It’s Time to Move is a long-term effort to make physical activity assessment, prescription, and referral a standard of health care delivery. The Physical Activity Alliance and the American Heart Association are working with multiple federal agencies, Congress, and non-governmental organizations to support all people in becoming more active.
Standardizing Measures
Standardizing measures for physical activity assessment, prescription and referral that can be integrated into electronic health records and prompt conversations and follow-through between clinicians and patients is a critical first step. We heard from clinician champions that a major initial effort for care integration in their health system was getting measures for physical activity assessment, prescription and referral into their electronic health records. We knew if we could do this nationally it would save time building the movement. Having standardized measures that everyone uses is also an important supplement to our national surveillance systems and can facilitate additional research on the relationship between physical activity and health with real time data.
Accordingly, we worked with Health Level Seven International (HL7), a non-profit organization that develops standards for health information exchange and integration, and a technical consultant to develop the first ever HL7 FHIR Physical Activity Implementation Guide with accompanying patient and provider apps (mobile and web-based) that can be integrated into health systems’ electronic health records (EHRs). We are continuing to test and refine these resources for integration with health systems, EHRs, digital health technology companies, and others.
Connecting Care to Community – Interoperability between Health Systems and Community-Based Organizations
We want to connect patients to community-based resources that offer supervised exercise interventions. We were successful in applying to have physical activity assessment included in the US Core Data for Interoperability, the minimum core data set required of all electronic health records in the US.
Making Movement Available and Affordable
We are also working on getting coverage and reimbursement for evidence-based supervised exercise programs. We are discussing coverage options with the Centers for Medicare and Medicaid Services. We are also scoping a pilot project in North Carolina with health systems, EPIC, and community-based organizations to demonstrate continuum of care. If successful, this effort could be scaled nationally.
In December 2024, we held a Benefit Design Roundtable in Washington, DC with Alston & Bird and Tivity Health and leading experts to strategize around coverage for supervised exercise programs. The main takeaway was to use existing reimbursement pathways as much as possible to enable broader access to supervised exercise therapy and physical activity programs.
Builiding the Economic Base
We contributed to and led studies that helped frame the economic argument about why “It’s Time to Move” is so important. This is especially important for conversations with public and private payers.
We collaborated with the Centers for Disease Control and Prevention and researchers at the University of Georgia on Inadequate Aerobic Physical Activity and Healthcare Expenditures in the United States: An Updated Cost Estimate, which found inadequate leisure-time aerobic physical activity accounts for $192 billion in annual health care costs among U.S. adults—12.6% of total national health care spending.
We led A Review of the Cost-Effectiveness of Supervised Exercise Therapy for Adults with Chronic Conditions in the United States that systematically evaluated the cost-effectiveness of supervised exercise programs for US adults with chronic conditions. We found a consistent, positive return on investment of $1.15-1.70 for every dollar spent.
What’s Next: Driving Change by Aligning Financial Incentives
We are starting to develop a clinical quality measure for physical activity assessment and referral. If adopted, this measure could financially incentivize integration of physical activity assessment, prescription, and referral into care delivery.
Join the Movement
Interested in partnering or learning more?
Contact:
Laurie Whitsel: laurie.whitsel@heart.org
National Vice President – Policy Research – American Heart Association
Senior Advisor – Physical Activity Alliance
Ayanna McKnight: ayanna@paamovewithus.org
Director of Operations and Communications- Physical Activity Alliance
The Physical Activity Alliance
The Physical Activity Alliance (PAA) is the nation’s leading coalition advancing policy and systems change to promote physical activity across the US population. The American Heart Association provides administrative backbone and strategic guidance to support the coalition’s important initiatives. The PAA has a bold vision to build a culture of movement where at least 50% of Americans meet the Physical Activity Guidelines by 2050.
Funding
Significant funding was provided for this work by the American Heart Association through generous gifts by individual donors. This project was partially made possible by the Centers for Disease Control and Prevention (CDC) (Contract #47QRAA20D003W). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC. These efforts are part of the CDC’s Active People Healthy NationSM Initiative that is working to help 27 million Americans become more physically active by 2027.
