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

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 50-100 101-1,000
1,001-10,000 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

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 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%
Telephonic
Coach Only
Clinic Only On-site
Coach &
Clinic
PercentofDistinctEmployees
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 ManagementProgram
Support
Structure Analytics & Reporting
Wellness Committees
Communications & Collateral
Incentives
Building a Foundation to Manage Health

Population Health Strategy

Contact Information
Timothy R. Cline
Phone: 412-454-8545
Email: Clinetr@upmc.edu
Amanda Budzowski
Phone: 412-454-8369
Email: Budzowskiar@upmc.edu

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

The Art and Science of Employee Engagement Through Health Coaching

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