Featured Articles                                                   February 2011, Vol. III, No. 10
Blue Cross Embeds Weight Coaching into Stop-Smoking Support Program

Blue Cross and Blue Shield of Minnesota (Blue Cross) has added a new weight maintenance coaching feature at no additional cost to members who use its Stop-Smoking Support program. This new coaching feature will help those smokers who resolved to quit this year but were worried about the side effect of weight gain. Smokers rate the fear of gaining weight as one of their leading barriers to quitting tobacco.

According to a study in the Journal of Smoking Cessation, more than 60 percent of callers to a quit line said they had concerns about weight gain after quitting smoking. In response to these concerns, Blue Cross is offering members who participate in the Stop-Smoking Support program up to three optional coaching calls with a weight coach to address their weight gain concerns as they quit tobacco. This added program feature will increase both the effectiveness and participant satisfaction with the Stop-Smoking Support program. "Individuals who use the optional weight coaching calls are more successful at quitting smoking and less likely to gain weight than individuals who do not take advantage of the support,” said a researcher.

Helping smokers quit is critical for Minnesota, because each year smoking is responsible for 5,135 deaths and costs $2.87 billion to treat the diseases and conditions related to smoking — such as cancer, emphysema and heart diseases. This economic impact is borne by all Minnesotans and equates to $554 for every man, woman and child in the state

In addition to individual support to quit, Blue Cross has worked alongside other Minnesota health organizations to support passage of a statewide, smoke-free law, raise the price of tobacco and protect youth from traditional and nontraditional tobacco products. These efforts and many others are having positive effects, as Minnesota’s smoking rate has declined from 22 percent in 1999 to 17 percent in 2007. But more work remains. Approximately 634,000 Minnesota adults still smoke as do another 56,000 Minnesota high school students. The tobacco industry continues to spend millions each year marketing its products to youth, women and populations that experience health disparities, and there has been a concerning rise in the number of people using multiple forms of tobacco.

Get more information here.

Quotable: 3 Ways to Change a Patient's Behaviors

"To change behaviors, we need to go beyond the traditional scientific evidence model about behavior change in terms of surface change, which is increasing knowledge, eliciting good intentions like New Year’s resolutions and setting goals to exploring deep change. One example of that is helping patients learn how to change their perceptions about the risks, benefits and harm from their unhealthy habits. Typically, patients minimize the benefits of the behavior change and maximize the benefits of staying the same. One of the difficulties is how to help people change their perceptions in order to facilitate behavior change. It can also involve exploring and addressing their differences in values between what they say and do — they may say they value their health, but they don’t actually take action. The last strategy is helping people understand their own emotional resistance to change — what’s holding them back. If we don’t know what’s holding these patients back, it’s going to be very difficult to help people move forward and develop the motivation to change."
                                        — Dr. Richard Botelho, University of Rochester Medical Center

Learn more about helping patients to change their behaviors.

Majority of Employers Say Incentive-Based Programs Successful at Gaining Employee Participation

Fifty-six percent of employers agree that incentive-based programs have a better than expected success rate at increasing employee participation in wellness programs, according to a study by Fidelity Investments® and the National Business Group on Health (NBGH). The survey, which looked at the behaviors and offerings of 147 mid- to large-size companies nationwide, is a follow-up to research Fidelity and NBGH conducted in 2009.

According to the study, employers utilized several different types of incentives in 2010 to encourage employees to participate in health improvement programs. These include offering cash and gift cards, and making additional contributions to health savings accounts, along with more punitive efforts such as reducing employer contributions to health plans if employees didn't engage in any programs. The incentives provided by employers averaged a total of $430 per employee in 2010, which was a 65 percent increase from $260 in 2009.

Half of all companies that provided such incentives in 2010 also offered them to dependents of employees, at an average value of $420. A small number of companies (12 percent) utilized negative incentives to encourage participation, for instance reducing employer contributions to health plans for those not participating. More employers (62 percent) offered incentives last year than in 2009 (57 percent).

In exchange for incentives, employees participated in a variety of wellness programs in four main categories: health risk management (e.g., on-site flu shots); lifestyle management (e.g., smoking cessation programs); condition management (e.g., nurse phone lines) and communication/education (e.g., company intranet wellness Web sites). Health risk management programs, such as biometric testing, will experience the most growth, with almost four out of 10 (39 percent) employers planning to add such a program. About one in three companies (32 percent) will add lifestyle management programs, which include preventive care reminders, and roughly one in three firms (30 percent) will add communication/education management programs, such as health and wellness newsletters. According to the survey, seven out of 10 (74 percent) employers offered 19 or more health improvement programs in 2010 and that number is expected to grow. In 2010, half (50 percent) of all employers added one new wellness program to their offerings and in 2011, 63 percent of employers plan to do the same.

Excluding incentives, the study found that the average employer spent just $154 per employee on health improvement programs vs. $108 in 2009. Condition management programs, such as monitoring diabetes treatment, consumed the majority (41percent) of the $154 spend, but that was a decline from 43 percent in 2009. Health risk management programs, such as health fairs, experienced an increase in spending to 20 percent in 2010 from 15 percent in 2009. Lifestyle management programs, such as stress management, received virtually the same spend (29 percent) in 2010 as the prior year (30 percent).

Read the full article here.

8 Elements of an ACO Structure
The accountable care organization (ACO) is a staple of healthcare reform. CMS will launch its Shared Savings Program — ACOs for Medicare patients — in January 2012. John Harris, principal with the consulting firm of DGA Partners, advises potential participants in an ACO to lay the groundwork now. In this interview, he recommends eight elements of an ACO infrastructure and weighs in on the patient-centered medical home's role in an ACO.

Listen to the podcast here.

New Chart: Power of Patient Education

To paraphrase a popular commercial, an educated consumer is the healthcare industry’s best customer. We wanted to measure the impact of patient education programs on health outcomes, medication adherence, healthcare utilization and other key indicators.

Click here to view the chart.

Driving Employees into Coaching Programs

Question: Which strategies do you plan to use to drive individuals into various coaching programs?

Response: Our plan is to get spouses involved; that’s been on our radar screen. We’re looking at ways to incent spouses to complete their HRAs. We’re also looking at people who have high-risk factors for targeted conditions. We’re looking at putting money into an incentive account based on people completing or participating in certain programs that are targeted to their risk factors. Our intention is not to put money in there based on them achieving certain results, or improvements like quitting smoking or reducing their weight by a certain amount, but by participating in certain programs. If enough people are participating and doing the right things, this will move the needle in a positive way for a large number of individuals and for our population as a whole.

(David Sensibaugh, director of integrated health at Eastman Chemical Company.)

Learn more about wellness programs for employees.

HCH Readers Save 10% on Coaching Resource

By assessing health risks in the populations they serve, employers, patient-centered medical homes, hospitals and healthcare case managers can more accurately identify, monitor and manage potentially high-expense conditions and reduce avoidable hospitalizations, readmissions, ER visits and other unnecessary utilization. In the Guide to Health Risk Assessment and Stratification, 12 industry thought leaders describe the processes of health risk assessment and stratification as well as applications and benefits of health assessment in the workplace and various healthcare settings. This 140-page guide also examines the HRA's impact on cost, utilization and patient health status. It contains more than 77 images and a Q&A chapter that answers more than 60 questions on HRAs.

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Get more information on our Guide to Health Risk Assessment and Stratification.

Healthcare Trends for 2011: Outlook Brighter Despite Reform Hurdles

This white paper summarizes results of the Healthcare Intelligence Network’s sixth annual Healthcare Trends for the Year Ahead e-survey conducted in October 2010, which reveals how 73 healthcare organizations perceived the business environment in 2010, are preparing for 2011 and anticipate implementation of the Patient Protection and Affordable Care Act (PPACA).

Download complimentary white paper here.

Take HIN's e-survey on Accountable Care Organizations in 2011.

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