Upload
shapeup
View
1.690
Download
1
Embed Size (px)
DESCRIPTION
Is telephonic coaching losing favor as an employee wellness component? Recent reports show that some large employers view telephonic coaching as expensive and having limited reach. If this is true, what are the other options? If not, what role should it continue to play? And what does the future of health coaching look like? Learn more by view these slides and watching the webinar at http://www.shapeup.com/lp/health-coaching-past-present-and-future
Citation preview
1 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
2 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Today’s Webinar Team
Rajiv Kumar, M.D.
Founder & Chief Executive Officer
Shawn LaVana
Vice President of Marketing
Elise Meyer
Marketing Associate
3 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Join the Conversation on Twitter
@shapeupdotcom
#healthcoaching
4 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
ShapeUp’s Mission Statement
Creating a healthier world by
leveraging social influence to
engage people in healthy activities
5 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
1. Why Health Coaching
2. Telephonic Coaching
3. Online Coaching
4. Peer Coaching
5. ShapeUp’s Approach
6. Discussion
Today’s Agenda
6 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Why Health Coaching? A Response to Rising Health Costs
7 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
0
20
40
60
80
100%
1960
$0.1T
1970
$0.1T
1980
$0.3T
1990
$0.7T
2000
$1.4T
2010
$2.5T
2020
OtherPublic
Med
icar
eO
ut-
of-
Po
cket
Other
Private
$4.5T
YearM
edc
aid
/S
CH
IPP
riva
teH
ea
lthIn
sura
nce
U.S. Healthcare Expenditures, 1960-2020
Note: ―Other Public‖ includes TRICARE, VA and all public health initiatives. Source: CMS; CBO; KFF/HRET Health Employer Health Benefits Survey, 2011; US Census Bureau
Total
Public
Total
Private
Out-of-
Employers = 1/3 of All Health Spending
8 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
0
20
40
60
80
100%5K+
1K-5K
200 to999
3 to199
199
9
200
0
200
1
200
2
200
3
200
4
200
5
200
6
200
7
200
8
200
9
201
0
201
1
0%
0%
2%
4%
('99-'11)
CAGR
Source: Kaiser Family Foundation; US Census Bureau
Percent of Covered Workers in Partially or Completely
Self-Funded Plans By Firm Size, 1999-2011
Large Employers Are Mostly Self-Funded
9 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Lifestyle Conditions Are Driving Costs
0
0 25 50 75 100 125 150M
$60BHealthcare
Cost
$60BHealthcare
Cost
Number of People Afflicted
Heart Disease
Alzheimer's/Dementia
Obesity/Overweight
HighCholesterol
Diabetes
Cancer
Hyper-tension
Heartburn
IrritableBowel
Syndrome
LactoseIntolerant
MetabolicSyndrome
Osteoporosis
Sleep
CeliacDisease
InflammatoryBowel
Disease
Cost of Healthcare, # of People Afflicted, and Nutrition Index by Condition
Source: Center for Disease Control; National Institutes of Health; Department of Health and Human Services; Illinois Department of Public Health; National Commission on Sleep Disorders Research;
American Heart Association; American Diabetes Association; Alzheimer’s Association; Epilepsy Foundation; Heart Rhythm Foundation; Celiac Sprue Association; International Osteoporosis Foundation;
American College of Gastroenterology; MedicineNet; Pharmacy Times; Sleep Disorders Guide; Physician’s Postgraduate Press
Manageable with
diet & exercise
Not manageable
with diet & exercise
10 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Telephonic Coaching Examining a Traditional Model
11 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
• What has been your experience with telephonic
coaching?
• Does the level of engagement justify the cost?
• Have you seen measurable health improvement?
• Is this approach best suited for certain employee types?
• Should employers stick with this model or ditch it?
Discussion #1: Telephonic Coaching
If you’d like to respond, please type the discussion number and your
organization name into the question box on the GoToWebinar control panel.
12 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
A Randomized Trial of a Telephone Care-Management Strategy
• Objective: To assess the effect on medical costs and resource utilization
• Methods: Randomized study of 174,120 subjects. Health coaches contacted at-risk individuals about shared decision-making, self-care, and behavior change.
• Results: After 12 months, the average monthly medical and pharmacy costs per person in the enhanced group were 3.6% ($7.96) lower than those in the usual support group ($213.82 vs. $221.78), driven by 10.1% reduction in hospital admissions. Intervention cost less than $2 per person / month
• Conclusion: Targeted telephonic intervention reduced medical costs and hospitalizations in a large population with a positive ROI.
Telephonic Coaching Can Really Work
http://www.nejm.org/doi/full/10.1056/NEJMsa0902321
13 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
The effect of a telephone-based health coaching disease management program on Medicaid members with chronic conditions
• Objective: To examine impact on healthcare utilization and expenditures in this population
• Methods: Examined changes in hospital utilizations, emergency department visits, ambulatory care, and Medicaid expenditures among participants for 1 year before and 2 years after enrollment vs. a control group.
• Results: Changes in acute hospitalizations, ambulatory care visits, and Medicaid expenditures were the same in both groups. After the 2nd year, ED visits were lower in the coaching group (8% vs. 23%).
• Conclusion: Telephonic coaching did not demonstrate significant effects on healthcare utilization and expenditures in this population.
But Telephonic Coaching Has Limits
http://www.ncbi.nlm.nih.gov/pubmed/21993059
14 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
―Doing The Telephone Tango‖
Is Telephonic Coaching Inconvenient?
http://ebn.benefitnews.com/news/telephone-tango-2710663-1.html
―Ella doesn’t recognize the number that shows on her caller ID.
She lets the call go to voice mail. The vendor rep leaves a
cheerful, but cryptic message. Ella doesn’t call back. Even
though the rep used our company name, and she vaguely
remembers a wellness program brochure, she’s not 100%
convinced it’s legit. In addition, she’s in the middle of making
dinner for her family, and the cable box is on the fritz. She’s got
more important things to worry about.‖
15 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Telephonic Coaching: Employer Opinions
―We’ve seen a savings of $869 per person per
year for the 530 people who have been
enrolled for two years. Telephonic coaching is
difficult, although for people who are struggling
with a certain issue, this type of support can
lead them to the next level.‖
ShapeUp Annual Employer Wellness Survey, 2012
16 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Telephonic Coaching: Employer Opinions
―Overall, we’ve heard good things from
our employees, but we would like to
switch to virtual coaching if we found a
model that works‖
ShapeUp Annual Employer Wellness Survey, 2012
17 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Telephonic Coaching: Employer Opinions
―We can’t tell if people are just checking
the box so to speak to get incentives
versus if this is something that is really
useful and that they are learning from.‖
ShapeUp Annual Employer Wellness Survey, 2012
18 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Telephonic Coaching: Employer Opinions
―Some vendors don’t get it. A couple of
calls and a letter won’t have an impact on
engagement.‖
ShapeUp Annual Employer Wellness Survey, 2012
19 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Telephonic Coaching: Employer Opinions
―I ask myself, how effective is telephonic
coaching itself? Given the small number
of participants, we pay a lot for it --
almost $500,000 for 3,000 people.‖
ShapeUp Annual Employer Wellness Survey, 2012
20 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Telephonic Coaching: Employer Opinions
―It’s unclear what the effect is. Utilization
is low – in the single digits.‖
ShapeUp Annual Employer Wellness Survey, 2012
21 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Telephonic Coaching: Employer Opinions
―We pulled the plug on telephonic health
coaching—only a small percent respond.
It’s not a very motivating model.‖
ShapeUp Annual Employer Wellness Survey, 2012
22 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Studies have shown that telephonic coaching can produce health improvement and a positive ROI
Other studies have shown little impact
Some employers report positive outcomes and employee feedback
Low participation and high cost are cited often
Employees may prefer other methods of contact
Some employers are looking for alternatives
Key Points About Telephonic Coaching
23 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
• What has been your experience with telephonic
coaching?
• Does the level of engagement justify the cost?
• Have you seen measurable health improvement?
• Is this approach suited for particular employee types?
• Should employers stick with this model or ditch it?
Discussion #1: Telephonic Coaching
If you’d like to respond, please type the discussion number and your
organization name into the question box on the GoToWebinar control panel.
24 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Online Coaching Understanding Its Efficacy
25 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
• Have you used any form of online coaching in your
workplace?
• Did employees prefer this method of communication vs.
telephonic/in-person?
• How did the cost compare to telephonic/in-person?
• Do you prefer human coaching or virtual coaching?
• Have you seen measurable health improvement?
Discussion #2: Online Coaching
If you’d like to respond, please type the discussion number and your
organization name into the question box on the GoToWebinar control panel.
26 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Automated Coaching via the Web
Rothert, Kendra et al. Obesity. Vol. 14 No. 2 February 2006
Web-based Weight Management Programs in an Integrated Health Care Setting: A Randomized, Controlled Trial
• Objective: Assess the efficacy of automated coaching for weight loss
• Methods: 2,862 overweight and obese members of Kaiser Permanente randomized into a tailored automated coaching system or information-only web-based weight management materials. Weight assessed via self-report at 3 and 6 months.
• Results: Automated coaching participants lost 3% of baseline weight, information-only participants lost 1.2%. Automated coaching participants said it was more personally relevant, helpful, and easy to understand.
• Conclusion: Automated coaching can produce weight loss outcomes.
27 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Human Coaching via the Web
Tate et al, JAMA 2003.
Effects of Internet behavioral counseling on weight loss in
adults at risk for type 2 diabetes: a randomized trial
• Objective: Compare effects of an internet weight loss program alone vs. with
additional of e-mail coaching for one year
• Methods: 92 overweight adults, randomized to basic internet program or
behavioral e-counseling and feedback from a counselor
• Results: Coaching group lost more weight at 1 year (-4.4kg) than control
group (-2kg).
• Conclusion: E-mail coaching significantly improved weight loss outcomes
28 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Human vs. Automated Coaching
Tate et al, Arch Intern Med Aug 2006.
A randomized trial comparing human e-mail counseling, computer-automated tailored counseling, and no counseling in an Internet weight loss program
• Objective: Compare human and automated coaching
• Methods: 192 obese adults randomized to 3 groups: no coaching, automated coaching, human e-mail coaching
• Results: At 6 months: no coaching group (-2.6 kg), automated group (-4.9 kg), human email coaching group (-7.3 kg)
• Conclusion: At 3 months automated and human email coaching were as effective but at 6 months human coaching was more effective.
29 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Online coaching is more scalable and can be more cost effective than telephonic coaching
Both human and automated online coaching appear to produce clinically significant results
Human coaching may produce better outcomes than automated coaching but at an increased cost
Online coaching offers the convenience of asynchronous messaging (e.g. email, SMS)
Some employers say that online coaching is inaccessible to their offline employees
Key Points About Online Coaching
30 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
• Have you used any form of online coaching in your
workplace?
• Did employees prefer this method of communication vs.
telephonic/in-person?
• How did the cost compare to telephonic/in-person?
• Do you prefer human coaching or virtual coaching?
• Have you seen measurable health improvement?
Discussion #2: Online Coaching
If you’d like to respond, please type the discussion number and your
organization name into the question box on the GoToWebinar control panel.
31 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Peer Coaching Exploring a Promising Approach
32 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
• Have you tried using peer coaching at your company?
• How did your employees respond to this approach?
• Did this produce higher or lower engagement than other
types of coaching?
• What was the health impact?
• Should more employers adopt this approach?
Discussion #3: Peer Coaching
If you’d like to respond, please type the discussion number and your
organization name into the question box on the GoToWebinar control panel.
33 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
An Online Recovery Plan Program: Can Peer Coaching Increase Participation?
• Objective: Evaluate whether addition of online coaching from a peer specialist increased participation in a bipolar disorder program
• Methods: 118 participants recruited, randomly assigned to online peer coaching vs. control group
• Results: Peer coaching participants were more likely to return to the website after registration (71% vs. 44%) and continue using the program after three weeks (38% vs. 9%)
• Conclusion: Peer coaching led to greater program engagement and retention
Peer Coaching & Engagement
Simon et al, Psychiatric Services, Vol 62 No. 6
34 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Diabetes Control with Reciprocal Peer
Support Versus Nurse Care Management
• Objective: Compare peer-support with nurse care
management
• Methods: 244 men with A1c > 7.5%, randomized. Half
matched with peer coach for weekly sessions, other
half matched to nurse care manager.
• Results: A1c decreased (8.02 to 7.73%) in peer group,
but increased (7.93 to 8.22%) in nurse group.
• Conclusion: Peer coaching holds promise as a
method for diabetes care management.
Peer vs. Nurse Coaching for Diabetes
Heisler et al, Annals of Internal Medicine, 2010.
35 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Benefits of Recruiting Participants With Friends and Increasing Social Support for Weight Loss and Maintenance
• Objective: Determine the benefits of social support for weight loss and maintenance
• Methods: Recruited participants (N = 166) either alone or with 3 friends or family members and then randomly assigned them to a standard behavioral treatment with and without social support strategies.
• Results: Participants recruited with friends and given social support had greater weight losses at 4-months (20 lbs) and 10-months (19 lbs) than those recruited alone (15 lbs and 12 lbs). In those recruited alone, 76% completed and 24% maintained weight loss in full through month 10. When recruited with friends and social support, 95% completed and 66% maintained weight loss in full.
• Conclusion: Recruitment with friends and social support led to greater weight losses and longer-term sustainability.
Peer Coaching via Recruitment & Support
Rena R. Wing and Robert W. Jeffery, 27 July 1998.
36 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
A Statewide Intervention Reduces BMI in Adults: Shape Up Rhode Island Results
• Objective: Evaluate weight loss outcomes
• Methods: Measure weight loss achieved among 3,311 participants in Shape Up RI, a 16-week workplace-based exercise and weight loss team competition.
• Results: 7 lbs, 30% achieved clinically significant weight loss of 5%, shifted the BMI distribution from mean of 29.4 to 28.2 and reduced the obese population from 39 to 31%. Weight loss maintenance at 10 months was 73%.
• Conclusion: Team-based, weight loss competitions can produce weight losses in large numbers of participants and may be sustainable long-term.
Peer Coaching via Team Challenges
Rena R. Wing, et al , Obesity (2009) 17 5, 991–995.
37 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Teammates and Social Influence Affect Weight Loss Outcomes in a Team-Based Weight Loss Competition
• Objective: Investigated the effects of teammates and social influence on individual weight loss and exercise outcomes
• Method: 12-week, team-based wellness competition
• Results: Overweight/obese completers lost 4.2% of initial body weight. Weight loss was similar among teammates. Having a greater percentage of teammates in the weight loss division and reporting higher social influence for weight loss were both associated with greater weight loss. Clinically significant (5%) weight loss tended to cluster within teams.
• Conclusion: Weight loss and the behaviors that lead to it are likely contagious, and harnessing and maximizing social influence for weight loss enhances outcomes.
The Social Influence of Peer Coaching
Tricia Leahey et al, Obesity, Feb 2012.
38 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
• Peer coaching can lead to higher participation and retention
• Peer coaching can produce significant health outcomes
• Peer coaching is the most cost effective approach
• Peer coaching is most effective when the coach shares similar health issues and goals
• Outcomes via peer coaching have been shown to be contagious, spreading from person to person
• Peer coaching can have limitations related to the lack of formal training of the coaches
Key Points About Peer Coaching
39 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
• Have you tried using peer coaching at your company?
• How did your employees respond to this approach?
• Did this produce higher or lower engagement than other
types of coaching?
• What was the health impact?
• Should more employers adopt this approach?
Discussion #3: Peer Coaching
If you’d like to respond, please type the discussion number and your
organization name into the question box on the GoToWebinar control panel.
40 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
ShapeUp’s Approach to
Coaching
41 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Empowered Peer Coaches for Everyone
• Turning colleagues into peer coaches
through the role of Team Captain
• Peer coaches empowered to recruit,
motivate, and hold peers accountable
• Allowing every member to serve as a
peer coach through support
mechanisms and user-generated
challenges
• Leveraging your potent employee
network at a low cost
42 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Online Fitness Coaches for the Motivated
• Provide additional expert support,
guidance, and education for motivated
individuals and teams (opt-in model)
• Focus on physical activity, nutrition, and
weight management
• Asynchronous messaging, integrated
into our social engagement platform
• Coaches drive utilization of the
platform, social interactions, team
cohesion, and healthy outcomes
43 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Key Takeaways from
Today’s Webinar
44 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.
Coaching is a dominant approach for employee wellness
Various studies have showed that each method of coaching can be
clinically effective
Many employers are looking for alternatives to telephonic coaching
Online coaching models offer greater reach, scalability, convenience,
and cost-effectiveness
Peer coaching holds promise as a low-cost, highly effective model for
harnessing the power of social networks
Further research is needed to understand the long-term impact and
sustainability of health coaching on behavior change
Key Takeaways from Today’s Webinar
45 Copyright © 2012 ShapeUp, Inc. Confidential & Proprietary.