Archive for the ‘Wellness/Prevention’ Category

Health Coaching Success Metrics and 8 More Behavior Change Benchmarks

July 7th, 2016 by Patricia Donovan

Satisfied clients and participants on track for goal attainment are two hallmarks of a can't-lose coaching initiative.

Satisfied clients and participants on track for goal attainment are two hallmarks of a can’t-lose coaching initiative.

What are the hallmarks of a winning health coaching strategy? The answer depends on what’s being measured: the effectiveness of the individual coach, the participant’s progress, or overall program success.

That’s the feedback from 111 healthcare organizations responding to the 2016 Health Coaching Survey by the Healthcare Intelligence Network.

If you’re looking to measure the health coach’s success, then client satisfaction is the best indicator, say 27 percent of these respondents.

On the other hand, for a gauge of an individual’s progress, look to the participant’s goal attainment, report 78 percent.

This same metric—goal achievement—is also the best indicator of program success as a whole, agree 64 percent.

The May 2016 survey documented a number of other health coaching benchmarks, including the following:

  • Motivational interviewing is a coach’s top tactic to effect behavior change, say 83 percent.
  • All-important ‘face time’ with coaches is plentiful: 47 percent embed or co-locate health coaches at points of care, with most onsite coaching occurring in primary care offices (50 percent) or at employer work sites (50 percent).
  • Nine percent even embed health coaches in hospital emergency rooms.
  • While a majority focuses on coaching high-risk individuals with multiple chronic illnesses, 51 percent now extend eligibility for health coaching to individuals stratified as ‘rising risk.’
  • Nearly half of respondents—48 percent—offer health coaching to patients and health plan members with behavioral health diagnoses.
  • Reflecting the surge in telehealth, 12 percent of respondents offer video health coaching sessions to clients.

Download an executive summary of the 2016 Health Coaching survey.

Infographic: Proven Preventative Healthcare Practices

July 1st, 2016 by Melanie Matthews

Adopting simple, proven preventative practices could save Americans billions in healthcare costs per year and allow most to live longer lives. Nurses trained in basic screenings and counseling can have profound impacts, according to a new infographic by the University of San Francisco’s Online Master of Science in Nursing program.

The infographic highlights 20 proven preventative services and the impact on the number of lives saved and healthcare costs if more people had access to these services.

Increasing demand for quality-based, pay-for-value healthcare has elevated the health coach’s contribution to chronic care management and population health. From supporting ‘rising risk’ populations telephonically to conducting home visits for recently discharged high-risk, high-cost individuals, health coaching offers an essential care management touch point.

2016 Healthcare Benchmarks: Health Coaching is the fifth comprehensive analysis of the health coaching arena by the Healthcare Intelligence Network, capturing key metrics such as populations, health conditions and health risk levels targeted by health coaching programs; risk stratification criteria; prevalence of embedded coaching within care sites; coaching tools and incentives as well as program outcomes and ROI from more than 100 healthcare organizations.

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Yale New Haven’s High-Risk Care Management Commences with Its Employees

January 14th, 2016 by Patricia Donovan

A care management pilot by YNHHS for employees and their dependents with diabetes was a template for future embedded care management efforts.

Disenchanted with vendors it engaged to provide care management for its workforce, Yale New Haven Health System (YNHHS) launched an initial care management pilot for its high-risk employee populations. The pilot went on to become a very robust program and served as a training ground for two more embedded on-site care management initiatives. Here, Amanda Skinner, YNHHS’s executive director for clinical integration and population health, provides details from on-site face-to-face care management for YNHHS employees and their dependents.

We have an RN care coordinator based on each of the four main hospital campuses of our health system: one in Greenwich, one in Bridgeport and two in New Haven. All of the RN care coordinators in this program are trained in motivational interviewing. The intent is for them to work with our high-risk, high-cost employees who have chronic diseases, and with their adult dependents that also fall into that population.

The care coordinators work with these employees across the entire system to help them access the care they need, identify their goals of care, get under the surface a little to determine barriers to their being as healthy as they can be, and manage them over time. We did create some incentives for employee participation in this program, including waived co-pays on a number of medications (for example, any oral anti-diabetics).

When we initially launched the program, we limited it to employees and dependents that had diabetes, because that was the population for which we had very robust data. We also knew that diabetes was generally a condition that lent itself well to the benefit of care coordination; that there were a lot of gaps in care. When we looked at our data, we saw that ED utilization was very high for this population; that their past trend was rising, that utilization of their primary care provider was actually below what you would expect. This meant that they were under-utilizing primary care, over-utilizing hospital services, and were not particularly compliant with care.

With that population, we saw a lot of opportunity that a care management program could help address. In general, diabetes is a condition that lends itself to accepting a helping hand, to help people understand their condition and address the medical and social issues so they can manage that condition more effectively.

The program has been tremendously successful. We expanded it this year to include wellness coaches based at all of our delivery networks’ main campuses as well. These coaches work with a lower risk population and are available to any health system employee that wants to work with a coach to set care goals and then meet with the coach monthly or quarterly to track improvements against those goals. This expansion is because we’ve seen such positive results from this program.

Source: 3 Embedded Care Coordination Models to Manage Diverse High-Risk, High-Cost Patients across the Continuum examines YNHHS’s three models of embedded care coordination that deliver value while managing care across time, across people, and across the entire continuum of care. In this 30-page resource, Amanda Skinner, executive director for clinical integration and population health at Yale New Haven Health System, and Dr. Vivian Argento, executive director for geriatric and palliative care services at Bridgeport Hospital, present a trio of on-site care models crafted by YNHHS to manage three distinct populations.

11 Value-Based Healthcare Reimbursement Trends to Know

November 24th, 2015 by Patricia Donovan

value-based reimbursement

One-fifth of healthcare companies experience annual savings of $100,000 to $500,000 from value-based payment models, finds a new Healthcare Intelligence Network Savings survey.

A survey by the Healthcare Intelligence Network on the growing trend of fee-for-value payments has documented healthy adoption rates, measured savings and steady gains in the area of preventive services related to fee-for-value formulas.

Seventy-one percent of survey respondents employ a value-based reimbursement or alternative payment model, according to the October 2015 survey. The study also determined that of those respondents not yet exploring a fee-for-value approach, 26 percent plan to do so in the coming year.

In assessing value-based payment formulas, 56 percent of respondents favor a pay-for-performance model, with 71 percent employing these models in contracts for commercial populations.

Despite healthy adoption of alternative payment approaches, one quarter of respondents say the infrastructure required to sustain value-based payment models is the reimbursement trend’s most significant hurdle—greater even than the challenge of data integration or patient engagement, the survey determined.

In evaluating healthcare providers for value-based rewards, respondents most often review markers tied to quality (82 percent), hospital readmissions (56 percent) and patient satisfaction (56 percent) to determine payment, the survey found. The use of physician report cards to track provider performance was reported by 63 percent of respondents.

The shift toward fee-for-value has had the greatest impact on the area of prevention, respondents said, with 69 percent attributing a rise in preventive care to value-based reimbursement models.

Other survey findings included the following:

  • Twenty-one percent of respondents reported savings from value-based payment models as ranging from $100,000 to $500,000 annually.
  • Value-based payment contracts most often were executed for populations having more than 100,000 beneficiaries.
  • Fifty-six percent said the market lacks sufficient technological support for value-based payment models.

Download an executive summary of results from the Value-Based Reimbursement survey.

Health Coaching Trends: Infographic

May 29th, 2015 by Melanie Matthews

A growing number of work sites offer face-to-face and/or telephonic health coaching as part of their wellness programs to help employees improve their health status and reduce healthcare costs.

A new infographic by WellSteps examines the effectiveness of health coaching programs, who should be targeted by health coaching efforts and the recommended number of health coaching interactions.

Evidence-Based Health Coaching: Motivational Interviewing in Action Validated in over 300 clinical studies, motivational interviewing (MI) remains the most patient-centered and effective approach for supporting better patient engagement and activation, disease self-care, treatment adherence and lifestyle management.

Evidence-Based Health Coaching: Motivational Interviewing in Action is the first MI video training series especially designed for clinicians who serve individuals at risk of, or affected by, chronic diseases. Whether you are serving in a wellness, disease management, or care management program, or a primary or specialty care setting, hospital or community program, this series will help you build the practical MI knowledge and skills you need to support your patient health and address the behavioral factors that are responsible for over 85% of avoidable healthcare costs.

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Infographic: The Value of an Investment in Health Management

May 13th, 2015 by Melanie Matthews

Reduced employee health risk, followed by reduced healthcare costs and improved employee productivity are among the top reasons employer invest in health and wellness programs, according to a study by Optum and the National Business Group on Health, depicted in a new infographic.

The infographic also examines eight other emerging reasons for a health management investment by employers.

Profiting from Population Health Management: Applying Analytics in Accountable CareAs ACA reforms continue to impact healthcare, population health management (PHM) is fast becoming the new buzzword for the management, integration and measurement of all interventions across the health continuum, from the healthiest populations to those with catastrophic illnesses. Rooted in the IHI’s Triple Aim, PHM dives deep into health analytics to reduce risk and associated health spend and provide a strong foundation for accountable care in a value-based system.

Profiting from Population Health Management: Applying Analytics in Accountable Care provides both a primer in PHM, identifying the challenges and opportunities of a robust population health management program, and an advanced case study in the use of analytics in PHM.

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4 Behaviors of the Highly Activated Patient

May 7th, 2015 by Patricia Donovan

The success of a population health intervention depends upon participants’ level of self-engagement. The Patient Activation Measure™ (PAM) designed to assess an individual’s knowledge, skill and confidence in managing their health, consists of a 13-item scale that asks people about their beliefs, knowledge and confidence for engaging in a wide range of health behaviors. Here, PAM developer Dr. Judith Hibbard, MPH, Dr.PH, describes some of the traits associated with a highly activated, engaged patient.

It is important to understand exactly what is happening with individuals at different levels and what is going to help them. We did several studies to find out if activation predicts behaviors, and to determine which behaviors it predicts. We did a national probability study and then replicated that study in the United Kingdom. They found almost exactly the same results as we had in the United States. Since then, there have been many more studies.

We found that people who scored higher on this measure were more likely to:

  • Engage in preventive behaviors like screenings or immunizations.
  • Engage in healthy behaviors, such as regular exercise and having a healthy diet.
  • Engage in more disease-specific self-management behaviors, such as monitoring or adherence.
  • Engage in more health information-seeking behaviors.

Once we saw these results, we began to look at the data a bit differently. We realized from the data that some behaviors don’t start until people move further along that dimension of activation.

Source: Three Pillars of Health Coaching: Patient Activation, Motivational Interviewing and Positive Psychology
health coaching
Judith Hibbard, MPH, Dr.PH, is a professor of health policy at the University of Oregon. For more than 30 years, she has focused her research on consumer choices and behavior in healthcare. Dr. Hibbard is the lead author of the Patient Activation Measure™ (PAM) and advises many healthcare organizations, foundations and initiatives.

Guest Post: Building the Right Health Management Program

February 10th, 2015 by Ann Wyatt, Regional Vice President, HealthFitness

 Ann Wyatt

Ann Wyatt, Regional Vice President, HealthFitness

While Sibson’s Healthy Enterprise Study found that 40 percent of all health management programs are not effective, research shows that organizations adopting the most effective programs—those in the top 25 percent– experienced 16 percent lower healthcare costs and a 35 percent lower rate of increase in costs than the rest.1,2

Well-designed programs lead to improved retention, better employee morale and increased productivity. Reams of data support that.3,4,5

It would seem the answer is simply to build a good program. However, it’s not that simple; what works varies by workplace, income, age and a host of other factors. The task is to develop the right program for your target group. Research6 published in September found comprehensive workplace programs do work, but their success depends on program goals, design and implementation. The program must fit into the organization’s culture.

For instance, a focus group conducted for a client of HealthFitness – a large manufacturing plant population, found that some of wellness program names sounded too “feminine” to attract the rural, blue-collar, mostly male workers. Messages about the importance of good health weren’t effective, but “Get fit for hunting season” was.

Another example: A technology company with employees making six figures launched a health management program. The incentive to complete a health assessment and attend a biometric screening? A $25 gift card. The participation rates were dismal.

Employees want meaningful and relevant programs.7,8

It needn’t be costly, and success isn’t reserved for the mega-firms. Kramer Beverage, a small company in New Jersey, earned American Heart Association recognition for its efforts to keep employees healthy. The company provides gym membership discounts, offers healthful food options at meetings and in vending machines, and has created a walking track outside the building.

Another small company with a limited budget wanted to test the wellness program waters but was concerned it didn’t have the funds to make a big splash. The company started by putting a bowl of fruit in every break room once per week. The buzz it created revealed that employees were hungry for health.

It comes down to finding out what employees are “hungry” for and “feeding” them the means to reach their goals. That can vary widely, from shaving 10 seconds off a 5K time to being readier to hunt. You don’t have to build the perfect health management program–just the right one.

1Healthy Enterprise Study, Sibson Consulting, (Winter 2011)

2Steven F. Cyboran and Sadhna Paralkar, MD. “Wellness Program ROI Depends on Design and Implementation” Society for Human Resource Management, July 26, 2013

3Parks, K., et al. “Organizational Wellness Programs: A Meta-Analysis.” Journal of Occupational Health Psychology, 2008

4Goetzel RZ, et al. “Do workplace health promotion (wellness) programs work?” J Occup Environ Med. 2014 Sep;56(9):927-34

52013 Aflac WorkForces Report conducted by Research Now

6J Occup Environ Med. 2014 Sept. op. cit.

7Aon Consumer Health Mindset,

8“Five voluntary trends to watch in 2014.” BenefitsPro , Dec. 13, 2013

Infographic: Weighing in on Obesity

December 12th, 2014 by Melanie Matthews

Three in five adults agree that obesity is a significant problem in the United States, according to a new infographic by TeleVox.

The infographic looks at the growing obesity rates among males in the United States and how to address obesity.

Since its passage, the Patient Protection and Affordable Care Act (ACA) has sent major ripples across the healthcare landscape. ACA has also underscored the value of disease management in population health as a strategy to improve health outcomes and slam the brakes on healthcare spend.

38 Disease Management Metrics: Population Health Benchmarks to Drive Accountable CareTo illustrate the contributions of disease management across the care continuum, the Healthcare Intelligence Network has compiled 38 Disease Management Metrics: Population Health Benchmarks to Drive Accountable Care. Through a series of 38 graphs and charts, this 35-page resource dives deep into several years of market research to document the role and outcomes of disease management in 11 key areas, as well as the high-focus diseases and health conditions.

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Guest Post: Living Better, Not Just Longer: Worksite Wellness at Any Age

October 27th, 2014 by Tanja Madsen

Population health management

Living healthier, more productive years is the goal of population health management.

Just 20 years ago, about one in 10 workers was over the age of 55; today, it’s one in five. We are aging as a nation. We are living longer than our forebears a century ago, but can effective population health management push back the serious effects from chronic disease so we can live healthier, more productive years?

In the typical lifespan, there is a point at which an individual first becomes chronically ill or disabled, and a further point at which a person dies. On average, the time between those two points is about 20 years, according to healthy aging pioneer James Fries. Fries envisions a world in which we may not add many more years to the end of life, but we can “compress morbidity,” or shorten the number of years we suffer from illness.

The key question is: how can we maximize the healthy years of our lives? It’s not just a question important to individuals; it’s critically important to our economy as well. Population health and a nation’s financial health are inextricably linked. This is the focus of the World Economic Forum’s Healthy Living initiative, which found that more than 60 percent of global deaths are due to diseases associated with preventable lifestyle risk: cardiovascular diseases, diabetes, cancer and chronic respiratory diseases.

Closer to home, CEOs of some of the nation’s largest companies unveiled a new initiative, Building Better Health: Innovative Strategies from America’s Business Leaders, to leverage their market power to identify an evidence-based approach to population health.

As our working-age population grows older, it’s critical that employers seize the opportunity to address the factors that influence health and can enhance productivity in older workers. For those of us who work in health promotion and prevention, that starts with a change in how we define the concept of “health.” Taking a cue from public health research, we must recognize that health is more than the absence of disease and take a whole-person approach to total well-being. Public health literature points to physical, social, economic, environmental and genetic “determinants of health” that combine to affect the health of individuals and populations. Using a more expansive term for this view of health, the Centers for Disease Control and Prevention notes that well-being includes, at a minimum, positive emotions, satisfaction with life, fulfillment and positive [physical] functioning.

This fuller definition of well-being comes into play as employers focus on the value of this aging workforce. Older workers offer tangible benefits for employers to keep them healthy and productive. Researchers found that older workers (over age 65) make fewer serious errors than their younger colleagues (age 20 – 31); they also offer experience, consistently high motivation, a balanced daily routine and stable mood.

The University of Louisville’s program, “Get Healthy Now,” opens health coaching to all interested employees, regardless of whether they are at low-, medium- or high-risk for chronic disease. Care-giving workshops are designed to help everyone from new parents to sandwich-generation Baby Boomers caring for elderly parents; elements include legal, financial and social factors. Mindfulness, yoga and relaxation are among the many classes offered to promote well-being. ROI analysis found the UofL program returned a benefit cost ratio of 7.16 to 1 after four years, and it has become a model for a statewide strategic wellness initiative called “Get Healthy Kentucky.”

Evidence-based workplace health management programs that offer tools to support healthy aging can help older workers maintain active, productive lives. Some interventions, such as in-person health coaching, are particularly effective for those over age 40. In addition to a continued focus on the key behaviors that can help delay the onset of health problems (avoid tobacco, exercise regularly, and maintain a healthy weight), it becomes more important than ever to invest in programs that enhance the emotional, physical, social and financial well-being of all workers—no matter their age.

Tanja Madsen

Tanja Madsen

About the Author: A veteran of health education and health management product development, Tanja Madsen is director of product management for HealthFitness. She is involved in the development of the innovative HealthFitness technology platform, the Persona™ behavior change model, a short, engaging health assessment and a new approach to coaching. A certified health educator, Tanja works with a team that includes registered dietitians, health educators, exercise physiologists and behavior-change experts who are responsible for the development and management of national programs to improve population health.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.