New Role for Health Insurers: Paying for Lifestyle Coaches

The CDC says that the greatest health risks of the 21st century—obesity, type 2 diabetes, hypertension and cardiovascular disease—are tied to lifestyle. About 117 million people in the United States had one or more chronic condition in 2012, according to the Wall Street Journal. Citing the CDC, the paper said that accounts for 86% of all health care spending.

According to the National Consortium for Credentialing Health and Wellness Coaches, there are about 15,000 to 20,000 wellness coaches. During coaching, patients are made to understand just how their behavior affects their health, and they’re encouraged to set goals and use techniques such as meditation to alter their lifestyle.

The newspaper says that insurers and large employers are more and more turning to these specialists to help effect lifestyle change. The newspaper also asks, in one of its subheadlines: “Does it work?”

The answer: Definitely, for a little while. A Mayo Clinic study of 100 people who’ve received wellness coaching found that a majority exercised more, started eating better and lost weight within 12 weeks. At the three-month follow-up exam, however, there had been some slippage.  

The lead author of the study, Matthew M. Clark, a clinical psychologist at Mayo Clinic, tells the newspaper that, “Many people can implement positive lifestyle changes, but maintaining change over time is extremely difficult. This finding highlights the importance of ongoing strategies and support for positive lifestyle changes.”

Whether wellness programs work was debated in a “Point/Counterpoint” in Managed Care in May. On the “nay” side was Al Lewis, CEO of Quizzify, and he told us: “Conventional workplace wellness has not worked, by any measure. Partly, that’s because only a small percentage of people who quit smoking or lose weight succeed in the long term even when they are self-motivated. And employers cajoling employees is the opposite of self-motivation.”

On the “yea” side was Harris Allen, PhD, head of the Harris Allen Group consulting company. He told us: “The question is not whether workplace wellness can exert an impact—it can—but how best to design a program so it will. Researchers at HealthPartners Institute have identified five elements defining comprehensiveness: health education, supportive physical and social environments, program integration into the organization’s structure, linkages to related programs, and worksite screening programs.”

This debate about the effectiveness of wellness programs seems not to have registered with people who receive concierge’ care and the doctors who provide it, according to the Los Angeles Times. These doctors focus on wellness, not fitness. “They work on health and fitness goals with their patients, and are available to speak with them regularly by cellphone to help them make better lifestyle choices,” the newspaper reports.

Source: Wall Street Journal