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Tailoring Diabetes Coaching to Patients Trims Hospital Visits

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As health plans ramp up efforts to “coach” patients with diabetes and other chronic diseases, a study in The American Journal of Managed Care® finds that customizing these efforts to patients’ knowledge and needs reduces hospital visits and improves some health measures.

FOR IMMEDIATE RELEASEFebruary 22, 2017

CRANBURY, N.J.—Giving patients with diabetes customized coaching sessions, rather than a one-size-fits-all approach, leads to fewer trips to the emergency room, fewer hospital admissions, and better blood pressure and glycemic control, a new study in The American Journal of Managed Care® (AJMC®) finds.

The study comes as health plans increasingly look for strategies, including health coaching, that can head off costly hospital visits or complications like kidney failure or strokes for patients with diabetes, heart disease, or other chronic conditions. Diabetes education and health coaching strategies take a variety of forms, from telephone coaching, to in-person classes, to digital programs that combine customized prompts with an online coach and support group.

The AJMC® study, led by Cindy Reistroffer, DSc, of Priority Health in Michigan, examined a group of 1520 patients in a commercial plan who received Coaching for Activation® (CFA), a tailored approach from Insignia Health designed to match coaching techniques with individual patients’ “knowledge, skills, confidence, and motivation.” Health measures, trips to the emergency room (ER), and hospitalizations were measured over a 19-month period, with results compared with 16,277 patients who received a more traditional care management program.

Results showed that the control group with traditional care management had 18.3% more trips to the ER and 97.8% more hospital admissions than the test group who had the combination of care management and customized coaching guided by CFA. The test group also had lower A1C levels and better systolic blood pressure. Medication adherence was not affected, but the authors write this may have been due to cost-sharing changes that increased immediate out-of-pocket costs for patients newly diagnosed with diabetes.

Significantly, the same care managers worked with both groups, the difference was the coaching method.

“The findings suggest that coaching interventions that are based on activation level may help care managers engage in more effective interactions that strengthen a patient’s role in managing his or her healthcare,” the authors write.

The authors suggest several areas for future research, including a study of whether Coaching for Activation would produce the same results among Medicare or Medicaid enrollees.

About The American Journal of Managed Care®:

The American Journal of Managed Care® (AJMC®) is a peer-reviewed, MEDLINE-indexed journal that keeps readers on the forefront of health policy by publishing research relevant to industry decision makers as they work to promote the efficient delivery of high-quality care. AJMC.com is the essential website for managed care professionals, distributing industry updates daily to leading stakeholders. Other titles in the AJMC® family include The American Journal of Accountable Care®, and two evidence-based series Evidence-Based Oncology and Evidence-Based Diabetes Management. These comprehensive offerings bring together stakeholder views from payers, providers, policymakers and other industry leaders in managed care. To order reprints of articles appearing in AJMC® publications, please contact Dr. Jeff Prescott at (609) 716-7777, x331.

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