Guest Post: Leveraging lifestyle interventions across the population health risk continuum

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By Dennis Richling, M.D.

Years ago, I worked as a disease management call center medical director. That experience profoundly influenced my point of view about helping people with chronic conditions improve their health.

So when HealthFitness purchased a disease management firm in 2011, we asked ourselves a strategic question: How can we apply the lessons learned from lifestyle coaching to improve chronic care management and create an integrated, personalized approach—one that offers a true return on investment?

We started with a simple premise: Lifestyle interventions should match participants with the predominant coaching need in their lives.

I observed traditional disease management approaches that depended on rigid clinical guidelines that kept the interaction focused on managing the disease process: a nurse assessed the gaps in the treatment plan, provided education and set goals for self-management. This works in a medical model, but from our review of cases we saw that most employees with chronic disease—about 70 percent in our employer programs–need a different approach. They’ve already figured out how to manage most of their chronic disease issues. They are compliant with their medications. They’re getting the medical care they need. But their underlying lifestyle issues continue to put them at risk for poor health and high claims costs.

HealthFitness health coaches have helped thousands of individuals make positive changes in their health through lifestyle interventions. Participants work with one coach throughout their program. The coaches and participants develop a connection with one another in a trusting, supportive partnership that builds motivation for change.

And we know it works–our clients consistently experience reductions in health risks, lower claims costs and health improvements.

The most effective lifestyle intervention is much more about the participant talking than about the professional on the phone collecting information about a chronic disease.  Research shows effective lifestyle intervention can reduce the risk of type 2 diabetes in people with impaired glucose tolerance, and this approach seems to be at least as effective as pharmacological interventions.[1]

But big changes, like a 20-pound weight loss, begin with small steps. What is effective? Tailor the coaching program to meet the participant’s unique set of values, strengths and interests, while leveraging current best practices for engagement. We’ve transformed our entire coaching program to integrate chronic care and lifestyle management into one seamless behavior management and lifestyle intervention.

Most employers embrace health coaching as a population health strategy because of the potential to save money—by improving productivity as well as lowering claims costs. Lifestyle interventions can work to achieve those goals across the population health continuum, leveraging coaching for those at low risk, advanced practice coaching for those effectively managing their chronic disease, and person-centered chronic condition management.

Dennis Richling, M.D.

Chief Medical and Wellness Officer HealthFitness

Dennis has a background covering clinical services, wellness product development, community education and programming, and health care policy research. He is also senior medical director for Trustmark, HealthFitness’ parent company. Dennis received his medical degree from Creighton University School of Medicine and is a fellow of the Institute of Medicine of Chicago. 


[1] Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. Clare L Gillies, Keith R Abrams, Paul C Lambert, Nicola J Cooper, Alex J Sutton, Ron T Hsu, Kamlesh Khunti. BMJ. 2007 February 10; 334(7588): 299. Published online 2007 January 19. doi: 10.1136/bmj.39063.689375.55

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Guest Blog Post Disclaimer

CCA invites guest bloggers to post on Voice on Population Health Blog as a benefit for our members and the industry and to allow for exchange of ideas and information regarding population health.

The views, opinions and positions expressed within these guest posts are those of the author alone and/or of the company the author represents and do not represent those of the Care Continuum Alliance (CCA), its members, or the industry as a whole. CCA is not responsible for the accuracy, completeness and validity of any statements made within this guest post article. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author(s) and any liability with regards to infringement of intellectual property rights remains with them.

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