Can Social Security save money by reimbursing patients for sports activities?


Christian smiles as he removes the heart monitor from his chest. At the age of 63, he has just completed one of the first sessions of his rehabilitation through sport. An uneventful recovery for this young veteran who suffered a heart attack at the beginning of July. “When you’re home alone, you tend to sit on your couch,” says the man who used to practice fencing at a club. Christian has been participating in the “As du cœur” program based on the principle of “prescription sports” for three weeks. For five months he will have two sessions per week with a coach specializing in cardiac rehabilitation at the Saint-Yves clinic in Rennes (Ille-et-Vilaine). But Christian won’t need to take a euro out of his pocket: his entire schedule will be covered by Social Security. With a clear goal: to improve health to avoid new costs.

The idea of ​​reimbursement for health sports activities is not new. But since its emergence five or six years ago, its deployment has stalled. Alain Fuch knows something about this. The head of the Azur sports health association, the medical consultant, is trying to convince the authorities of the benefits of rehabilitation through sports. In 2014, he conducted an experiment with 50 people suffering from cardiovascular pathologies. These patients, who continued sports with a personal trainer, “cost” 4,000 euros a year in healthcare costs, reducing the bill by 1,300 euros. “We no longer need to show that physical activity has a positive effect on health, this is well known. But we have shown that it also makes it possible to save money, ”says Alain Fuch.

“We pay upstream to avoid processing downstream”

This financial element is enough to convince Health Insurance that it won’t say no to some savings, especially after “twenty-two months with open pockets,” as Arnaud Boyer points out with reference to the Covid-19 pandemic. “This five months of healthy sports is estimated to cost around 600 euros per patient. If we compare it to a stent, it is not even the cost of dressing and hospitalization. CPAM deputy director of Ille-et-Vilaine, continues.

In the Breton division, about forty patients with heart attacks participate in this new experience. “There are people who do not like to run. But we can all find a festive activity. Céline Chouhan, head of the rehabilitation department at the Saint-Yves clinic, explains, “Our aim is to develop the concept of enjoying sports, to give the patient a habit so that he can resume physical activity when he returns home.”

“When you’re alone, it’s not fun”

In Ille-et-Vilaine, the clinic specializing in the follow-up care of patients suffering from cardiac pathologies is not the only clinic with the authority to resuscitate patients. Sports coaches working at fitness centers such as L’Orange Bleue (in Vern-sur-Seiche) and The Sunrise center (in Fougères) are also trained in accepting fragile patients. “It’s important to be supervised. When you’re completely alone, it’s not fun,” says adapted physical activity teacher Camille Le Marre. After a heart attack, Brigitte lost all her strength. This wonderful 72-year-old athlete tells us. “I couldn’t do anything anymore. As soon as I climbed two steps, I was out of breath. I wanted to let things flow.” Thanks to group lessons that included cardio and muscle strengthening, Brigitte sees her daily life improve day by day. And the chance of relapse is decreasing.

The “As du Coeur” operation, launched in October, is being implemented in eleven French departments and involves between 600 and 700 patients in total. The aim of the Azur Sport Santé association is to demonstrate the impact on both the health of patients and the health insurance wallet. “And we know that if it’s good for the heart, it would work for cancer patients or diabetics, too.” Cardiovascular diseases are the second leading cause of death in France after cancer. Their treatment costs 18 billion euros each year, or 10% of the country’s healthcare expenditures.