the art and science of employee engagement through health coaching

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


• 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


– 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


70% of our health and well-being is determined by lifestyle

factors that generally results from our everyday choices. 1


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

https://www.google.com/url?q=http://mooreco360.com/series/oneboard&sa=U&ei=AapGU7L3Oc2rhQe174G4CA&ved=0CDIQ9QEwAg&usg=AFQjCNFOS_WYUVODzcLPgdKFjPfDSvYMow


• 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


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

Lifestyle Improvement

IS

Good Medicine

Employer Utilization in

Health Coaching


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


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


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


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


• Mitigate Health Risks

• Arrest disease progression

• Reduce medical costs

• Increase employee

productivity

• Improve QOL

Goals of Health Coaching


Health Coaching Paradigm Shift

Lifestyle Intervention

Support, Delivery, and Evaluations


Recommended Program Offerings

Lifestyle Improvement Programs:

– Weight Management

– Nutrition

– Tobacco Cessation

– Stress Management

– Physical Activity

– Personalized Program


Lifestyle Program Materials

Evidence-based | Curriculum driven | Best in class


Comprehensive and Self Contained

Workbook | Toolkit | Trackers | Inserts


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

http://www.him.com/


Soft Touch


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

Health Coach Training


Health Coach Backgrounds

Interdisciplinary Team

#1 Asset


Coaching Communication (Motivational Interviewing)

Process of Inquiry

• Reduces resistance

• Resolves Ambivalence

• Increase intrinsic motivation

• Builds on strengths

• Expands perception


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


Focus on Member Needs

Motivation

Commitment

Accountability

Feedback

Self-Efficacy

Reinforcement

Knowledge

Social

Support

Self

Awareness

Resource

Awareness


Build Self- management Skills

SMART Goals

Self

Monitoring

Problem- Solving

Assertiveness

Task-specific skills

Self-talk


State-of-the-Art Training Methods

• Multi-media Instruction

• Observation

• Role-play

• Brainstorming

• Demonstration


MyHealth Coach Training Curriculum

• 15 modules

• 20 modules

• 24 modules

• 8 modules

Health Coaching Operations

Core Health Coaching

On-site Health

Coaching

Delivery Skills


Detailed Coaching Guides


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


Quality Assurance Review


Certification Criteria

Certified Level Advanced Level Mastery Level

Core Training

Complete 101 Training

Complete Program Training

Listen to one complete call

series



Listen to one complete call series



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


Recognition/Career Path Development

Name

Weight Management __/__/__ Tobacco Cessation __/__/__

Physical Activity __/__/__ Stress Management __/__/__

Nutrition Basics __/__/__


Best In Class


Engaging employees in health coaching is an industry-

wide challenge.

Supercharging

Engagement with On-site

Coaching


Supercharging Engagement

• Demystify health coaching

• Promote your wellness Model

• Crosswalk to services

• Sustainable culture of health

• Improve health and productivity

• Incentive education


Who is an on-site health coach?

Certified Expert

• Listen to you

• Motivate you

• Guide you

• Connect to resources

• Hold you accountable


On-site Coaching Opportunities

• Personal Health Review

• Online tutorial

• Coach on Call

• Non-invasive Biometrics

• Fitness Testing

• Cyber Coaching


On-site Coaching as a Wellness Practice

On-site Coach Wellness Program


Our Approach

Discover

and Assess Design

Implement and

Communicate Evaluate

and Refine


For wellness programs to have a substantial impact on

employee health and behaviors, wellness must be imbedded

into the culture.


Formula for Success

Culture of Health

Incentive Design

Infrastructure

On-site Coach


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


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


• 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


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


Population Health Strategy

Questions?


Contact Information

Timothy R. Cline

Phone: 412-454-8545

Email: [email protected]

Amanda Budzowski

Phone: 412-454-8369

Email: [email protected]

mailto:[email protected]

mailto:[email protected]


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