Providers use 'health coaching' to teach patients about how lifestyle affects health
Good coaches produce good athletes through encouragement, training and discipline. Now some providers are betting that the same approach will produce better patients--leading to better outcomes and saving money. Their method: a form of disease management known as health coaching. The strategy helps certain patients manage chronic illnesses and contributing lifestyle factors. "Health coaching helps patients focus on the biggest sources of what's making them feel unhealthy and lets them work together for health improvements," says Julie Meeks, M.D., CEO and founder of The Haelen Group, Indianapolis, a consultancy that promotes the concept.
Coaching helps patients use health care more effectively, says Richard Citrin, Ph.D., senior vice president of employer services at Corphealth Inc., Fort Worth, Texas, a managed behavioral care company that uses the method. "Disease management ... only targets a small portion of the patient population," Citrin says. "Health coaching goes the next step. It uses advice, role playing and other techniques to help people change their unhealthy behaviors, and teach them to use health services appropriately."
Take back pain. Many experts consider chronic back pain, exacerbated by stress and demanding lifestyles, to be as much a psychosocial issue as a physical one. MVP Health Care, Schenectady, N.Y., a health plan that covers 540,000 people in Vermont and New York state, has targeted the condition for early intervention. MVP identified 1,000 members with persistent back pain to give them coaching from health advocates.
In a series of phone calls, advocates ask patients about their pain perception, habits and other factors to determine impediments to health, and teach them to manage their conditions. Typically, patient-advocate contact is frequent early in the process--six to 12 weeks--then tapers off into a maintenance stage, with occasional contact from advocates as patients improve. "This is much more of a mind/body approach, and certain diseases lend themselves better to [health coaching]," says Jerry Salkowe, M.D., MVP Health Care's senior director of quality improvement. "It requires a behavioral change on the part of the patient, so it's a big challenge. But we're helping members improve their quality of life."
Meeks estimates that coaching saves $2 to $3 for every dollar spent. According to the National Business Coalition on Health, one cost-effective strategy would be to use health coaching along with predictive modeling systems to identify individuals at highest risk for high near-term health care costs. "Employers are screaming for solutions that will stabilize their costs. Their concern has literally spawned the industry to proactively identify conditions that would benefit from health coaching," she says.
MVP, which started its program in April, has no cost data, but Salkowe estimates savings of up to $1,000 per patient. The insurer plans to expand it to other chronic pain. Coaching has helped "reduce impairment, reduce the frequency of visits and identified all kinds of devastating situations. It's part of our continuum of care," Salkowe says.