Posts Tagged ‘Obesity’

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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Infographic: Obesity in America and Beyond

September 26th, 2013 by Jackie Lyons

More than one billion people worldwide are overweight and 500 million are obese, according to the Food and Agriculture Organization of the UN.

The United States currently spends $147 billion annually on medical costs related to obesity, according to a new infographic from HealthcareColleges. This infographic explains the extent of global obesity, projects future obesity statistics, and identifies what might be done to improve the current state of affairs.

Obesity in America and Beyond

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You may also be interested in this related resource: Obesity – Behavioral, Medical & Surgical Management, 3rd Edition.

Infographic: America, Land of the Obese

September 3rd, 2013 by Jackie Lyons

Obesity is officially an epidemic, and it costs the healthcare system approximately $90 billion per year, according to the surgeon general.

In the United States, one in three adults and one in six children are considered obese, according to a new infographic presented by PhentermineWars.com. This infographic also identifies factors and risks, health concerns and deaths associated with obesity, current obesity rates, the top 10 obese states and more.

America the Obese

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You may also be interested in this related resource: 2013 Healthcare Benchmarks: Health Coaching.

Meet Nurse Turned Health Coach Jeaneen Mullenhard: Moving from Fixing Disease to Preventing it

June 7th, 2013 by Cheryl Miller


This month’s inside look at a health coach, the choices she made on the road to success, and the challenges ahead.

Jeaneen Mullenhard, MSN, FNP-BC, CHC, CWC, owner of Fundamentally Healthy Coaching Program, specializing in weight loss and diabetes

HIN: What was your first job out of college and how did you get into health coaching?

(Jeaneen Mullenhard): I was a late bloomer. I got my original nursing diploma from the Maryland General Hospital School of Nursing. My first job after that was at St. Agnes Hospital on a medical surgical unit. I worked as a registered nurse (RN) in a host of different fields for about 20 years before I went back to college. I did inpatient, outpatient, insurance physicals, chart reviews; I was a legal nurse’s consultant, and a school health nurse. I also did pediatrics and ran pediatric free-standing urgent-care centers for a little while.

When I went back to college, at Bowie State University, I did an RN and MSN program, and received my family nurse practitioner (FNP) degree. My first job out of college was officially as an FNP with the Minute Clinic, one of the nationwide retail health clinics owned currently by CVS Pharmacies.

Every job I’ve ever had has taught me something. The one thing that really stood out to me as I progressed and moved forward in my FNP career was that it always seemed like we were chasing the cart. And by that I mean, always running to stamp out disease, never preventing it.

One of my more recent FNP jobs was for a national company that provides onsite healthcare clinics to some major self-insured employers. I was the clinical quality manager, and helped develop guidelines and protocols for the company on a nationwide basis. They were developing a health and wellness program, which is how I got exposed to health coaching. They sent me to Wellcoaches to learn about it, and I helped them develop 17 health and wellness coaching programs for their clinics. I thought, “I’ve only fixed disease, I’ve never prevented it before. That’s an interesting concept.” So it was a real eye opener for me, because I wasn’t quite sure what I was going to learn. I found that there was a tremendous amount to learn. And it actually helped me make changes in my own life.

Have you received any health coaching certifications? If so, please list these certifications

Because of my medical background and FNP degree I received both a Certified Wellness Coach and Certified Health Coach certification.

Has there been a defining moment in your career, perhaps when you knew you were on the right road?

The defining moment would have to be, as far as health coaching is concerned, when I participated in the Coach the Coach program at Wellcoaches. They pair coaches, so I had one of them coach me, and then I coached a different coach. Receiving that coaching has really been very important to me, because it helped me to keep myself well, focused and on track so that I’m better able to help my clients. And I see the difference in my own coaching, in how I approach things.

How has your medical background impacted your coaching?

For one, I don’t have to ask a lot of questions. I understand why people are saying, ‘I have this, and my doctor said that.’ But one of the drawbacks to having a medical background is, having done it so long, it is very hard not to flip and be the expert as opposed to the coach. I sometimes have to sit on my hands, bite my tongue and not say, “Really, this is how you need to do this.” Coaching is client-focused. Now I’m finding that I don’t want to be the person with all the answers. I want to help other people find their own answers that are going to work for them.

In brief, describe your organization.

I founded Fundamentally Healthy about a year ago. I specialize in helping people with weight loss, weight management and diabetes lifestyle management. It’s a single-person practice, with offices in both Severna Park and Stevensville in Maryland. I do some group coaching in my Diabetes Free Zone program, which is part of Diabetes Free America, where I help serve my diabetic clients and get everybody to share and open up, and it has worked very well. I also offer individual coaching, and some Medicare Wellness services. Now that Medicare has begun to cover those services, this will hopefully lead the way for other insurers to start looking at wellness services and coaching as a covered benefit. I also do independent health coaching for Take Shape for Life, a lifestyle management program focusing primarily on weight loss with some meal replacements, but mostly learning lifestyle changes, dietary changes, eating patterns as well as exercise, sleep and stress management.

What are two or three concepts or rules that you follow in health coaching?

First, that it’s a very safe zone. In order to really explore where your vision lies, and to really get down to basics, you have to be able to be honest with yourself. I tell my clients that it’s okay, no matter what they say, it’s more important to get it out there just so that they can hear or see it.

Second, that it’s also a positive zone. Everything should be focused on the positive. There are negatives that happen in our lives, and it’s important to aknowledge them, but it’s more important to focus on the positives.

What is the single most successful thing that your company is doing now?

Right now, my company is doing a lot of community outreach to get the message out about what coaching is and how it can benefit anyone, no matter how young or how old you are. Not a lot of people in our area (rural to suburban on Maryland’s Eastern Shore) know about health coaching. It’s a relatively new concept. Most people think it’s personal training. So I’m doing a lot of community outreach and free seminars, going to various community groups and speaking to them about health coaching.

What is the single most effective workflow process, tool or form that you are using in coaching today?

My most effective process is frequent communication. I conduct weekly coaching sessions with most of my clients. And I typically touch base with them via email twice in between sessions just to let them know that the support is there if they need it. If they’re feeling challenged, they can email. If it’s an emergency, they can call. I want them to know that it’s not a once a week, one hour thing, it’s something they have to work at all the time and it doesn’t matter if it’s morning, night, there’s a link via email to connect with someone who is there to support them.

Do you see a trend or path you have to lock on for 2013?

With Medicare opening up and offering more wellness services, particularly obesity prevention services, that’s going to be a big impetus to get the wellness initiatives out there. And for 2013 the biggest thing is going to be about the resources available to promote those wellness initiatives.

What is the most satisfying thing about being a health coach?

For me the most satisfying thing is that I have an opportunity to work with people who truly are interested, invested and engaged in improving their health. I work part-time at an urgent care walk-in center and sometimes the only thing those clients are engaged with right then is: ‘Make my fever go away, make my head stop hurting, make my ear stop hurting, make the cough go away.’ It’s not about the underlying symptoms, how to get there. So it’s very nice to see that people are really interested in prevention, that they’re interested in making changes, that they’re invested in that.

What is the greatest challenge in health coaching and how are you working to overcome this challenge?

The greatest challenge right now is that private health coaching is not covered by insurance. I have recently engaged in dialogue with a physician who is a former deputy state health director. She is working with the state health insurance exchanges about the value of health coaching and having it included as part of those insurance exchange plans. I’m very excited about that.

Where did you grow up?

I was born in Baltimore, Maryland. My father was in the military, so we moved around a little bit. But home has always really been in the Maryland area.

What college did you attend?

I got my masters degree from Bowie State University in Bowie Maryland.

Is there a moment from that time that stands out?

Just that I survived, because I was an adult learner when I went to college. I had two teenaged daughters and a full time job.

Are you married and do you have children?

I am married to the same man for the last 30 years and I have two adult daughters. One is a physical therapist and my oldest daughter is married with two little boys, so I have two grandchildren.

What is your favorite hobby and how did it develop in your life?

Recently people have asked me that same question, and I always tell them my hobby is working. I don’t really have a hobby, to be honest. I’m one of those people who doesn’t like the grass to grow under her feet. So I do a lot of volunteer work. I am on the Anne Arundel County (Maryland) Obesity Prevention subcommittee, I am the treasurer for the Maryland Academy of Advanced Practice Clinicians, and I’m a member of various professional and civic organizations that do a lot of volunteer work. So my hobby is working.

Is there a book you recently read or a movie you saw that you would recommend?

The most recent movie that I saw that I would highly recommend was Lincoln. It was very well done and it was very nice to see our forefathers actually taking a few minutes and having some very reflective thoughts.

Any additional comments?

It’s a matter of moving forward. I really enjoy what I do and I love the opportunity to be able to get information out about health coaching, and about the value of it to our communities.

Healthcare Update Week in Review: Medical Homes for Teens, Healthcare Spending Slow

April 29th, 2013 by Cheryl Miller


A majority of mental health issues emerge in adolescence, with 14 being the most prominent age, according to a new study from UCSF’s Department of Pediatrics.

It’s a frightening statistic; at a time when kids are dealing with real life situations (grades, peer pressure, pimples) they also have to struggle with less tangible conditions, like anxiety, depression, even learning disorders.

Yet, despite the widely known prevalence of this, nearly half of today’s adolescents lack a medical home, which could provide them with the appropriate treatment, researchers say. The medical home’s comprehensive, team-based care could be the best way to help teens and families through this scary time. More on how this healthcare model can be effective inside this issue.

Assessing the effectiveness of team-based care delivery methods is also the subject of a new study published in Population Health Management.

Researchers from George Washington University, Virginia Commonwealth University, and Carilion Family Medicine conducted case studies of small primary care practices to assess three team-based care models and to see if they can improve primary care delivery and patient outcomes. Improving patient care, practice workflows, and patient and physician satisfaction, researchers say, are competencies that have become expected of physicians as the healthcare landscape evolves.

The art of appreciative inquiry, a health coaching tool that is becoming more accepted in the medical community, can also help improve patient care and satisfaction. While all coaching tools are used to help inspire and engage people, appreciative inquiry is particularly effective because it builds on a person’s strengths instead of weaknesses, says Dennis Richling, MD, chief medical and wellness officer for HealthFitness. Too often attention goes into fixing what’s broken instead; by tapping into what’s already positive, the person is empowered to continue to make positive changes.

Fixing the nation’s economy is key to the record slow growth in health spending in recent years, say analysts in a new Kaiser Family Foundation report.

Based on statistical modeling and analysis by health cost experts at the Foundation and Altarum Institute’s Center for Sustainable Health Spending, studies find that the economy is responsible for 77 percent of the slowdown in health spending, a category encompassing what individuals, employers and governments collectively spend. The remaining 23 percent results from changes in the healthcare system, including higher deductibles and other cost-sharing that dampen patients’ use of services, as well as various forms of managed care and delivery system changes.

Though the recession will likely continue to dampen health spending growth over the next couple of years, the study projects that expected economic growth will drive up health spending in years ahead, gradually adding 3.5 percentage points to the annual growth rate by 2019. This would push the annual growth rate in health spending back over 7 percent, which is much closer to historical averages.

And lastly, current methods for estimating the costs and savings of federal health legislation also need to be fixed, because they are missing billions of dollars in potential long-term returns from effective obesity prevention policies, according to a new study released by the Campaign to End Obesity.

Changing the way cost estimates are created would give policymakers a clearer picture of costs and savings, the report concludes.

7 High-Impact Ideas to Prioritize Prevention

February 22nd, 2013 by Jessica Fornarotto

Reimbursement for prevention efforts and employer engagement are among seven high-impact recommendations from the Trust for America’s Health (TFAH) to prioritize prevention and improve the health of Americans.

“A Healthier America 2013: Strategies to Move from Sick Care to Health Care in Four Years”, a new TFAH report, illustrates the importance of taking innovative approaches and building partnerships with a wide range of sectors in order to be effective.

The report outlines top policy approaches to respond to studies that show that more than half of Americans are living with one or more serious, chronic diseases, a majority of which could have been prevented; and also that today’s children could be on track to be the first in U.S. history to live shorter, less healthy lives than their parents.

The seven recommendations documented in the report are:

  1. Advance the nation’s public health system by adopting a set of foundational capabilities, restructuring federal public health programs and ensuring sufficient, sustained funding to meet these defined foundational capabilities;
  2. Ensure insurance providers reimburse for effective prevention approaches both inside and outside the doctor’s office;
  3. Integrate community-based strategies into new healthcare models, such as by expanding ACOs into accountable care communities;
  4. Work with nonprofit hospitals to identify the most effective ways they can expand support for prevention through community benefit programs;
  5. Maintain the prevention and public health fund and expand the community transformation grant program so all Americans can benefit;
  6. Implement all recommendations for each of the 17 federal agency partners in the National Prevention Strategy; and
  7. Encourage all employers, including federal, state and local governments, to provide effective, evidence-based workplace wellness programs.

“A Healthier America” also features more than 15 case studies from across the country that show the report’s recommendations in action.

The report also includes recommendations for a series of 10 key public health issues: reversing the obesity epidemic; preventing tobacco use and exposure; encouraging healthy aging; improving the health of low-income and minority communities; strengthening healthy women and healthy babies; reducing environmental health threats; enhancing injury prevention; preventing and controlling infectious diseases; prioritizing health emergencies and bioterrorism preparedness; and fixing food safety.

Infographic: The Global Childhood Obesity Epidemic

September 28th, 2012 by Melanie Matthews

Globally one in 10 children are obese, but the epidemic is not getting the attention it deserves, according to new metrics by GLOBALHealthPR, which measured the online conversation rates for childhood obesity.

An infographic by GLOBALHealthPR analyzes online conversation rates for childhood obesity compared with other diseases.

The Global Childhood Obesity Epidemic

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Adult Obesity Rates Could Exceed 60 Percent in 13 states by 2030

September 25th, 2012 by Cheryl Miller

A reduction in BMI by just 5 percent could dramatically reduce the rates of obesity-related diseases and healthcare costs

The number of obese adults, along with related disease rates and healthcare costs, could increase dramatically in every state in the country over the next 20 years, according to a new report from Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

Thirteen states in particular could see obesity increases upwards of 60 percent if things don’t change, with Mississippi set to have the highest numbers. The number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension and arthritis could increase 10 times between 2010 and 2020 and double again by 2030. Medical costs associated with treating these diseases could increase by $48 billion to $66 billion per year in the United States, and the loss in economic productivity could be between $390 billion and $580 billion annually by 2030.

But if Americans reduced their average body mass index (BMI) by just 5 percent by 2030, the rates of obesity-related diseases and healthcare costs could be significantly reduced, the report claims. Every state could help thousands or millions of people avoid obesity-related diseases, while saving billions of dollars in healthcare costs.

“We need more effective interventions with the population as a whole,” says Dr. Dennis Richlin, chief medical director and wellness officer for HealthFitness, an integrated health coaching program, in a recent HIN webinar. “There is a whole sub-population within employers, and some have taken on employees with programs that have resulted in risk reductions, cost savings and weight change,” he said. “We can make a difference, but it’s not a quick fix…but we could start to see significant changes over the next five years.”

Patient satisfaction could be one of the most significant changes among those involved in health and wellness programs, according to our currently running Population Health Management survey. But getting patients to embark on and remain engaged in such a program remains the greatest challenge for those considering launching one, say nearly half of our respondents at this point in the survey.

In other news, another way to lower healthcare costs could be by extending physician office hours. A new study links the two, finding that patients whose usual source of care offers extended hours by remaining open during evening and weekend hours had less use of and lower associated expenditures for office visits, prescription medications, ED visits and hospitalizations than patients without such access.

And one way to use those extended hours in the waiting room could be by reviewing healthcare benefits, because, according to a new survey from Aetna, choosing them is the second most difficult decision to make behind savings for retirement. In fact, choosing benefits is considered to be tougher than purchasing a car, making decisions about medical tests or treatments, and even parenting. The main problem is complicated, conflicting information. See what our managing editor has to say about this in her blog post Is Choosing Healthcare Coverage Really Harder Than Parenting?

But there is some uncomplicated good news for Medicare Advantage members: it continues to remain strong, with a projected enrollment increase of 11 percent in the next year, and no increase in premiums, according to the CMS.

Read all of these stories in their entirety in this week’s Healthcare Business Weekly Update.

Health and Wellness Incentives in 2012: Participants Have to Hit Clinical Marks

September 13th, 2012 by Patricia Donovan

health incentives

Incentives in 2012: Rewarding Risk Assessment, Lifestyle Change

Showing up isn’t enough any more to earn a cash- or benefit-based incentive for health improvement, say respondents to HIN’s fourth annual Health & Wellness Incentives survey. Instead, employers and health plans are rewarding measurable achievements in health behavior change &#151 weight loss, smoking cessation, BMI reduction or other lifestyle changes that reduce an individual’s risk of developing or exacerbating a chronic (and costly) illness.

“That’s the future of population health management,” concurs Patricia Curran, principal in Buck Consultants’ National Clinical Practice. “Companies have developed incentive programs, but they’ve found that awarding incentives just for participating is not necessarily achieving the outcomes they want. Just taking the health risk assessment and the biometric screenings isn’t getting the results.”

While completion of a health risk assessment (HRA) remains the most heavily incented health improvement activity for the fourth consecutive year, according to two-thirds of survey respondents, more companies are incentivizing the lifestyle behavior changes of weight loss (57 percent) and smoking cessation (51 percent) than 2011’s favored activities of preventive screenings and participation in on-site wellness.

This makes sense, says Ms. Curran. “They’re making participants toe the mark. They have to meet certain health goals, and they’re going to be measuring that effort. They’re going to incentivize individuals for meeting those goals going forward. It’s a new trend — making people more aware of the importance of these health goals. [Companies] really want to see people getting results, so they’re going to be targeting things like weight management, tobacco cessation, BMI.”

In other survey findings, the use of texting to communicate incentive program details doubled in the last year, from 7 to 14 percent. Social networks and health portals also gained favor for this purpose. At the same time, more are relying on the more traditional communication modalities of work site flyers and table cards, a trend that has risen steadily from 61 percent in 2009 to 68 percent in 2011 to 84 percent this year.

“You have to leverage the right tools and techniques matched to those consumers or their preferences,” notes Jay Driggers, director of consumer engagement at Horizon Blue Cross Blue Shield. A key area of study for Driggers’s consumer engagement team is behavioral economics, which he refers to as “the carrots and the sticks, things that will motivate people to change their behavior or to do something.” Incentives fall into this category, he says.

The survey also identified a 2 percent increase in the awarding of incentives via contests and drawings, a practice reported by 57 percent of 2012 respondents. “In most cases, I think a lottery can be a cheaper option that will drive more participation than a one-to-one reward,” suggests Driggers, who recently outlined Horizon’s approach to consumer engagement in its patient-centered medical home initiative.

Other 2012 survey results:

  • The number of respondents reporting incentives program ROI of between 3:1 and 4:1 has doubled in the last 12 months, from 2.6 percent in 2011 to 5.3 percent this year. Program ROI of between 2:1 and 3:1 remained constant at 14 percent from 2011 to 2012.
  • The use of biometric screening to identify participants for incentive-based programs rose slightly in 2012 to 40 percent, up from 36 percent in 2011. Opt-in or self-registration remains the top identification tool, at 62 percent.
  • Group incentives lost some favor this year, in use by just 23 percent, versus 36 percent of 2011 respondents.
  • In new survey data this year, 20 percent extend eligibility for health and wellness incentives to domestic partners.

For more survey highlights, download the executive summary of Health & Wellness Incentives in 2012: Rewarding Risk Assessment, Lifestyle Changes. A detailed analysis of these metrics, including year-over-year trends, is provided in 2012 Healthcare Benchmarks: Health & Wellness Incentives.

8 Successes Achieved by Diabetes Management Programs

August 23rd, 2012 by Jackie Lyons

Patient-Centered Diabetes Management: Driving Outcomes with Education and Behavior Change

Large payoffs in patient compliance, patient satisfaction and medication adherence resulted from programs aimed at managing diabetes, according to respondents to HIN’s 2011 “10 Questions on Diabetes Management” survey. In their own words, respondents described the greatest successes achieved by their diabetes management programs:

1. “Our greatest success is knowing the impact we have already made helping our patients, friends and families realize that they are not alone in this battle. We have produced results time and time again, proving this epidemic can be managed.”

2. “Diet and nutritional talks and cooking demonstrations have stirred consciousness and thoughtfulness towards dietary protocols.”

3. “The indigent population we manage through our program has had only one hospital admission for a diabetes-related problem in 2011. That’s impressive!”

4. “Improved mental status and treatment compliance in other spheres.”

5. “High level of patient engagement; increased patient-provider contacts and communication; and reduced hospitalizations and overall costs.”

6. “Significant ROI in one year using randomized control trial (RCT) methodology.”

7. “More knowledge of the condition and decrease in gaps in care.”

8. “Standardization of diabetes management programs, incentives, benefit enhancements and enhanced methods to reach members who opt out of one-on-one nurse coaching.”

2012 Healthcare Benchmarks: Diabetes Management provides more actionable data from the 83 responding organizations on current diabetes management programs and their impact on population health outcomes and healthcare spend.