Research Update: Health Coaching "Pays for Itself"

By Mark Joyella

How about this selling point for coaching? Coaching saves money.

A study just published by the “New England Journal of Medicine” finds telephone-based health coaching, when offered to a wide group of patients, ultimately saves more money than it costs. “With phone coaching, the client is educated, calm, and knows their body,” said coach Elizabeth Crouch, who was not involved in the study. “(The client) understands any new symptoms that require healthcare intervention."

The study, funded by Health Dialog Services—a Boston-based company that, it should be noted, provides the telephone coaching services used in the study—found average monthly medical and pharmacy costs were about eight dollars a month cheaper for patients who were offered coaching. With the coaching program costing two dollars a month per patient, the net health care savings was about six dollars.

David Wennberg, chief science and products officer at Health Dialog, was an author of the study. He told "The Wall Street Journal" that one of the groups who may have benefited from coaching were those "chaotic users of the health care system" who tended to get answers to their aches, pains and questions by running directly to the emergency room (at extremely high cost). The study, which followed 174,120 individuals over a twelve-month period, is described as the "largest randomized controlled trial study of care management ever published."

The coaching, Wennberg told the Journal, did not attempt to steer patients toward low-cost health options, or away from pricey procedures. Instead, he says, the coaching's focus was on facilitating the kinds of interactions between patient and doctor that will lead to the most effective treatment.

"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," Wennberg told the Journal. "We are careful to grease the communication between patients and physicians," not prescribe or advise treatments. Most physicians would rather have a fully informed patient with objective information than 50 pages of downloaded information from the Internet," he said.

Ultimately, according to the study's authors, the majority of the money saved came from a ten percent reduction in annual hospital admissions. "By answering medical questions and explaining conditions and treatment options, our coaches help people become active consumers in their own healthcare," says a Health Dialog statement. "Coaches also help people prepare to ask the right questions at their doctor visit so that they can fully understand the risks and benefits of their treatment choices. And coaches teach people how to communicate their personal values effectively and appropriately with medical professionals.

"The payoff for companies deciding to support this kind of coaching, Grant says, is that employees make better decisions about their own healthcare, and become far more productive on the job. "(They) stay at work, versus (making) frequent trips to the doctor," Grant says, noting that the employer's cost for healthcare stabilizes or drops. A side benefit—not part of the study—Grant believes, is that this kind of coaching empowers workers to spread the word, educating "family, friends and community."