the art and science of employee engagement through health coaching
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Advancing the quality, accessibility,
and affordability of health care
The Art and Science of Employee
Engagement through Health
Coaching
Presented by:
Dr. Tim Cline & Amanda Budzowski
Copyright 2014 UPMC Health Plan. All rights reserved.
Today’s Presenters
Timothy R. Cline, PhD, MCC;
Senior Director, Clinical Training and
Development, UPMC Health Plan and
UPMC WorkPartners
Amanda Budzowski, MPH, MS,
CHES, On-site Health Coaching Manager
UPMC Health Plan and UPMC WorkPartners
Copyright 2014 UPMC Health Plan. All rights reserved.
• Participants will be able to identify best practices in
member engagement, program design, and training
delivery methods.
• Participants will understand how to overcome
engagement barriers in the workplace.
• Participants will recognize how onsite coaching “done
right” can supercharge engagement in health coaching,
wellness, and health management programs.
Learning Objectives
Time for a Poll
Copyright 2014 UPMC Health Plan. All rights reserved.
– Review current state of employee wellness program
delivery
– Explore best practice model for lifestyle health
coaching
– Learn how you can supercharge employee
engagement through on-site health coaching
Learning Objectives
Copyright 2014 UPMC Health Plan. All rights reserved.
70% of our health and well-being is determined by lifestyle
factors that generally results from our everyday choices. 1
Copyright 2014 UPMC Health Plan. All rights reserved.
Why Health Coaching?
How Many Americans Can Say “Yes” to All 5?
1. I am within 5 pounds of my ideal body
weight
2. I exercise 30 minutes or more most days of
week
3. I eat a healthy diet with 5 fruits/vegetables
most days
4. I don’t use tobacco products
5. I have 2 or fewer alcoholic drinks per day
Copyright 2014 UPMC Health Plan. All rights reserved.
• Participants will be able to identify best practices in
member engagement, program design, and training
delivery methods.
• Participants will understand how to overcome
engagement barriers in the workplace.
• Participants will recognize how onsite coaching “done
right” can supercharge engagement in health coaching,
wellness, and health management programs.
Learning Objectives
Time for a Poll
Copyright 2014 UPMC Health Plan. All rights reserved.
Leading Causes of Death in US
Disease Reduction
Compared to U.S. Comment
Heart Disease 64%*−83%** 80% due to modifiable risk
factors
Cancer 60%* Approximates NCI
estimates
Diabetes 91%** No type 2 epidemic
All-cause Mortality 50%* 25 year Okinawa program
—similar findings
* Knoops et al and **Rimm, Stampfer, JAMA 2004;292:1433-1439
Copyright 2014 UPMC Health Plan. All rights reserved.
RAND: Percentage of Employers Offering Wellness Program, by Employer Size3
51%
39%
62%
85% 86% 91%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%Percentage of Employers Offering Wellness
Program, by Employer Size
All employers 50-100 101-1,0001,001-10,000 10,000-50,000 > 50,001
Copyright 2014 UPMC Health Plan. All rights reserved.
RAND: Workplace Wellness Offerings3
79% 77%
72%
52% 52%
36%
5%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90% Among Employers Offering a Lifestyle Management Program, Percentage Offering Specific Interventions
Nutrition/ Weight Smoking Fitness
Alcohol Drug Abuse Stress Management Health Education
Copyright 2014 UPMC Health Plan. All rights reserved.
2013 Healthcare Benchmarks: Health Coaching2
74%
59% 54%
42%
32% 28%
14% 12%
6% 3%
0%
10%
20%
30%
40%
50%
60%
70%
80%
1
Modalities Used for Program Delivery
Telephonic Face-to Face Web site
E-mail US mail Group Sessions
Texting Smart Phone app Other
Avatars
Copyright 2014 UPMC Health Plan. All rights reserved.
25.3%
74.7%
Does your Organization Offer Health Coaching?
Yes
No
2013 Healthcare Benchmarks: Health Coaching2
Lifestyle Health Coaching:
A Best Practice Model • Goals
• Paradigm
• Core programs
• Delivery options
• Health coach training
• Supercharging engagement
Copyright 2014 UPMC Health Plan. All rights reserved.
• Mitigate Health Risks
• Arrest disease progression
• Reduce medical costs
• Increase employee
productivity
• Improve QOL
Goals of Health Coaching
Copyright 2014 UPMC Health Plan. All rights reserved.
Recommended Program Offerings
Lifestyle Improvement Programs:
– Weight Management
– Nutrition
– Tobacco Cessation
– Stress Management
– Physical Activity
– Personalized Program
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Lifestyle Program Materials
Evidence-based | Curriculum driven | Best in class
Copyright 2014 UPMC Health Plan. All rights reserved.
Comprehensive and Self Contained
Workbook | Toolkit | Trackers | Inserts
Copyright 2014 UPMC Health Plan. All rights reserved.
Hard Science
Healthcare Intelligence Network (2013). 2013 healthcare benchmarks : Health Coaching. www.him.com 2
0% 10% 20% 30% 40% 50% 60% 70%
Motivational Interviewing
Stages of Change
Self-efficacy
Mindfullness
Health Belief Model
Socail Cognitive Theory
Appreciative Inquiry
PAM
Visualization
Other
Theory of Planned Behavior
Positive Psychology
Behavior Change Tools
Copyright 2014 UPMC Health Plan. All rights reserved.
Health Coaching Delivery Options
Matched to individuals’ learning styles and preferences
Coach-delivered
Coach-supported self-study
Telephone-
based
Program
On-site
group
Call on
CoachTM
Online
Text Tip
Support
Tool
Workbook
Tele-group
Additional Support
Copyright 2014 UPMC Health Plan. All rights reserved.
Health Coach Backgrounds
Interdisciplinary Team
#1 Asset
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Coaching Communication (Motivational Interviewing)
Process of Inquiry
• Reduces resistance
• Resolves Ambivalence
• Increase intrinsic motivation
• Builds on strengths
• Expands perception
Copyright 2014 UPMC Health Plan. All rights reserved.
Stages of Change
Stages of Change A Spiral Model
“Linear progression
is a possible but
relatively rare
phenomenon with
addictive behaviors.”
-J. Prochaska,PhD.
Maintenance
Action
Preparation
Contemplation
Pre-contemplation
Copyright 2014 UPMC Health Plan. All rights reserved.
Focus on Member Needs
Motivation
Commitment
Accountability
Feedback
Self-Efficacy
Reinforcement
Knowledge
Social
Support
Self
Awareness
Resource
Awareness
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Build Self- management Skills
SMART Goals
Self
Monitoring
Problem- Solving
Assertiveness
Task-specific skills
Self-talk
Copyright 2014 UPMC Health Plan. All rights reserved.
State-of-the-Art Training Methods
• Multi-media Instruction
• Observation
• Role-play
• Brainstorming
• Demonstration
Copyright 2014 UPMC Health Plan. All rights reserved.
MyHealth Coach Training Curriculum
• 15 modules
• 20 modules
• 24 modules
• 8 modules
Health Coaching Operations
Core Health Coaching
On-site Health
Coaching
Delivery Skills
Copyright 2014 UPMC Health Plan. All rights reserved.
QAR and Skills Building Sessions
• Self-referred, supervisor-referred, & random QARs
• Individual and group supervision/feedback sessions
• Focus: continuous clinical quality improvement
Dissemination of innovative & effective coaching
skills/approaches
Problem-solve coaching challenges
Copyright 2014 UPMC Health Plan. All rights reserved.
Certification Criteria
Certified Level Advanced Level Mastery Level
Core Training
Complete 101 Training
Complete Program Training
Listen to one complete call
series
Complete 101 Training
Complete Program Training
Listen to one complete call series
Complete 101 Training
Complete Program Training
Listen to one complete call series
Knowledge-based
Exam Score
≥ 80% on any administration
≥ 80% on any administration
≥ 90% on 1st administration
OR
≥ 80% on Knowledge Exam
+
≥ 2.0 on the Health Coach
Scenario Essay Exam
(on a 3 pt. scale)
Total # of Coaching
Sessions Completed
(per program)
1
25
50
Average QAR Score
(on a 3 point scale)
2.0
(on a single QAR)
2.1
(on 10 consecutive QAR’s)
2.25
(on 10 consecutive QAR’s)
Present Case Review
(Baseline-30 Day F/U)
N/A
N/A
2.3 on a 3 pt. scale
Copyright 2014 UPMC Health Plan. All rights reserved.
Recognition/Career Path Development
Name
Weight Management __/__/__ Tobacco Cessation __/__/__
Physical Activity __/__/__ Stress Management __/__/__
Nutrition Basics __/__/__
Copyright 2014 UPMC Health Plan. All rights reserved.
Engaging employees in health coaching is an industry-
wide challenge.
Copyright 2014 UPMC Health Plan. All rights reserved.
Supercharging Engagement
• Demystify health coaching
• Promote your wellness Model
• Crosswalk to services
• Sustainable culture of health
• Improve health and productivity
• Incentive education
Copyright 2014 UPMC Health Plan. All rights reserved.
Who is an on-site health coach?
Certified Expert
• Listen to you
• Motivate you
• Guide you
• Connect to resources
• Hold you accountable
Copyright 2014 UPMC Health Plan. All rights reserved.
On-site Coaching Opportunities
• Personal Health Review
• Online tutorial
• Coach on Call
• Non-invasive Biometrics
• Fitness Testing
• Cyber Coaching
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On-site Coaching as a Wellness Practice
On-site Coach Wellness Program
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Our Approach
Discover
and Assess Design
Implement and
Communicate Evaluate
and Refine
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For wellness programs to have a substantial impact on
employee health and behaviors, wellness must be imbedded
into the culture.
Copyright 2014 UPMC Health Plan. All rights reserved.
Formula for Success
Culture of Health
Incentive Design
Infrastructure
On-site Coach
Copyright 2014 UPMC Health Plan. All rights reserved.
Two Case Studies of Employer Groups
Case 1: 24 Months: On-site Coaching (2,630 employees)
• 4% of unique employees to 55% of employees
Case 2: 12 Months: On-site Coaching (150 employees)
• 5% of unique employees to 46% of employees
Employee Engagement in Lifestyle Health Coaching
Copyright 2014 UPMC Health Plan. All rights reserved.
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
TelephonicCoach Only
Clinic Only On-siteCoach &
Clinic
Perc
en
t o
f D
isti
nct
Em
plo
yees
On-site Model
Lifestyle Management Participation
Baseline Year
Year 1 On-site Model
Year 2 On-site Model
Total Health Management Synergy
Copyright 2014 UPMC Health Plan. All rights reserved.
• 97% agree their coach was friendly, approachable,
professional and knowledgeable
• 98% agree that they were satisfied with program materials
• 100% agree that by participating in health coaching their
health has or will change for the better
On-site Coaching Satisfaction
Copyright 2014 UPMC Health Plan. All rights reserved.
Online Health Tools
HRA
Biometric Screenings/
Assessments
Health Coaching
Worksite Health
Programs
Dedicated Account Management Program
Support
Structure Analytics & Reporting
Wellness Committees
Communications & Collateral
Incentives
Building a Foundation to Manage Health
Copyright 2014 UPMC Health Plan. All rights reserved.
Contact Information
Timothy R. Cline
Phone: 412-454-8545
Email: Clinetr@upmc.edu
Amanda Budzowski
Phone: 412-454-8369
Email: Budzowskiar@upmc.edu
Copyright 2014 UPMC Health Plan. All rights reserved.
1. Danaei, G, et al (2009), “The preventable causes of death in the United States:
comparative risk assessment of dietary, lifestyle, and metabolic risk factors,”
PLoS Meidicine, Vol 6 No 4, e1000058.
2. Healthcare Intelligence Network (2013). 2013 healthcare benchmarks : Health
Coaching. www.him.com
3. Mattke, S., & et.al (2012). Workplace wellness programs study: final report.
RAND Corporation. http://www.rand.org/pubs/periodicals/health-
quarterly/issues/v3/n2/07.html
References
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