Health Coaching Programs Lower Costs and Improve Quality Outcomes

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Bettering the patient experience while also improving the health of your population and cutting costs is largely considered the “holy grail” for healthcare organizations today.  While many organizations are making measurable improvements when it comes to quality of care and outcomes, achieving cost savings simultaneously can seem like an uphill battle.

Health Dialog recently analyzed financials, clinical, and member satisfaction results for a regional health plan with more than 362,000 commercial, Medicaid and Medicare members to determine how the company’s population health management programs impacted members with diabetes, coronary heart disease and musculoskeletal conditions. Here’s an overview of the results:

HEDIS Score Improvement

More than 90 percent of health plans in the U.S. use the Healthcare Effectiveness Data and Information Set (HEDIS) to evaluate care performance and service.  With 94 measures determining quality performance standards (i.e., cancer screenings, heart attack treatment, mental healthcare, flu and childhood vaccination records, high blood pressure treatment and asthma medication management) this benchmark helps organizations identify gaps in care and implement preventative measures to avoid costly doctor’s office and hospital visits.

Over a three-year period, members within the regional health plan who were targeted for a gap closure and coached by Health Dialog produced better HEDIS scores compared to members who were not coached. Members with diabetes on average increased rates by 9 percent for HbA1c screening, 16 percent for retinal eye exams and 13 percent for LDL screening. Further, members with coronary heart disease on average increased rates by 11 percent for LDL screening.

Lower Rates of Preference-Sensitive Back Surgeries

Shared decision making (SDM) can help members with preference-sensitive conditions make more informed healthcare decisions. With this regional health plan, shared decision making tools had a huge impact on reducing costs and unnecessary utilization. Members with back conditions who participated in Health Dialog’s shared decision making coaching program had fewer back surgeries, including:

  • 20 percent fewer laminectomies
  • 22 percent fewer laminotomies
  • 31 percent fewer corpectomy fusions
  • 31 percent fewer posterior fixations
  • 42 percent fewer discectomies

Improved Medication Adherence

Improving medication adherence is key to slowing disease progression and preventing costly readmissions. According to the Centers for Disease Control and Prevention, 3.8 billion prescriptions are written annually in the United States, but “approximately one in five new prescriptions are never filled, and among those filled, approximately 50 percent are taken incorrectly, particularly with regard to timing.”

Health coaching had a measurable impact on improving medication adherence and medical cost savings. Members with diabetes, who were coached by Health Dialog, improved by 12 percent for diabetes medications and 7 percent for statin and blood pressure medications. When members understand their treatment plan and have resources in place to help fulfil it, they’re far more likely to achieve long-lasting positive outcomes.

Better Member Satisfaction

Not only did Health Dialog’s health coaching help the organization improve their bottom line, but members ultimately felt satisfied with and eager to recommend the program. 88 percent of members felt their health coach was knowledgeable about their health condition, while 90 percent felt the reading materials sent to them by Health Dialog were helpful to understand their condition. 86 percent of members would recommend health coaches to family and friends.

Health coaching is a cost-effective way to extend care and improve health and quality outcomes. Over a three-year period, Health Dialog’s regional health plan client generated $23.7 million in medical cost savings, along with nine percent savings of expected medical costs for coached members with diabetes, coronary heart disease and musculoskeletal conditions. With personalized engagement and on-demand support programs, your organization too can achieve lower costs and better-quality outcomes with high member satisfaction.

To learn more about health coaching, visit:

To learn more about shared decision making, visit:

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