Nursing Notes

September 28, 2010

Study: Broader Telephone-Based Health Coaching May Save Money

Filed under: Nursing — Shirley @ 3:37 am
Tags: , , ,

Here is an interesting article from The Wall Street Journal Health Blog.   This article is fairly long, so only part of it is below.  Please click over and read the article completely.  Here is an example of “thinking outside of the box” to try to accomplish better outcomes for some of the patients that seem to fall through the cracks or worse, who just give up entirely.

Let me know what you think, won’t you?  There are some interesting comments at the original site, also.


By Katherine Hobson

Offering telephone health coaching to a broader-than-usual swath of patients may save money, according to a study just published in the New England Journal of Medicine.

Typically this kind of care management, as it’s called, is offered to people who have trouble managing their chronic conditions or who are facing a big treatment decision — such as surgery or medical management for lower back pain. But a randomized study conducted by Health Dialog Services compared that approach to its own program, which offered phone-based health coaching to a larger proportion of those folks and also to some “chaotic users of the health-care system” — people who don’t have a chronic illness but, for example, seem to turn to the ER for all their routine care, David Wennberg, one of the study’s authors and chief science and products officer at Health Dialog, tells the Health Blog.

The study randomly assigned a patient population of 174,120 people to either the traditional support or enhanced support programs. The former, with its more limited criteria, enrolled 3.7% of its patient pool; the latter enrolled 10.4% of its own pool. The support was the same in both groups: helping with behavior changes such as exercise as well as offering shared decision making tools intended to give patients the pros and cons of treatments they’re considering. (Shared decision making is the approach many say should be used in prostate cancer, for example, given its complex array of treatment options.)

Average monthly medical and pharmacy costs were 3.6% lower across all the patients in the enhanced support group compared to the usual-support group. In other words, says Wennberg, if employer A’s company used the enhanced model, it would save an average of $7.96 per employee compared to employer B, using the more restrictive traditional model.

Of course, we should note here that it would be to Health Dialog’s benefit if companies extended these services, at $2 per person, to a greater proportion of their workers.

We wondered if patients are suspicious that the phone coaching was biased in favor of cheaper treatments, whatever their appropriateness for the patient. Wennberg says the decision making tools are created by the nonprofit Foundation for Informed Medical Decision Making. Here’s a description of their partnership.

And we also wanted to know whether doctors are agitated when patients receive outside health coaching about treatments. “The goal of this is to have a well-informed patient talking to a well-informed physician, preferably his or her own primary care physician,” says Wennberg…[read the rest of the article]

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  1. Just so happens, I am the nurse that left the comment to the physician who thought the article was self serving. Didn’t get a response back from him. I follow your blog and have left comments before. You know, just honestly in my opinion, patching illnesses up with prescription medications and never getting to the root of the problem is just that. A patch job. Until an individual learns to take personal responsbility for their own health care and change habits that caused the illness to begin with, there is never going to be health reform. I realize I am talking generalities, and I am not factoring in things like genetics, etc. I’m only commenting on the issues that are avoidable because of lifestyle choices. I have experience great success with my clients and total change of health for the good because of coaching. I am only getting started officially in this field, and hope to have great success in the future.I am not talking about my success, but the success in the changing health of my clients. In my heart, there will be no greater joy than to truly see peoples lives changed. Joyce Harrell,RN,OCN (

    Comment by Joyce Harrell,RN,OCN — September 28, 2010 @ 4:12 am | Reply

    • Joyce, Thanks for the informative and appropriate comment. I am very interested in Health Coaching myself, so hearing from you is doubly rewarding.
      I fully agree with you that the physician totally missed the mark. He gave a knee-jerk response out of fear of loss of income or something. How could he not want his patients to be living a healthier and happier life? Our system is set up to reward physicians only when people are sick. No wonder we, as a nation, don’t take any responsibility for our own health. I hope we have an opportunity to talk again. I’d love to hear how you got into health coaching and what you are doing with it today. I need some positive information to keep me moving in the right direction. Thanks again for the comment.

      Comment by Shirley — September 28, 2010 @ 1:08 pm | Reply

  2. Hi There! I Love reading your insights to nursing situations. Yes, he missed the mark, and I was quick to let him know it. Too bad, I don’t think he got on the site to see it. Funny, it’s OK that they make a huge salary. Many are quick to criticize something other than the medical doctor and pharmaceutical companies because we are judged as trying to make money. Funny, isn’t that what they are doing? At least what I am wanting to do, truly helps the client live a happier and healthier life!!! I would love to connect with you. Email me anytime! I am pretty busy for the next few weeks, but you can see my email, so write me, and we can at least start somewhere. I would be glad to share my story…

    Comment by Joyce Harrell,RN,OCN — September 29, 2010 @ 3:55 am | Reply

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