Posts Tagged ‘weight management’

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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Hospitals More Likely to Offer Nutrition Health Coaching, Group Sessions

February 26th, 2014 by Jessica Fornarotto

Health coaching is a critical tool in population health management, helping to boost self-management of disease and reduce risk and associated cost across the health continuum. In its fourth Health Coaching e-survey, conducted in 2013, the Healthcare Intelligence Network captured the ways in which healthcare organizations implement health coaching as well as the financial and clinical outcomes that result from this health improvement strategy.

Drilling down to the hospital/health system perspective, this survey analyzed this sector’s health coaching program components, delivery methods, and more.

Health coaching programs by hospitals and health systems are more inclined to address weight management, tobacco cessation and nutrition than coaching programs overall, survey results reveal. For example, 87 percent of responding hospitals offer nutrition-related coaching, versus 70 percent overall.

Conversely, this sector, which comprised 27 percent of survey respondents, is only a third as likely to address falls prevention (7 percent versus 19 percent overall) and much less likely to address medication adherence (33 percent versus 51 percent overall).

When Coaching is Provided

Coaching delivery methods differed for this sector as well. While no respondent in this sector reported the use of a smartphone app, responding hospitals/health systems were three times as likely as health coaching or disease management respondents to conduct group coaching sessions (53 percent of hospitals versus 14 percent of health coaching or disease management organizations), and significantly more likely to conduct face-to-face coaching (73 percent versus 59 percent overall).

Hospitals/health systems are only half as likely to mandate participation in coaching (7 percent versus 12 percent overall), yet are more likely to incent program participation (60 percent of hospitals/health systems versus 50 percent overall).

Excerpted from: 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.

4 Population Health Management Tools to Identify At-Risk Patients

February 15th, 2013 by Jessica Fornarotto

Our EPIC platform at Bon Secours Health System consists of different tools that our nurse navigators can use to identify at-risk patients, for instance the ability to create registries, states Robert Fortini, vice president and chief clinical officer at Bon Secours Health System. Bon Secours uses four main tools to help better manage the health of its population, including a tool that identifies barriers and non-adherence, as well as a risk calculator that measures frequent ER visits.

Inside of our EPIC platform, the documentation tool or encounter type that is created by using our discharge registry falls into one of four categories. It’s either a post-hospital admission, a post-emergency department visit, it could be for ongoing case management and the referral can come from any direction — the PCP, a managed care partner, or hospital case management. Then, if someone falls into a place where they’re at a gap in care, we use a number of different tools to identify those gaps in care.

To illustrate the documentation tool, take a patient who’s been admitted to the hospital, has spent some time there, and has been diagnosed with congestive heart failure (CHF). Everybody is focused on CHF these days because of value-based purchasing. And everyone is trying very hard to improve 30-day readmission rates now that there’s a penalty associated from that Medicare reimbursement.

We’re using a tool that allows our nurse navigators to stage the degree of heart failure. From within the documentation’s work space, we can launch the ‘Yale tool,’ which allows us to establish what stage of heart failure that patient is in; class one, class two, class three, class four. Then, a set of algorithms are launched based on these stages’ failure and we will then manage the patient according to those algorithms.

If a patient falls into a class four category, for example, we may bring them in the next day or that same day for an appointment, rather than wait five or seven days because they’re at more risk. We may also make daily phone calls or interventions; we may network in the home health and make sure that they have scales for weight management and assessment of heart failure status. All of those interventions will be driven by the class of heart failure that patient falls into.

The second tool that we use is a workflow around ejection fractions. Depending on the patient’s ejection fraction, we will define specific interventions that the nurse navigator will follow.

We have a third tool that’s part of the encounter type in the EPIC where we identify barriers and non-adherence. We look at several elements: Are there communication preferences that the patient requires in order to be clearly communicated with? Is there any cognitive impairment? Are financials a barrier? What are their utilities at home? What’s their learning style?

Each of these categories launches another subset or agenda that we can document in detail; specifically on what obstacles exist for that patient and then what goals we should be setting to breach those obstacles.

Finally, we have a risk calculator that’s specific to frequent ER visits. Using this risk calculator, we enter length of stay (LOS) in the hospital, acuity, comorbidities and the number of ED visits in the last six months. That will then generate a risk index. If that risk index is 11 or greater, that person is considered in a higher risk category and that will drive interventions that are more intensive; daily calls, being brought in sooner, maybe the implementation of a dosage titration, an algorithm around diuretic management for weight in a heart failure patient, etc.

Infographic: Engagement Strategies for Employee Health

January 31st, 2013 by Patricia Donovan

Since the wellness program at Eastman Chemical Company first launched in 1991, it has evolved into a strategic initiative focused on creating a healthier, more productive workforce. The company’s robust program today includes health coaching, health assessments, screenings and condition management, as well as physical activity, weight management and stress management programs.

A return on investment analysis of Eastman’s health management program showed a $3.20 return for every $1 spent, giving Eastman a $6.38 million total medical and drug claims savings during a three-year period.

A key driver of success for Eastman’s program has been its approach to engagement. This HealthFitness infographic highlights effective strategies used by Eastman to gain and sustain participation in healthy behaviors.

international care coordination

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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.