Health CoachWelcome to the Wild West

Nancey Trevanian Tsai, M.D.

Disclosures

Board of Directors for American Council on Exercise (non-remunerated position)

Certified Personal Trainer

Advance Health and Fitness Professional

Health Coach

Patent-holder, Institute of Applied Neurosciences, Medical University of South Carolina

Overview

Definition?

“Health Coach”

“Clinical Coach”

“Wellness Coach”

Accreditation?

NCCA

Others

Integrative care

Practice improvement?

PQRS

Practice enhancement?

Cash flow beyond E&M

Definition?

“Health Coach”

Nutrition

Fitness

Behavioral change

“Clinical Health Coach”

Same as above, but seeks to claim more medical education

“Wellness Coach”

“Lifestyle coach”

Welcome to the Wild West!

Historically, health coach probably evolved out of nutritional sciences and professional certifications.

However, health is more than ‘packets of nutrients’

Integrate fitness, nutrition, and address emotional health to optimize long-term behavioral change

NCCA: National Commission for Certifying Agencies

Created in 1987

Has accredited over 300 programs from over 120 organizations to include many from healthcare (nursing, dental, EMTs, etc.)

Ensure health, welfare, safety of the public through accreditation of professional programs

Consistent with The Standards for Education and Psychological Testing

Standards require demonstrate of a valid and reliable process for implementing, maintaining, and governing certifications

Peer-reviewed

NCCA: National Commission for Certifying Agencies

Has proven experience as a certification organization

The process of becoming accredited is educational and will create an even better product

Join other professional groups that have long history of providing peer-reviewed courses of

study

Health Coach

Why?

Epidemic of chronic lifestyle related diseases

Evidence demonstrates coaching is effective

Move toward value-based care

Provides integrative education, including nutrition, fitness, and behavioral change through motivational interviewing

Improve outcomes of health benchmarks

Everyone can use techniques; designated health coaches offer quality at lower present-value cost

Practice Improvement?

PQRS: Physicians Quality Reporting Service

CMS requirement

Avoid penalty

Incentive pay

PQRS offers incentives for care providers to promote health through preventative measures or discussion of behaviors through motivational interviews

Health Coach can assist in gathering and providing health promoting information

BMI and f/u

Unhealthy alcohol use

Tobacco cessation

Weight and physical activity assessment in children/adolescents

Practice Enhancement?

Traditional Model

Provider as expert

Patient told what to do

One size fits all solutions

Extrinsic motivators

Patient assessed on “compliance”

Ignores barriers to change

Leads

Health Coaching

Patient as expert in own life

Patient chooses viable solutions

Individualized solutions

Intrinsic motivators

Collaborative and facilitated change

Addresses barriers to change

Guides

Practice Enhancement?

Motivational interviewing

Engaging, Evoking, Focusing, Planning

Open-ended questions, Affirming, Reflective listening, Summarizing

Cognitive behavioral coaching

Change irrational beliefs into rational ones

SMART goal setting

Specific, Measurable, Attainable, Relevant, Time-based

Practice Enhancement?

After-hours opportunity

Group behavior modification

Cash-only workshops

Summary

Health coach as a partner to physiatric practice

Definition is still being refined

Recommend course providers to obtain NCCA accreditation

Health Coaches can be another provider to offer information meeting PQRS requirements (EHR, registry, etc.)

Possibility of health-promoting opportunity to patients

Shalom!