Featured Articles                                                   June 2010, Vol. III, No. 2
Care Coaching Improves Outcomes, Reduces Costs for Patients with Behavioral and Physical Health Conditions

Care coaching — consultation with licensed mental health counselors and RNs with experience in psychopathology and behavior modification — reduces medical expenses attributed to hospital admissions, lengths of stay and ER visits while improving health outcomes for health plan members suffering from both physical and behavioral health conditions, according to a peer-reviewed study from Health Integrated and HealthNow New York. The study also found that care coaching resulted in a positive net ROI of 3.84 for the health plan during the one-year review period.

The study authors examined the use of care coaching for an identified high-risk population with the goal of assessing how care coaching contributed to optimal patient care to improve clinical outcomes and reduce healthcare utilization. In the study, care coaches worked with members and supervising Health Integrated medical directors who, in turn, consulted with membersí primary care physicians (PCPs) to validate or modify treatment plans in accordance with evidence-based guidelines. During the year-long study, 3,305 members of a regional HealthNow New York health plan were assigned to dedicated care coaches, who fostered collaborative relationships with the membersí attending PCPs. Once enrolled, members were screened for behavioral health conditions as well as psychosocial issues such as anxiety, affective disorders and chemical dependency alone, or as comorbidities to other medical conditions. All of these conditions can have a significant negative effect on total healthcare costs, according to the authors. The care coaches helped members establish individual goals that included taking medication appropriately, following their doctorsí treatment plans, losing weight and appropriate physical activity.

Over the 12-month period, researchers identified and evaluated three key measures with results reported on a per thousand basis:

  • Acute care facility admissions were reduced from 44.91 to 23.66.
  • Average length of stay measured in hospital days was reduced from 276.15 to 146.59 days.
  • Visits to the EDs were reduced from 71.90 to 53.05.

When associating these results with claims data during the review period, researchers found there were considerable costs savings to the health plan as compared with claims costs from the base period. The program had a positive net ROI of 3.84 during the time period reviewed and for which data are available. According to Sam Toney, vice chairman and chief medical officer of Health Integrated and one of the studyís authors, "Addressing behavioral health conditions along with medical symptoms is extremely effective at improving member health while also reducing costs. No matter the behavioral health condition or psychosocial issue — whether it is depression, substance abuse or maladaptive behavioral patterns — looking at the Ďwhole patientí leads to innovative and integrated approaches to managing psychosocial barriers along with physical conditions."

Get more information here.

Quotable: Health Coaching Job Description

"[Calling people on the phone and not reaching them] is not the glorious part of the job, nor the job that we want to talk a lot about, but it is a very important part of the job. If we donít dial the phone, weíre not going to reach the individual, but we also know that we donít reach the individual every single time we dial the phone. So be honest about what the job entails; donít sugarcoat it [when hiring health coaches]."
                                        — Darcy Hurlbert, Ceridian Lifeworks.

Learn more about health coach hiring and training.

Blues Plan to Offer Health Coaching for Chronic Pain, Fall Prevention

IBC's ConnectionsSM Chronic Pain Program is designed to help IBC's members learn the most effective ways to cope with their chronic pain so they can resume daily activities and improve their productivity and quality of life. A health coach will work with a member to identify and reduce pain triggers — psychological or physical factors like stress, lack of sleep or musculoskeletal sources of pain. The health coach will also help the member understand specific tests, evaluations and treatments for chronic pain. A health coach is a health professional averaging 10-15 years of clinical experience with specialized training in helping people manage chronic conditions by providing evidence-based information and support.

IBC also has developed a ConnectionsSM Fall Prevention Program, which is designed to diminish preventable falls among seniors in hopes of reducing avoidable hospitalizations and ER visits associated with these falls over time. To prevent this loss of mobility, or disability, a health coach will encourage the member to perform balance and gait exercises, make modifications to the home environment, and work with their physician and/or pharmacist to better manage their medications. Both the chronic pain management and fall prevention programs were recently added to IBC's suite of award-winning disease management programs that serve over 1.5 million members. These programs expand the ConnectionsSM Health Management Program.

IBC's Connections Health Management Program is designed to help members become better informed healthcare consumers. Through the program, members with chronic conditions such as diabetes, lung or breathing problems, or heart conditions can learn how to improve their health and overall quality of life. In addition, the program supports members who are facing a significant medical decision, as well as members who have everyday health concerns, by providing 24-hour access to health coaches.

Read the full article here.

Health Coaching in Primary Care
Margaret Moore, CEO of Wellcoaches Corporation, discusses the effects a physician's health choices and behaviors can have on a patient's compliance with health coaching efforts, the role of a medical fitness coach in primary care, and the impact positive psychology can have on health coaching.

Listen to the podcast here.

New Chart: Tools That Measure Medication Adherence

Medication adherence programs can improve patient care and lower healthcare costs by more effectively managing chronic medication utilization. We wanted to see how healthcare organizations with medication adherence programs measure adherence and compliance levels in their populations.

Click here to view the chart.

Ideas to Improve Health Program Participation

Question: What are some creative approaches to increasing health promotion program participation?

Response: The single most important factor is that these coaching programs just donít drop in from the blue unrelated to anything else thatís going on inside the company. The participation, results and improvement will be a direct function of the buy-in from senior management and from their demonstration of their belief in the effort — not only in terms of the ROI, but in terms of whether this is the right thing to do for their employee population. Anything that communicates that message will be important.

(Dr. Craig Nelson, director of health services research with American Specialty Health.)

Learn more about increasing participation in health promotion programs.

HCH Readers Save 10% on Coaching Resource

An all-new follow-up to the best-selling 2009 edition, Benchmarks in Health & Wellness Incentives, 2010 Edition: Utilization and Effectiveness Data to Drive Health Promotion, Compliance and ROI is packed with actionable new data on incentives activity, including the growing trends toward integrating incentives with health benefits and financial penalties for individuals with certain health risks. This resource provides the latest metrics on the prevalence of incentives, favored incentive types, the population health management activities most often incentivized, identification and eligibility of recipients, and incentive program challenges, measurement tools, results and ROI.

HealthCoach Huddle subscribers should use ordering code HCH to purchase this product at a special price!

Get more information on health and wellness incentives.

Fixing What Hurts: What's Working in Pain Management

Pain can wound a patientís wallet at a cost of $500 to $30,000 annually. Pain can also create roadblocks in day-to-day life: many chronic pain patients lose an average of 4.6 hours per week, which costs employers $61.2 billion annually. To relieve the physical and fiscal suffering associated with pain, many healthcare organizations have implemented pain management programs. To discover how these programs work and who is using them, the Healthcare Intelligence Network conducted a non-scientific online survey. In response, 186 organizations, including hospitals, nursing homes and health plans, shared their experiences with pain management programs.

Download complimentary white paper here.

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