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Health Coaching Plays Role in the ACO

Patrick T. Buckley, MPA, IHC, for HealthLeaders Media, February 24, 2011

One way to facilitate the accountability partnership is to employ or contract the services of integrative health coaches within the ACO. Integrative health coaching (IHC) encourages patients to change personal behavioral patterns. Armed with behavior modification tools and skilled in the art of motivational interviewing, integrative health coaches are specially trained to motivate clients into taking positive steps and assuming personal responsibility for lifestyle improvements. The purpose of IHC is to create structured and dynamic partnerships that move people toward not just wanting to adopt a healthy lifestyle, but to actually do it.

Additionally, integrative health coaches use both innovative and practical strategies to help patients explore options for which the primary care physician may not have the time or knowledge. Suppose, for example, a patient sees a primary care physician in the ACO for a back-related issue. Depending upon the seriousness of the patient’s condition (e.g. how long she/he has had the back pain, what may have caused it), the patient may have several options, including do nothing, seeing a physiatrist, an orthopedist, a neurosurgeon, an anesthesiology-trained pain management specialist, or maybe a chiropractor.

After initially consulting with the PCP who prescribes a muscle relaxant, the patient meets with an integrative health coach to review the benefits, costs, likely outcomes, and lifestyle changes associated with treating back pain and with sustaining a healthy back. Together, the coach and patient develop a personalized healthy back plan with specific actions designed toward achieving concrete milestones. The plan is geared toward achieving the best outcome possible for the patient while utilizing the most cost-effective diagnostic and therapeutic modalities in the process.

In the above example, the integrative health coach acts as a conduit between the primary care physician and the patient, providing assistance to patients and feedback to the medical team as to the patient’s progress with his or her issues. Employing health coaches particularly works well with the medical home model, as professionally trained coaches provide a bridge between the interdisciplinary specialties (pharmacy, dietary and nutrition, physical therapy, etc.) and the patient or a group of patients. Health coaches are not case managers in the traditional sense; rather, they encourage self-health management and personal goal-setting among patients.

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