Note: This is an authorized excerpt from 2016 Healthcare Benchmarks: Health Coaching. To download the entire report, go to http://store.hin.com/product.asp?itemid=5144 or call 888-446-3530.
2016 Healthcare Benchmarks: Health Coaching In this comprehensive analysis on health coaching, 111 healthcare organizations weigh in on health coaching tools and work flows, program components, hiring guidelines, program delivery modalities and evaluation, coaching case loads, results and challenges, and much more in response to a May 2016 survey by the Healthcare Intelligence Network. Proactive outreach based upon HRA/biometric triggers and multi-modal communication [are our most successful health coaching strategies]. > Hospital/Health System One-to-one relationships between employee and RN coach [is our most effective health coaching tool]. > Health and Wellness Satisfaction and risk reduction among those completing six coaching sessions and post-assessment is our greatest success from health coaching. > Hospital/Health System [When hiring health coaches, we look for] empathy, experience working with individuals in behavior change settings, motivational interviewing-based certification or other wellness coaching certification, client-centered personality. > Health and Wellness 2016, Healthcare Intelligence Network http://www.hin.com 2
2016 Healthcare Benchmarks: Health Coaching This special report, based on results from the Healthcare Intelligence Network s industry survey on Health Coaching conducted in May 2016, is the latest installment in HIN S Healthcare Benchmarks series. Executive Editor Melanie Matthews HIN executive vice president and chief operating officer Project Editor Patricia Donovan Document Design Jane Salmon 2016, Healthcare Intelligence Network http://www.hin.com 3
Table of Contents About the Healthcare Intelligence Network... 6 Executive Summary... 6 Survey Highlights... 7 Key Findings... 7 Program Components... 7 Results and ROI...8 Most Effective Tools, Processes and Work Flows...8 About the Survey... 8 Respondent Demographics... 9 Using This Report... 9 Responses by Sector...10 The Hospital/Health System Perspective... 13 The Health and Wellness Perspective... 14 Respondents in Their Own Words... 15 Most Effective Tool, Workflow or Protocol...15 Most Successful Population Health Strategy to Date... 16 Details of Future Programs... 18 Conclusion...19 Responses to Questions... 20 Figure 1: All - Current Health Coaching Program... 21 Figure 2: All - Planned Health Coaching Program... 21 Figure 3: All - Populations Assigned to Health Coaches... 22 Figure 4: All - Health Risks Levels Eligible for Coaching... 22 Figure 5: All - Health Coaching Stratification... 23 Figure 6: All - Targeted Health Conditions... 23 Figure 7: All - Co-Location of Health Coaches...24 Figure 8: All - Sites for Co-Located Health Coaches...24 Figure 9: All - Health Coach Duties... 25 Figure 10: All - Health Coaching Delivery Modalities... 25 Figure 11: All - Behavior Change Tools...26 Figure 12: All - Health Coaching Incentives...26 Figure 13: All - Penalties for Non-Participation... 27 Figure 14: All - Average Monthly Coaching Caseload... 27 Figure 15: All - Preferred Coaching Education Level...28 Figure 16: All - Health Coaching Success Factors (Client)...28 Figure 17: All - Health Coaching Success Factors (Coach)...29 Figure 18: All - Health Coaching Success Factors (Program)...29 Figure 19: All - Health Coaching Impact...30 Figure 20: All - Health Coaching ROI...30 Figure 21: All - Health Coaching Challenges... 31 Figure 22: All - Organization Type... 31 2016, Healthcare Intelligence Network http://www.hin.com 4
Figure 23: Hospitals - Current Health Coaching Program... 32 Figure 24: Hospitals - Planned Health Coaching Program... 32 Figure 25: Hospitals - Populations Assigned to Health Coaches... 33 Figure 26: Hospitals - Health Risks Levels Eligible for Coaching... 33 Figure 27: Hospitals - Health Coaching Stratification... 34 Figure 28: Hospitals - Targeted Health Conditions... 34 Figure 29: Hospitals - Co-Location of Health Coaches... 35 Figure 30: Hospitals - Sites for Co-Located Health Coaches... 35 Figure 31: Hospitals - Health Coach Duties... 36 Figure 32: Hospitals - Health Coaching Delivery Modalities... 36 Figure 33: Hospitals - Behavior Change Tools... 37 Figure 34: Hospitals - Health Coaching Incentives... 37 Figure 35: Hospitals - Penalties for Non-Participation... 38 Figure 36: Hospitals - Average Monthly Coaching Caseload... 38 Figure 37: Hospitals - Preferred Coaching Education Level... 39 Figure 38: Hospitals - Health Coaching Success Factors (Client)... 39 Figure 39: Hospitals - Health Coaching Success Factors (Coach)... 40 Figure 40: Hospitals - Health Coaching Success Factors (Program)... 40 Figure 41: Hospitals - Health Coaching Impact... 41 Figure 42: Hospitals - Health Coaching ROI... 41 Figure 43: Hospitals - Health Coaching Challenges... 42 Figure 44: Health & Wellness - Current Health Coaching Program... 42 Figure 45: Health & Wellness - Planned Health Coaching Program... 43 Figure 46: Health & Wellness - Populations Assigned to Health Coaches... 43 Figure 47: Health & Wellness - Health Risks Levels Eligible for Coaching... 44 Figure 48: Health & Wellness - Health Coaching Stratification... 44 Figure 49: Health & Wellness - Targeted Health Conditions... 45 Figure 50: Health & Wellness - Co-Location of Health Coaches... 45 Figure 51: Health & Wellness - Sites for Co-Located Health Coaches... 46 Figure 52: Health & Wellness - Health Coach Duties... 46 Figure 53: Health & Wellness - Health Coaching Delivery Modalities... 47 Figure 54: Health & Wellness - Behavior Change Tools... 47 Figure 55: Health & Wellness - Health Coaching Incentives... 48 Figure 56: Health & Wellness - Penalties for Non-Participation... 48 Figure 57: Health & Wellness - Average Monthly Coaching Caseload... 49 Figure 58: Health & Wellness - Preferred Coaching Education Level... 49 Figure 59: Health & Wellness - Health Coaching Success Factors (Client)... 50 Figure 60: Health & Wellness - Health Coaching Success Factors (Coach)... 50 Figure 61: Health & Wellness - Health Coaching Success Factors (Program)... 51 Figure 62: Health & Wellness - Health Coaching Impact... 51 Figure 63: Health & Wellness - Health Coaching ROI... 52 Figure 64: Health & Wellness - Health Coaching Challenges... 52 2016, Healthcare Intelligence Network http://www.hin.com 5
About the Healthcare Intelligence Network The Healthcare Intelligence Network (HIN) is an electronic publishing company providing high-quality information on the business of healthcare. In one place, healthcare executives can receive exclusive, customized up-to-the-minute information in five key areas: the healthcare and managed care industry, hospital and health system management, health law and regulation, behavioral healthcare and long-term care. Executive Summary 70% of 2016 survey respondents have a health coaching initiative. Migration toward quality-based, pay-for-value healthcare has elevated health coaching s contribution to chronic care management and population health. From supporting rising risk populations telephonically to visiting recently discharged high-risk, high-cost individuals at home, health coaches aim to score all-important health behavior change. And by far, a coach s top tactic to effect this change is motivational interviewing (MI), say 83 percent of respondents to the 2016 Health Coaching survey by the Healthcare Intelligence Network, many of whom also identified MI as their most effective coaching strategy in a separate open-ended survey question. Of the 70 percent of this year s respondents with health coaching ventures, 56 percent focus program efforts on individuals with complex comorbidities. An integral component of chronic care management for 79 percent of respondents, health coaching is employed nearly as often to assist populations struggling with weight management or physical inactivity. Increasingly, clients get all-important face time with coaches: in 2016 metrics, 47 percent embed or colocate health coaches at points of care, with most onsite coaching occurring in primary care offices (50 percent) or at employer work sites (50 percent). On average, a health coach is assigned up to 99 cases to manage at any given time, according to the 2016 survey. Twenty-eight percent of respondents believe 50 to 99 cases is a comfortable health coach workload. And how to determine a winning health coaching strategy? Goal attainment is the top barometer of an individual s progress in coaching, say 78 percent, while client satisfaction is the best measure of the health coach s success, according to 27 percent. We do not call them health coaches but rather nurse navigators who are in selected physician offices. The health coaching duties fall to these employees. 2016, Healthcare Intelligence Network http://www.hin.com 6
Respondent Demographics Responses to the May 2016 Health Coaching Survey survey were submitted by 111 organizations. Of 78 respondents identifying their organization type, 28 percent were hospitals or health systems; 18 percent were health and wellness providers; 9 percent were population health management providers; 8 percent were health plans; and 6 percent were managed care organizations. Also, 23 percent categorized their organization as Other. 72% include case management in a population health program. Using This Report This benchmarking report is intended as a resource for healthcare organizations searching for comparable data and means to measure implementation and progress. It is also a helpful planning tool for organizations readying initiatives in this area. The initial charts and graphs presented here represent results from all respondents; images in subsequent sections depict data from high-responding sectors. (Figure titles begin with the segment they represent: for example, All, Health Plans, Hospitals, etc.) Often, one of the largest responding sectors is composed of respondents identifying their organization type as Other. In general, we do not depict results from this segment because it represents a wide range of organization types, including consultants and product vendors. However, you will always find a graph indicating the demographics of respondents. Here are some additional tips for using this report: 99 See how you measure up: Scan this report for your sector, and see how your program compares to others. Note where you lead and where you lag. 99 Evaluate your efforts: Think about where you have been focusing your efforts in this area. Look for trends in the data in this report. Look for benchmarks set by your sector and others. 99 Set new goals: Use the data in this report to set new goals for your organization, or to raise the bar on existing efforts. 99 Use it as a reference book: Keep this report accessible so you can refer to it in your work. Use these data to support your efforts in this area. If you have questions about the data in this report, or have feedback for our team, don t hesitate to contact us at info@hin.com or 732-449-4468. Most effective workflow(s): Active listening to understand where the patient is and using that to help develop a plan of action. 2016, Healthcare Intelligence Network http://www.hin.com 9
Figure 11: All - Behavior Change Tools Which behavior change tools do health coaches use? Motivational interviewing Stages of change Positive psychology Self-efficacy Social cognitive theory Self-developed Patient Activation Measure(TM) Health Belief Model Other Appreciative inquiry Implementation intentions Planned behavior theory 33.8% 32.4% 29.4% 26.5% 20.6% 17.6% 14.7% 11.8% 10.3% 10.3% 61.8% 82.4% 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% 2016 HIN Health Coaching Survey May, 2016 Figure 12: All - Health Coaching Incentives Do you offer incentives for health coaching participation? 44.9% Yes No 55.1% 2016 HIN Health Coaching Survey May, 2016 2016, Healthcare Intelligence Network http://www.hin.com 27