value of providing this type of care. Proactive Living believes that this will lead to an increase in ACLM and ACPM membership, ABLM certifications, and other long-term benefits to the field of LM.

Conclusion

Proactive Living believes that the intersection of Corporate Wellness and LM offers a unique opportunity to improve the health of populations and market LM. The company seeks to create a symbiotic relationship that will help address the joint issues of reimbursement for LM services and greater public recognition of the specialty. Proactive Living aims to work with employers; lifestyle medicine, preventive medicine, and other similarly trained practitioners; as well as health insurance companies and health professional organizations (such as ACLM, ACPM, and others) to create the necessary mechanisms to make LM an integral part of health care.