Tivity Health is at the forefront of empowering seniors to age in place through innovative programs like SilverSneakers, Prime Fitness, and WholeHealth Living. These initiatives not only improve physical health but also enhance overall well-being, allowing older adults to maintain independence and vitality in the comfort of their homes. Seniors can boost mobility and strength with customized fitness programs and engage in virtual wellness activities to stay connected and active from home.
Caroline Khalil, Chief Operating Officer, Tivity Health
Megan Antonelli, Chief Executive Officer, HealthIMPACT
VO 0:00: Welcome to Digital Health talks. Each week, we meet with the healthcare leaders making an immeasurable difference in equity, access and quality. Hear about what tech is worth investing in and what isn't. As we focus on the innovations that deliver. Join Megan Antonelli, Janae sharp and Shahid Shah for a weekly no BS deep dive on what's really making an impact in healthcare.
Megan Antonelli 0:30: Hi everybody. This is Megan Antonelli. Welcome to Health Impact, live digital health talks. I'm thrilled to introduce our distinguished guest, Caroline Cahill, Chief Operating Officer of tivity health, with her strategic performance driven approach, Caroline has been instrumental in enhancing operations, forcing forging crucial partnerships ativity health, her expertise in Medicare and commercial wellness benefits, combined with her passion for lifestyle medicine, makes her the perfect speaker for today's topic. We're going to talk about empowering aging in place and holistic healthcare at home. Hi Caroline, nice to meet you. Glad you could join us. How are you today?
Caroline Khalil 1:08: I'm great. Thank you so much for having me. I'm very excited to be here with you today.
Megan Antonelli 1:12: Me too. You know we talked a little bit about your background before we got started, fellow New Yorkers as it as it is, but displaced to the West Coast, I guess. But tell us, tell our audience a little bit about your background and how you made your way to Tiffany.
Caroline Khalil 1:28: Yeah. So I am, like you said, from New York. I hail from strong Island, as they call it, and I've been living out here in Arizona for 20 years, when I moved out to Arizona, I had the luxury of, you know, evaluating what I was passionate about, and what I was passionate about was the impact of lifestyle on health. And so I made a very big career change and went into fitness and wellness, and you know, that kind of like, loosely lifestyle medicine, part of the of the industry, and found my way to Tiffany health. And at the time, Tiffany health was developing a really cool program for seniors, and it was part of their health plan benefit. And that program way back when, I won't age myself too much, but way back when, was SilverSneakers, and I've had the honor of being part of it for a very long time now, and building it to now. It's over 19 million people are eligible for Silver Sneakers, and that just makes me so proud of the fact that this program has that kind of reach and has that positive impact on people's lives.
Megan Antonelli 2:52: That's amazing. I mean, I remember Silver Sneakers back from, you know, probably 20 years ago, maybe doing doing Medicare Advantage events, you know, conferences, bringing people together around this. And SilverSneakers was such a, you know, sort of innovative, but also simple approach, you know, to getting people to become more active and changing behaviors. You know, tell us a little bit about about the approach.
Caroline Khalil 3:19: Yeah, and you're absolutely right. It is a very simple approach, right? Because the idea behind it is, how can we get as many people involved in their health and wellness? And the way that we do that is by offering over 30,000 gyms across the country where people can access the Silver Sneakers benefit. And it's as simple as walking into a gym asking, do you have Silver Sneakers? And, you know, signing up at the gym, and then it includes a whole lot more. But at its simplest, and probably going back to, you know, when you were first involved in it, that core has remained tried and true till now. So that is the core of it,
Megan Antonelli 4:04: yeah, that's amazing. And tell us a little bit about, you know, what some of those levers are to success, to getting people engaged in their own healthcare. And, you know? So that holistic approach,
Caroline Khalil 4:15: yeah, I think it's honestly just taking the first step, right? So the first step is finding out that you have that kind of program available to you, it's wonderful that so many medicare advantage and medicare supplement health plans offer this as part of the benefit package. And really, you know, it gives members an opportunity to have something that they're not necessarily paying extra for, and it makes fitness, exercise, wellness community, so much more accessible to them. And so by, you know, taking that first step, making sure that you're eligible for the program, and you know, you can either use one of the. Facilities that's partnered with us across the country, or for others who you know maybe don't want to walk into a gym just yet, we do have online programs as well, and those are interactive. They're live. It's not necessarily just pre recorded. So we are always looking to foster along with the exercise, along with the improvements and how you know you take strides towards your health, we're also always fostering community. How can you get to know other people who share your same goals and together support each other and work towards those goals? Because we know that we all are much more successful when we have that kind of support system, right?
Megan Antonelli 5:45: Yeah, no community and sort of that motivation behind it is such a big piece of of, you know, keeping at behavioral change and exercise and habits, but also during, you know, I think we saw a lot of you know, and hear a lot about loneliness with our older population, and how they can be a part of that. So that that makes sense in terms of, you know, that that piece of it tell us a little bit about, you know, what are, you know, the community being one of them. What are some of the real key success factors to the program and some of the examples that you've seen?
Caroline Khalil 6:19: Yeah, I would say one our gym partners are a tremendous part of that success, right? And how they have welcomed a population that wasn't necessarily the target of the fitness industry, right? And they've welcomed our members with open arms. They have done activities and all kinds of events for them, they have the instructors, the following that our members have around instructors who teach SilverSneakers programming, and how those instructors have fostered a sense of community throughout the country as well as I love Megan, when I hear stories of, oh, we met at a Silver Sneakers class, and we started dating and we got married, or, you know, this person has become my best friend, and I met them through Silver Sneakers. To me, you can't put a price on that kind of thing, right? And this is all happening while people are improving their health by exercising, by getting out there, people driving one another to the Silver Sneakers class or to the gym together. I can't tell you about the number of coffee clubs that exist around you know, just an opportunity for people to create community, to, you know, address this loneliness problem that we hear about so much. I was looking up a stat on loneliness and the NIH estimates it to be a $6.7 billion problem, right? The fact that we can make any kind of incremental improvements to that is so meaningful and so impactful on our society,
Megan Antonelli 8:15: yeah, and I mean that coupled with, obviously, the benefits of exercise, and, you know, the obesity problems and all of that that this would, you know, be able to combat both of those things through that holistic approach? What about I mean, and when I say simple, because, of course, getting people to to exercise is by no means simple, right? It takes a lot, and it takes a lot of different levers to create that change and, you know, impact the their behavior around what does tivity do with technology to make these programs more accessible to seniors?
Caroline Khalil 8:50: Yeah, it's a good question. And you know, as ever since the pandemic, our world is so much more technologically focused, right? And that is goes the same for SilverSneakers. Before the pandemic, we probably had less technology to offer our members, but since then, one of the most successful offerings that we have is what we call SilverSneakers live and if you're a member, you get to join a live community, so it's not pre recorded with an instructor, one of our best instructors, actually, because it's our hand picked team of like Train the Trainer instructors, and you get to attend an interactive, live class. I mean, we have over 200 a week that people can choose from, and it includes everything from like mind mindfulness classes to more high intensity activities, and the interaction that happens, the the chats, the the way that people are interacting. With the instructor, the love letters we get back. Those are the best. The love letters we get back for things like, you know, before I started taking this class, I wasn't able to, you know, walk across the room because I had just had surgery, and because of the progress of continually taking this class daily, or, you know, however many times a week, I have made such improvements, my doctor is so impressed, and it the physical benefits are enormous. But to me, the level of confidence, the level of self assurance, the level that people have of, oh, I don't have to worry about falling like falls are so expensive for us as a country and for the healthcare system. I think the last count was 50 billion is spent on falls annually. So to give someone that assurance, to give someone that confidence, to give someone a path to get stronger, no matter the age is so, so important.
Megan Antonelli 11:12: Oh, yeah, for sure. I mean, falls are often the, you know, they're the biggest indicator of kind of deteriorating health too, right? So getting in there to prevent them. And, you know, it's amazing. I mean, you know, on one level, it's like, you see now the things that you know when you're it's like the new 40 or they show the Golden Girls and the Golden Girls, you know, and though they were like 45 and, you know, we think of them as 60, but you know, at the end of the day, it's the fact that people have, you know, sort of built exercise into their lifestyle that has kept people younger. I mean, yeah, there's also some other things that help, but, yeah, no, but exercise is the bleeding indicator of of hell. You know, in terms of,
Caroline Khalil 11:52: it's so true and like we were talking about before the podcast, like, if you do anything, it's like, just start, even if it's 15 minutes a day, the impact that exercise has on everything from mood to mental health issues to sleep to weight management to diabetes control. And that's aside from, like, all the the health care stuff that we talked about, like the fall prevention, the loneliness, the, you know, lower back pain. If it were a pill, it would be the most expensive pill, honestly, the most effective and the most expensive and right, don't you know, I, whoever's listening to this, don't overwhelm yourself by thinking, oh, I need to do high intensity interval training, or just 15 minutes of whatever it is, even walking like I was looking over some research that said 8000 steps a day is like the level of that should Be your minimum daily, because it improves all cause mortality like so easy to do, right?
Megan Antonelli 13:07: Although easier when you're a New Yorker, always. That's what I've found that I have moved out of New York. It's amazing how much harder it is to get to that 8000 or 10,000 benchmark. But it isn't hard. It's like,
Caroline Khalil 13:22: you bring up a good point, though, because, you know, in New York, it's so woven into the fabric of your day, right? So how can you incrementally, little by little, weave that into your day? So like, maybe you start parking a little bit farther every time, right? Well, maybe you, you know, do another lap around the grocery store make sure you didn't forget everything. It's all those little things really do add up, although No, nothing's gonna beat those subway stairs, though, right?
Megan Antonelli 13:51: That is true, particularly the ones at Grand Central. But yes, no, it is. But that, you know, and I think the great thing about the Silver Sneakers program has been the reminders and the simple, you know, the simple kind of education around that, and the communication to make it, you know, this isn't about high intensity training or, you know, making sure that you've started some you know, that you're running marathons. It's the the little things you do in life to keep that health health, you know, health and exercise around you. What about in terms of, you know, we talked about loneliness, we've talked about community. What are some of the specific programs, or, I guess, are there specific programs around kind of that linkage between mental health and physical health that the activity is doing for seniors?
Caroline Khalil 14:36: Yeah, we're doing a lot more in terms of cognitive health, mental health, and it starts, you know, it's again, it bleeds into all areas of life, but even focusing on mindfulness meditation, all those things do contribute. Yoga is one of our popular offerings. Tai Chi is one of our. Popular offerings. We don't always make the link of, how can cognitive cognitive health improve through exercise, but honestly, exercise is one of the greatest interventions. I know I sound like a broken record, but it's one of the greatest interventions for saving off mental decline. And you know, some of what comes with that. And so we have classes that focus specifically on cognitive health. But again, any kind of exercise you do is going to help your cognitive health?
Megan Antonelli 15:37: Yeah, no, absolutely. And what about, I mean, the idea around, and we've heard it, the phrase used, and, you know, sort of this aging in place. And, you know, kind of, what is that? What does that mean to tivity, or to, you know, in the world of this?
Caroline Khalil 15:54: Yeah, so as more and more of us get older, right? Because more, well, I think it's 11,000 people a day turn 65 I think that's the latest number. So as more and more of us get older, we know that, like the healthcare system or the senior living options are not going to be able to accommodate everybody as they age, right? And I think it's fair to say all of us, if not the majority of us, want to stay in our homes, have independent lives for as long as possible. And I think that's what is often meant when the you know, aging in place is referenced. So how do you best do that? Well, I mean basic things, right? You need to be able to get up if you fall, you need to be able to, you know, go from a seated position to standing unassisted so that you can maneuver around your house. Right? You're going to need to know how to be able to maybe climb up on a ladder and change the light bulb without fearing falling. All that kind of stuff comes through one self assurance, right, that if I do that, I'm not going to put myself at risk. But also, strength, right? Strength, mobility, range of motion. Those are all the things that are core to the Silver Sneakers programming that's available. You know, again, falls really become a problem. Because people break hips. They break, you know, bones. If you are doing weight bearing training, your bones are stronger. If you were worried about, if I reach up, am I going to be able to, like, am I going to pull a muscle? Well, range of motion exercises help that all those things function to allow you to live independently, longer reaction times for driving, right? Like, all of this, all it all goes back to exercise. Megan, everybody needs to exercise.
Megan Antonelli 17:59: eah, yeah. Well, and that's, you know, I think everybody, it's like you think about, I mean, certainly with our parents, and as we look to aging, you know, the idea of being in a nursing home and, and, you know, some, you know, that type of living that not only is expensive, but isolating, and not with our families or where we want to be. So, you know, and you see that converging with, you know, sort of this move towards home based health care. And you know what's possible, right? I mean, we can have doctor's appointments over our phones now, you know, you know, can't quite get surgery that way. Still have to go into the hospital. There's certain things that will always be done in the hospital. But, you know, certainly exercise. I mean, we've seen the there's home based gyms and home based healthcare around that kind of stuff. So tell me a little bit where, you know, where does tivity see its role as that becomes even more of a reality? Yeah,
Caroline Khalil 18:55: I think tivities role in that is to as early as possible. And again, this, this. The good thing is, most of our society now recognizes the value of exercise, right? And more and more, as people become Silver Sneakers members, more of them have some sort of experience with exercise, versus, like my parents generation, that was not the norm. And so Timothy's role in that one is to provide you, as someone who's turned 65 with a benefit that's at no additional cost to you. So that's one piece of it where you don't have to worry about, okay, I have to, you know, find the money to do this two to provide you with programming that is going to take into account anything that you might be considering at 65 or older, like, maybe you've had an injury, maybe you, you know, you were a former athlete, and you're dealing with, you know, different. Um, mobility issues. Maybe you're somebody who's just getting started, or maybe you're but marathon runner, right, who's been doing this for years and years, and how it's Tiffany's job to provide something for everyone. And to say, here's an option for you, no matter where you are on your you know, health and wellness journey, no matter where you are on your fitness journey, and this will keep you independent for as long as possible, and hopefully indefinitely, right?
Megan Antonelli 20:32: So if you know, tell me a little bit about how Medicare Advantage members now are getting this information, like when you said it's, was it 19 million that are eligible for this? Yeah, you know, how, how is it that we get to the point where they're all using it? Where are they getting that information? Is it coming from their their insurance company? Is it email? Is it a brochure that they get? Is it they're also their doctors, you know, making them aware of it. What? What's the what's the ideal communication? I guess,
Caroline Khalil 21:04: is, yeah, the ideal communications all the above, right? Like this is such a vast program, and just that health and wellness journey really should be coming from all those directions, because we're, we're creatures of habit, and the more we hear something, the more something is repeated. That's when it begins to sink in the simplest, simplest way. If you don't know what health plan you have, if you don't know anything, just go to silversneakers.com and we will guide you through the process to see if you do have the benefit, and even if you don't have the benefit, we believe in this so much that we include free content for those who might not have the benefit. We can also guide you to health plans that offer it most of the time. You'll hear about Silver Sneakers during AEP or at the beginning of the year, because that's when people start to think about fitness programs, but do not let that stop you, like go to the website. We'll ask you a few simple questions. We'll tell you if you're eligible. We'll show you a gym that's nearby. We'll give you options for if you want to, you know, do your exercise program at home. That's an option too. So just, just make the commitment 15 minutes a day, start there.
Megan Antonelli 22:27: Now Absolutely. And I think, have you guys done, I mean, one of the things that we talk about, and I think we talk about a lot with digital health, you know, just whether it's apps and wearables and, you know, the value and the evidence behind them. And I think that, you know, with this, it's like, when people use it, they see results, right? Do you guys do any, you know, publish any research around that? Do you have, like, member data that you share that shows, shows the value of these programs?
Caroline Khalil 22:57: Yeah, you know, we do a lot in terms of data. We are very, very data driven organization. Ultimately, we're answering a health plans, right? And health plans love to crunch numbers. They love to see results. We also want to keep a pulse on the Silver Sneakers member and what that member is looking for. So we have a multitude of different ways that we gather that data, and we do publish research based on that. And I can send you some some links to like one of the Yeah, one of the ones that is used quite often is one that shows that people who engage in the Silver Sneakers program have less hospitalization than those who don't. So I can, I can follow up and send you some links to some of our research. And,
Megan Antonelli 23:49: yeah, that's perfect. And we can add them to the the feed when it comes through. But, yeah, no. I mean, it is, you know, I think that that research, but I think also, because you're, you are working with the payers, and they are so data driven, you know, it speaks to both the longevity and the success of the program, right? Because, not only by the just sort of the nature of that model, you've had to to sort of cater to that, but but prove the value, you know, because that's what they're looking for. So,
Caroline Khalil 24:21: Yeah, that's exactly right. If it, if it did not have the data behind it, if it did not have the cost savings behind it, it wouldn't have survived 30 years, right? With ma plans, especially, right,
Megan Antonelli 24:35: right? For sure, it's remarkable that Ma has survived as long also working, but it is, yeah, no, that's great. Well, as you look to, you know, what's next, you know, are there sort of integrations happening? How do you guys look at the, you know, that digital play of what's going on, what's the. And what's, what does the next frontier look like?
Caroline Khalil 25:02: I think the next frontier is a lot of personalization, right? So we're hearing a lot about data and AI and, you know, like all, all that is very much in the in the news lately, are there ways to customize the program so that it's meaningful for each individual member different ways that we can do that, and then also a lot of emphasis on All right? Well, how do you more specifically, maybe tackle things like diabetes management? How do you more specifically tackle things like fall prevention in different ways. I think there's a lot of that coming, and then always, like we have a killer team that develops programming that takes into account a variety of different things, whether it's age, whether it's activity level, whether it's chronic conditions that's always happening in the background, and then how do we get that out? And also always, always, like, how do we get more and more people involved so that they're getting the benefits, be it from the sense of community or from the physical benefits, or from, you know, even educational material as well.
Megan Antonelli 26:23: Yeah, I mean, it's an interesting time. I think we just had Raj agual on the show, and he's with 2030 health and, you know, just looking at what does it look like. And obviously there's also the impact of GLP ones on, you know, specifically around obesity management and weight management. But you know, the importance of exercise never goes away. And in fact, even with those, I think it's more so, because there's, you know, evidence, you know, as you lose weight, you need to really work on maintaining your muscle mass, and so that physical activity becomes even more important. Are you seeing, you know, sort of discussions around that, particularly with the payers, of how there's how there could be a linkage there, or is that maybe to come?
Caroline Khalil 27:07: Yes, we definitely are, and there's certainly more conversation on that topic as a whole. But I think you said it very well in that even aside from weight management, the benefits of exercise. Like to go back to, you know, cognitive health, right? And to stave off cognitive decline, I think we as a culture have have always correlated, like weight management with exercise. And more and more the research is showing it's so much broader, right? So what I like about things like the GLP ones is it's giving people the confidence to then begin an exercise regimen. And that's a real thing, you know, like sometimes walking into a gym can be super intimidating, and so our job is to give people as many options as possible, so that one of those options speaks to each individual. And so maybe I'm not ready to set foot in a gym, but I'm okay, you know, doing an online, live class where people don't have to see me yet, but I kind of feel like I'm part of something, or I am able to engage in a walking club in my community. So again, the Our job is to provide options so that everyone feels like there is something for them, right?
Megan Antonelli 28:36: And it is. It's that holistic approach, and, you know, and in some cases, yes, weight is that barrier to then to exercise. And once you get beyond that, then exercise is a lot easier. But it's that holistic approach to all of this that then gets you to that place of, you know, being able to both, you know, improve your mental health, your you know, lifestyle, and you know your quality of living, and hopefully even you know the the length of your life, right? Yes, yes, awesome. Well, thank you so much. Caroline. Tell our audience how to how to best reach you and and find out more about TiVi and the SilverSneakers program.
Caroline Khalil 29:12: Yes, so you can reach me or find out more about tivity, ativityhealth.com, and to find out more about the SilverSneakers program. It's silversneakers.com and you can find out if you're eligible there as well. And yeah, welcome that you know, anybody does reach out, would love to, would love to hear from the audience and and continue the conversation. Yeah.
Megan Antonelli 29:37: Well, thank you so much for joining us. Caroline, it's so great to hear about such a program with such longevity and really it's impacted millions of lives over the years. So thanks for sharing your invaluable insights on empowering seniors to age in place.
Caroline Khalil 29:52: My pleasure, Megan, thank you for having me on and always look forward to a conversation with other fellow New Yorkers.
Megan Antonelli 29:58: So absolutely super fun. And hope, hopefully we can meet each other soon in New York. We can go to go to the next health impact and have you on the stage in person. So that would
Caroline Khalil 30:09 : be wonderful. That would be great. I will go and get some New York food,
Megan Antonelli 30:15 : some pizza and bagels, but we'll have to walk it off. Always,
Caroline Khalil 30:20 : always on the list those
Megan Antonelli 30:23 : To our audience. Thank you so much. Remember, aging in place is not just possible, but it's a great and wonderful, healthy experience, and it will add years to your life. So don't hesitate to check out Silver Sneakers or all get you know that the age where it's appropriate is coming faster than we know it. So thanks so much for joining us today, and we'll see you soon on another digital health talks.
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