October 27, 2009
President Barack Obama
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
Dear Mr. President:
We commend the administration’s recognition of the value of Americans choosing healthy lifestyles. Your emphasis on prevention as an integral part of health care reform is an important step forward in improving the health and welfare of Americans. Rewarding people and organizations that embrace prevention and wellness has the double benefit of improving health outcomes and saving money in the long term.
The International Council on Active Aging is a professional association that includes organizations in the public and private sectors serving Americans ages 50 and older. Our members—area agencies on aging, retirement communities, seniors and community centers, wellness centers—are experts in providing programs and facilities to support active aging. Active aging, as defined by the World Health Organization, is the "process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age."
We are writing today to urge you to expand the definition of "prevention" beyond medical screenings. We recognize that health screenings are an important part of health care, enabling early detection and treatment. We believe, however, that older adults’ choices in lifestyle and activity are as important as medical screenings to maintaining health and well-being.
The International Council on Active Aging recently convened a meeting of industry leaders and allied organizations who engaged in a nonpartisan process to identify priorities and action items that will expand the definition of prevention to include active-aging and wellness concepts. We have identified recommendations, listed on the following page, that are specific and actionable.
These recommendations focus on physical activity—including both recreational activity and planned exercise—because physical activity is measurable and a well-documented means to maintain or improve function, mobility and overall mental and physical health. People who are healthier have lower health care costs. For example, according to HealthPartners Research Foundation, people who were 50 years and older and started exercising moderately 90 minutes a week saved an average of $2,200 per year in medical costs.
For aging adults, a healthy lifestyle additionally results from intellectual and social activity, emotional balance, volunteering or paid work, a safe environment conducive to active living and a spiritual or inner compass. As the administration moves forward in planning prevention programs, we ask you to keep in mind that many types of activity improve health.
1. Increase physical activity and healthy lifestyles among adults ages 50 years and older by offering tax incentives to companies that implement workforce wellness programs. Financial incentives for the employees and for the employer should increase according to employee participation.
2. Define clear markers of success that can be used by community centers, seniors centers, retirement housing and other organizations to show outcomes associated with lifestyle choices. The International Council on Active Aging and private organizations have key indicators that can demonstrate participation, health status and improvement over time. These indicators are compatible with other metrics that are being used; for example, the HEDIS measures for physicians or the proposed CMS reimbursement to physicians who prevent decline.
3. Encourage older adults to take charge of their health and improve their quality of life by extending tax deductions for physician-prescribed exercise programs for health conditions, e.g., hypertension, diabetes, heart disease, obesity (Department of the Treasury, Rev. Ruling 2002-19, qualified medical expense) to include fitness center visits, personal training sessions or rehabilitation therapy maintenance exercise programs when attendance can be proven and the results of periodic assessments can be reviewed.
4. Provide physicians and health care professionals with appropriate reimbursement and recognition for prescribing exercise and providing health education and regular lifestyle counseling to patients with chronic disease by requiring professional organizations and insurance companies to create billing codes for physicians and allied health professionals, such as nurse practitioners, for group sessions, individual counseling and wellness classes.
5. Increase the capacity of the health care workforce to understand and effectively treat older adults by encouraging scholarships or reimbursing costs for training and required classes in subjects such as gerontology, physical activity and exercise, health promotion or disease prevention.
The organizations and professionals who support active aging welcome the emphasis on prevention and wellness in the discussions on health care. We urge you to direct policymakers to include support for programs that give adults the opportunity to live a healthy, active and engaged life.
Please do not hesitate to contact Colin Milner at International Council on Active Aging if you wish to discuss these recommendations.
International Council on Active Aging
Director of Clinical Affairs and Industry Relations
American Medical Directors Association
President & CEO
American Council on Exercise
Corporate Fitness Works
IDEA Health & Fitness Association
Robert P. (Bob) Thompson
Institute for Preventive Foot Health
National Coalition for Promoting Physical Activity
Chairman of the Board
Kay Van Norman
Brookdale Senior Living Inc.
Classic Residence by Hyatt
Corporate Director of Rehabilitation Services
Erickson Retirement Communities
VP of Clinical Operations
Genesis Rehab Services
EVP of Operations
Kisco Senior Living
Regional Director of Wellness and Fitness
Peninsula United Methodist Homes
Executive Vice President, Operations
RehabCare Group, Inc.
Director of Resident Programs
Senior Lifestyle Corporation
President and CEO
Williamsburg Landing Retirement Community
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About the International Council on Active Aging (ICAA)
ICAA is the world’s largest membership association dedicated to changing the way we age by uniting professionals in the retirement, assisted living, recreation, fitness, rehabilitation and wellness fields. The council supports these professionals with education, information, resources and tools, so they can achieve optimal success with the growing population of people who are 50 years and older. As an active-aging educator and advocate, ICAA has advised numerous organizations and governmental bodies, including the US Administration on Aging, the National Institute on Aging (one of the US National Institutes of Health), the US Department of Health and Human Services, Canada’s Special Senate Committee on Aging, and the British Columbia ministries of Health, and Healthy Living and Sport.
For interviews or more information about ICAA or aging-related issues, contact:
Colin Milner, CEO, International Council on Active Aging
Toll-free: 1-866-335-9777 (North America only)
Telephone: 604-734-4466; cell: 604-763-4595
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