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A switch in focus to outcome-based reimbursement, something that's already in place at for-profit Kaiser Permanente—a company that, according to Bodor, stays profitable by keeping people out of the intensive care unit—is another Affordable Care Act goal. According to a report by Trust in America's Health, for every dollar spent on prevention, approximately $6 are saved in healthcare costs.
"The reality is that every time we keep someone out of the emergency room, it saves the public a lot of money," says Michael DiRosario, clinic manager at the Forestville Wellness Center, which was opened in 2011 by West County Health Centers.
Geared specifically toward the uninsured and low-income populations that don't normally have access to alternative medical services and preventative health education, the wellness center offers acupuncture, nutrition for diabetes and smoking cessation group meetings, cooking demos, and Zumba and yoga classes.
"What lots of places are starting to focus on is how we can get people to think about wellness and lifestyle changes," says doctor of osteopathy Connie Earl, who's practiced integrative medicine at the Forestville Wellness Center since November 2011. Though most people dread entering clinical settings, creating community by focusing on healthy lifestyles has made a marked difference.
"People love coming here," says Earl. "They say they love the feel of the place. It shifts the feel since they're actually getting treatment for chronic medical conditions, and feel more empowered in their own healthcare."
The Petaluma Health Center is a federally qualified health center that serves approximately 18,000 patients. After moving to a 6,000-square-foot building in November 2011, the facility was able to expand the services in its Center of Good Health. Now, the primary care clinic—which serves low-income individuals along with those with private insurance—is taking prevention to a level not often seen in healthcare settings. The center sees on average 200 wellness group visits a month, for sessions on smoking cessation, child obesity (an issue of serious concern in the United States) and chronic pain. The facility offers medical acupuncture (getting an average of 100 visits a month), yoga, Zumba, tai chi, meditation and hour-long integrative medicine consultations with Dr. Fasih Hameed, a doctor who recently spearheaded a conference in Santa Rosa focusing on "Integrative Medicine for the Underserved."
The crux is getting out of chronic-disease cycle, says Luke Entrop, wellness program manager.
"Tobacco use, poor diet and lack of exercise lead to heart disease, type 2 diabetes, lung disease and cancer, which account for 50 percent of U.S. deaths per year," he adds. "If we can get on the prevention end of things, we're getting to the heart of these chronic conditions of our time."
Entrop sees the Center of Good Health and the preventative approach as a way to promote healthy living for people of all backgrounds.
"With more affordable healthcare coverage, we're able to reduce the cost of acute emergent health conditions by working on some basic behavior change and nutrition education," he says. "These are some of the driving factors of more expensive healthcare costs. By investing in prevention, we're able to reduce costs in the long run."