Health coaches champion strides toward wellness
Daniel Leslie spends a lot of time coaching and motivating people to stay healthy — but none of his work happens at a gym or on a ball field.
It's all done over the phone — and has nothing to do with sports. Leslie is a health coach for insurer Cigna Corp. He counsels patients to lose weight and improve their diets during weekly or monthly phone calls.
Leslie, 25, of Castle Shannon is part of a small but growing profession in health care that's expanding because the medical industry is searching for ways to help unhealthy Americans change their lifestyles. The goal is to reduce health care costs by keeping people healthy.
Health coaches are popping up in primary care practices, employer health clinics, drugstores and insurance companies to help people quit smoking, eat better, get more exercise and stick to their drug regimens.
“I hear a lot of times (from patients) that they know they had a call with me and that kept them motivated,” Leslie said.
Experts say Americans' poor health is costing the economy billions of dollars a year through lower work productivity and high medical bills that are draining employer resources. And just getting patients in to see a doctor isn't enough.
“People have been wagging their finger for a long time, saying this is what you need to do,” and it hasn't worked, said Tim Cline, senior director of clinical education and training for UPMC Health Plan, which employs about 230 health coaches.
“Health coaches are skilled at being able to address resistance and resolve ambivalence that people have to making a change,” Cline said. “It's the most powerful tool we have to curb not only the incidence of chronic disease, but also the cost.”
A growing number of employers who purchase Cigna health coverage are adding health coaching to their wellness programs, said Jen Joy, vice president of clinical operations and consumer health engagement. Cigna employs about 250 health coaches at its call center in Robinson.
“Physicians really want to be able to do these things, but there's a time and resource issue,” Joy said.
Spice and seasoning maker McCormick & Co. Inc. recently implemented a health coaching program through Cigna. The company is trying to expand use of health coaches by its 3,500 United States employees, because it's seen results from having a pharmacist work directly with a small group of diabetics, said Joan Hovatter, manager of the Baltimore-based company's health and wellness programs.
McCormick has seen its annual medical cost drop by about $1,500 for each of more than 100 diabetic employees who have worked closely with a pharmacist to improve their wellness and better control blood glucose levels, Hovatter said.
“Yes, we are seeing a return on investment,” she said. “If it's working for 112 people and we can promote it (to more employees), then the better it's going to be for us.”
Highmark Inc., the state's largest health insurer, employs 330 registered nurses as health coaches, spokeswoman Adrienne Baldini said. While the company expects health coaches be a growing health care profession, most new coaches will be employed in doctor practices rather than at insurers, she said.
Changing reimbursement models to favor keeping patients healthy, rather than paying by volume of visits, “will enable providers to take on many of the functions (of health coaches), especially the coordination of care for members with chronic disease,” she said.
While experts agree that health coaching is becoming more popular, there are no exact numbers on how many coaches are working in the United States, said Colleen Miller, a co-founder of the National Society of Health Coaches in Winchester, Tenn.
“There are lots of people using the health coach title, but without any certification,” she said.
The society, which has certified more than 1,100 coaches since 2007, is advocating for national certification standards. Miller said coaches should at a minimum have a license in a clinical field such as nursing or pharmacy.
Rite Aid Corp., the Camp Hill-based drug store chain, started a health coaching program in March in which patients can be referred by their primary care physicians to a pharmacy to devise “personalized health care action plans.” The program, called the Rite Aid Health Alliance, is available in Los Angeles, Buffalo, N.Y., and Greensboro, N.C.
“We will help patients with the resources and support necessary to successfully manage their conditions and improve their overall health and well being,” Rite Aid CEO John Standley said in March.
Leslie, who worked for two years in a physical therapy department at an area hospital after graduating from University of Pittsburgh, said he moved to health coaching because he wanted to have a bigger role in preventing people from getting sick.
“It all started when I was in college,” he said. Learning about “the prevalence of obesity and diabetes. … That was a big motivator to find a position where I could help out with that.”
Cline said health coaches are effective because they translate the big, sometimes scary, lifestyle changes that doctors demand of their patients into small, manageable goals. And coaches “wear a variety of hats” depending on what the patient needs, from “cheerleader to accountability check to skills builder.”
As Cigna's Joy put it, “All of us have behavior that we engage in that we know is unhealthy.”
She continued: “The reality is, why we don't change is because change is hard. ... Our coaches are specifically trained to help with realistic goals.”
Alex Nixon is a staff writer for Trib Total Media. He can be reached at 412-320-7928 or firstname.lastname@example.org.
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