The architecture for how to successfully accomplish healthcare reform is a mixed bag of strategies revolving around care coordination, team-based care, and population health management. But are we overthinking the simple need to help individuals lead healthier lives?

True reform hinges on creating a healthcare culture that is focused on patient self-motivation through behavioral and inspirational support from qualified healthcare professionals. In other words, this means embracing health coaching.

Who are health coaches?

A health coach is a supportive member of the care team who focuses on helping patients improve their overall health through lifestyle adaptations. Often, qualified allied health professionals, such as medical assistants (MAs) are entrusted with these responsibilities. In many cases, allied health professionals may function as health coaches as part of their overall responsibilities.

“Prior studies have shown that additional patient support or case management by registered nurses, pharmacists, or other licensed professionals can have positive impacts on patients' health,” said Rachel Willard-Grace, MPH, research manager at the University of California, San Francisco’s Center for Excellence in Primary Care, in an article for the American Academy of Family Physicians.

Over the past 10 years, Union Health Center in New York City has successfully created and sustained a robust health coaching program. The center is now recognized as a level 3 patient-centered medical home. Union Health Center believes its health coaches - all medical assistants - are succeeding in the care model thanks to proximity, flexible scheduling, standardized tracking, and evidence-based communications approaches. The Center operates in teams, where the health coach is a member of the larger team that focuses specifically on high-risk patients.

The need for health coaching

“True healthcare reform springs from the capacity of individuals in a population to build self-care skills, improve their health behaviors and accept accountability for their health. It is not about giving motivation but inspiring it,” said William Applegate, PhD, executive director of Iowa Chronic Care Consortium in an issue of Medical Home News.

The good news is that many physicians and non-physician providers are starting to rely on health coaches and partnering with them to help connect the dots for an individual patient’s lifestyle and care plan.

The importance and value of a health coach is growing exponentially as America faces rising healthcare costs and increasing accountability for quality outcomes. According to the CDC, more than half the U.S. population has been diagnosed with a chronic medical disease, which accounts for up to 90 percent of the national healthcare spend and drives health coach intervention. The more important reality of this data is that most chronic conditions can be prevented or improved dramatically by eliminating some of the major risk factors, such as diet, smoking, and exercise.   

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Health coaching encourages the individual, not the physician, to establish goals by focusing on self-management and internal motivation. Health coaches contribute to successful outcomes in a number of ways, including:

• Partnering with patients to identify health goals

• Collaborating with and supporting healthcare providers in helping patients improve their health and well-being

• Facilitating the process of lifestyle change to prevent or ameliorate lifestyle-related diseases and optimize whole health and well-being

• Exploring and providing information, resources, and referrals to providers as appropriate

• Supporting client self-empowerment and activating patients to direct own path of healing

• Guiding population health processes and practices of the medical organization.

Training more health coaches

Understanding health coaching fundamentals can help clinicians engage, motivate, and better meet the needs of their patients, especially those suffering from chronic disease(s).  To deliver health coaching as part of their core job responsibilities, clinicians need accessibility to the training tools and techniques that can have a positive impact.

By integrating health coaches who have mastery of the critical skills along with providers who help facilitate a culture of change, patients can be more engaged and accountable for their health behaviors and overall goals.

“All of this requires a shift in thinking,” said Davene Yankle, MS-HSM, BSN, RN, manager of clinical services for OhioHealth Physicians Group, in an interview with the National Healthcareer Association. “The goal of team-based care and health coaching is to do away with care that rescues a patient from a singular diagnosis at a given point in time and replace it with comprehensive, continuous coaching.”  

Jessica Langley is the executive director of Education and Advocacy at the National Healthcareer Association.