Featured Articles                                                   November 2009, Vol. II, No. 7
Medication Adherence Index Built from Positive Psychology, PAM™

A new medication adherence index that combines evidence-based patient behavior mapping scores associated with positive psychology and behavior change with the Patient Activation Measure™ (PAM™) developed by Judith Hibbard, Ph.D.and colleagues is enhancing one coaching company's ability to segment patients into the most effective and efficient medication adherence pathways.

AdherenceRx uses the Patient Adherence Index (PAI™) and its suite of interactive tools in its Patient Adherence Pathways, which can range from intensive behavioral health coaching for high risk patients to more automated reminder messaging, virtual coaching, patient incentives and financial support programs. AdherenceRx health coaches support patients with guidance, resources and tools to change their motivations, beliefs and behavior towards taking prescribed medications as directed by their healthcare professional.

The PAM™ assesses an individual’s knowledge, skills and confidence in one’s ability to manage their personal health. The PAM™ segments patients into four progressively higher “activation levels,” shedding light on self-management abilities and potential barriers associated with non-adherence.

“We know that higher levels of activation strongly correlate with improved self-care behaviors, including higher rates of adherence,” said Chris Cresswell, CEO of Washington, D.C.-based AdherenceRx, LLC. “Providing our health coaches with these new evidence-based tools will help us tailor interventions to what is realistic and achievable for an individual along a journey of improved medication adherence and healthier lifestyles.”

Read full article here.

Quotable: Motivation for Medication Adherence

"Patients don’t know what to do or how to take medication. Often, they’re not motivated to take it. They’re ambivalent about the fact that it is necessary and that it is going to help them. Another factor that causes non-adherence is the cost and the number of times a day they must remember to take it. We assume the motivation is something that we can control. However, motivation is internal. All we can do is educate an individual and support them to be motivated.”
                                        — Connie Commander, president of Commander’s Premier Consulting Corporation and immediate past president of the Case Management Society of America.

Learn more about patient-centered medication adherence strategies.

HRAs More Effective When Linked to Coaching

Completing a health assessment linked to a health coaching or disease management program can increase its potential to positively influence some health behaviors — such as visiting the doctor more often, filling more prescriptions and having more cervical cancer screenings — according to an article by two Harvard professors in the September/October 2009 issue of Health Affairs magazine.

After examining data from CIGNA from January 2004 through June 2006, the authors concluded that while completing a health assessment may have some influence on health behaviors, the potential to affect behavior may be greater if there is a financial incentive for completing the assessment, if the assessment is directly linked to health coaching or disease management programs, or if financial incentives are provided for achieving risk reductions. Women, healthier people and people enrolled in consumer-driven health plans were most likely to complete an assessment.

In 2008 CIGNA began using a new health assessment powered by analytics from the University of Michigan Health Management Research Center under an exclusive agreement. The health assessment is linked to online health coaching for nutrition, sleep, stress and physical activity, and individuals are immediately offered this coaching if analysis of their health assessment indicates it may benefit them. Individuals can also access health coaching over the phone if their employer chooses this service as part of its benefits plan. Some people might also be contacted to participate in a disease management program based on an analysis of their health assessment.

Read the full article here.

Benchmarks for Health Coaching ROI
When evaluating health coaching and population health programs, it is rare to see ROI in a coaching program's first year, but generally by the second and third years, ROI begins to build, advises Paul Terry, Ph.D., president and CEO of StayWell Health Management. Terry evaluates the value of self-reported data, assesses the impact of health coaching on an organization's productivity, presenteeism and absenteeism, and gives some benchmarks for ROI in health coaching.

Listen to podcast here.

Recommended Ratio of Coaches to Clients

Question: Depending on the coaching method used — telephonic, one-on-one, Web — what is the recommended ratio of coaches to employee population?

Response: Our coaches handle online and telephonic clients interchangeably. Our coaches have between 400 and 500 active cases at any given time. That does not mean that they have unique interactions with 400 to 500 individuals on a monthly basis. The interactions with the coach are intensified in our programs in the first six months, and then we do long-term follow-up for the second six months. There can be a handful of months where a coach might not have any interaction with an individual, but we still consider that case active.

(Darcy Hurlbert is health and wellness product specialist with Ceridian Lifeworks.)

Learn how to build a health coach hiring and training game plan that improves health outcomes.

HCH Readers Save 10% on Coaching Resource

To optimize program success and ROI, health coaching will need to be powered by multi-channel outreach — land lines, Web, e-mail, cell phones and even PDAs — and reinforced by tightly interwoven communication and incentive programs. In The Next Generation of Health Coaching: Multi-Platform Models for Sustained Behavior Change two health coaching veterans describe the skills, technology and training to equip health coaches for this eventuality.

HealthCoach Huddle subscribers can use ordering code HCH to purchase this resource at a special price!

Get more information on preparing coaches for Health Coaching 3.0.

New 2009 Benchmarks! Patient Education and Outreach: Prevention, Self-Care Top Lessons

How prevalent are patient and member education programs, and which health areas are addressed by these efforts? How are healthcare organizations delivering health education, and who is the primary health educator? What is the chief impact of patient education programs, and how do organizations measure ROI from patient education efforts? The Healthcare Intelligence Network set out to answer these questions and others during its 2009 Patient Education and Outreach Benchmarks e-survey. This just-published executive summary of responses from 134 healthcare organizations offers lessons in the value of educating patients and members about disease management and self-care.

Download complimentary white paper here.

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