Can Social Security save money by compensating patients for sports?

Taking off the heart monitor surrounding his chest, Christian smiles. At age 63, he had just completed one of his first sports-assisted rehabilitation sessions. Smooth recovery of this young elderly man who suffered from a heart attack in early July. “When you’re at home alone, you tend to stay on your couch,” says the man, who used to fencing at the club. For three weeks now, Christian has been participating in the As du cœur program, based on the principle of “sport by prescription”. For five months, he will have two weekly sessions with a trainer specialized in cardiac rehabilitation at the Sainte-Yves clinic in Rennes (Île-et-Villaine). But Christian won’t have to take a euro out of his pocket: his entire program will be covered by Social Security. With a clear goal: to make him feel better in order to avoid new expenses.

The idea of ​​reimbursement for recreational sports is not new. But since its inception five or six years ago, its deployment has stalled. Alain Fouch knows something about it. The president of the Azur sports health association, a medical advisor, is trying to convince the authorities of the merits of rehabilitation through sports. In 2014, he conducted an experiment with 50 people suffering from cardiovascular pathologies. While they “cost” 4,000 euros a year in medical expenses, these patients, who resumed sports with a personal trainer, reduced the bill by 1,300 euros. “We no longer need to demonstrate that physical activity has a positive effect on health, this is well known. But we have shown that it also saves money,” says Alain Fouch.

“We pay upstream not to be treated further downstream”

This financial element is enough to convince the Health Insurance that will not give up some savings, especially “after twenty-two months spent with open pockets”, as Arno Boyer points out in relation to the Covid-19 epidemic. “It is estimated that these five months of healthy sports cost about 600 euros per patient. Compared to a stent, it’s not even about the cost of a dressing and a night in the hospital. We pay upstream to avoid downstream processing,” continues CPAM Deputy Director Île-et-Vilain.

In Breton’s department, about forty heart attack patients are taking part in this new experience. “There are people who don’t like to run. But we can all find something to have fun with. Our goal is to develop an idea of ​​the pleasure of sports, to develop the habit of the patient to continue physical activity when they return home,” explains Celine Shuang, head of the rehabilitation department of the Saint-Yves clinic.

“When you’re all alone, it’s not fun”

In Ile-et-Villain, a clinic specializing in the follow-up treatment of patients with cardiac pathologies is not the only one authorized to put patients on their feet. Sports trainers working in fitness centers such as L’Orange Bleue (in Vernes-sur-Seiches) and The Sunrise (in Fougères) have also been trained to treat debilitated patients. “It is important to be in control. When you’re all alone, it’s not fun,” admits Camille Le Marr, teacher of adapted physical activity. After a heart attack, Brigitte lost all her strength. Tells this great athlete 72 years old. “I couldn’t do anything else. Once I climbed two steps, I was out of breath. I wanted to let it all go.” Through group classes that alternate cardio and muscle strengthening, Brigitte sees how her daily life improves every day. And the probability relapse recedes.

Launched in October, Operation As du Coeur is deployed in eleven French departments and is expected to affect a total of 600 to 700 patients. The purpose of the Azur Sport Santé Association is to show the impact on both the health of patients and the health insurance wallet. “And if it’s good for the heart, we know it will also work for cancer patients or diabetics.” Cardiovascular disease is the second leading cause of death in France after cancer. Their treatment costs 18 billion euros a year, or 10% of the country’s health spending.