Health Coaching – An Emerging Trend

Health coaching is the use of evidence-based, skillful conversation, clinical strategies, and interventions to actively and safely engage clients in changing their health behavior to better manage their health, health risks, and acute or chronic conditions. This leads to optimal wellness, improved health outcomes, lowered health risk, and lower costs for healthcare. The work of health coaches can be considered to be falling into two overlapping categories: Management and Prevention. A health coach is neither a therapist nor a doctor, which is important to note. Fully certified health coaches, however, have completed one of the demanding training courses recognized by the National Board of Health and Wellness Coaches (NBHWC) and have since passed a board certification exam. Insurance companies are now more open to and willing to cover clients' work with board-certified health coaches than ever before as a result of the removal of regulatory barriers and the increased use of telehealth. The foundation of health and wellness coaching is an evidence-based principle: Behavior change is activated and maintained when it is internally driven. Certified professional health coaches can help ethnic/racial minorities generally reduce their chance of developing chronic diseases, promoting population health by enhancing their ability to withstand future infectious epidemics. As per Piramal Health Coach by July 2021 there were over 5000 National Board-Certified Health & Wellness Coaches and 80+ NBWC training programs.

Health Coaching Types and Specialties:

Health Coaching is a highly specialized sector of the digital health market that can take many forms like group coaching, inpidual coaching and offline and online coaching.

Group Coaching Vs Inpidual Coaching

Group Coaching: Group coaching is typically suited to a group of two or more people and is frequently sought by corporate clients for their staff. It can also be made available to people who would not be able to afford one-on-one tutoring as a cost-effective alternative.

Inpidual Coaching: Inpidual coaching is a good option for people who might want their Health Coach to provide them with more inpidualized assistance, attention, or guidance. People with special requirements, such as those with a chronic ailment or highly particular goals, may choose this strategy.

Online Vs Offline:

Although health coaching began with face-to-face contact, current technological improvements have made it possible for both the coach and the client to have an online encounter enhancing the digital health market. The virtual format's capacity to transcend physical boundaries and expand access to coaching services, particularly in rural regions, is just one of its many advantages. There is numerous specialist Health Coaching expertise in this expanding business, including a commitment to developing highly customized programs to enhance the lives of their customers.

Specialties:

1. Preventive:

Preventive specialties include but are not limited to:

Preventive health is important in order to prevent cancer, obesity, diabetes, and many other non-communicable Disease. Health coaches play a vital role in preventive health care. While doctors are now unfortunately neck-deep in treating patients with existing illnesses and tasked with minimizing the most significant life-risk factors, Health Coaches are at the forefront of preventative health care. In rural areas, especially, community health professionals play a crucial role in providing people with health care that are culturally appropriate. People with disabilities or the elderly can stay in their homes for a longer period of time owing to the assistance of home health aides. Similar to that, health coaches can help people start and maintain healthier lifestyles by offering them tailored support.

The term "health coaching" refers to a wide range of services, such as but not limited to:

• Movement coaching: Personal training or online coaching to hone movement techniques and impart skills are relevant to the inpidual, building life strength and resilience to easily handle daily or performance demands.
• Programming: Monthly training prescriptions and recommendations tailored to each client that includes all facets of their mobility, including daily self-care, conditioning, gym work, and recovery.
• Nutrition Coaching: Dietary advice and habit formation based on the demands and lifestyle of the inpidual.
• Lifestyle coaching: Advice on rest, stress reduction, breathing exercises, self-care, hydration, recuperation techniques, and more.

2. Symptom and Disease Management:

Symptom and Disease Management specialties include but are not limited to:

Health coaching is an effective method for controlling chronic conditions. It is becoming more widely recognized as a successful strategy for influencing and supporting sustained behavioral changes in people with chronic illnesses, particularly those that are complex, like diabetes or addiction. Through illness information and ongoing support, a health coach may be the advocate patients and doctors need to enable people to take charge of their own health. As potent as the patient-coach relationship may be, the digital health market has the potential to enhance it and improve inpidualized care. Technology is now being used by many businesses to expand the reach of health coaching and provide its advantages to more people with chronic diseases.

Failure to control chronic conditions can exacerbate the condition, lead to the emergence of new conditions, cause treatment to fail, and raise the risk of mortality. According to the Centers for Disease Control and Prevention, medication non-adherence accounts for up to 125,000 fatalities annually and 30% to 50% of treatment failures. 

Benefits of receiving health coaching include:

• Support for self-management, including instruction in illness-specific skills, the promotion of healthy lifestyle modifications, and healthy behavior promotion.
• Disease-specific information, including answers to any queries one may have on their condition, drugs, and other treatments.
• Helping one to find and use alternative medical treatments, as well as assisting in navigating the healthcare system.
• Emotional assistance might assist the person in adjusting to the psychological effects of chronic illness, alcohol addiction & smoking cessation.

Health Disorders Due to Alcohol Use in the U.S., 2022 (%)

Source: National Center for Drug Abuse Statistics

Note: Here, adolescents are defined as any person between ages 10 and 19 irrespective of gender, and above 19 data is split into men and women.

Causes of Alcohol-Related Deaths, 2022 (%)

Source: National Center for Drug Abuse Statistics

Alcohol Use Disorder Diagnoses Among Age Groups, 2020

Source: National Center for Drug Abuse Statistics

Note: AUD - Alcohol Use Disorder

COVID-19 Impact on Health Coaching:

The area of health coaching is witnessing an unheard-of boom, in part owing to the epidemic, which has increased focus and scrutiny on all aspects of health and wellness. As per CNBC publications of LinkedIn, it was found that the need for healthcare support workers, which includes health coaches, has increased significantly by 34% just since 2019. As of early last year, the market for health coaching services was estimated to be worth $7 billion and still expanding. The Bureau of Labor Statistics reports that this need isn't going anywhere any time soon. The employment outlook for those working in the field of health education is expected to increase by 17% between 2020 and 2030. Mental distress during and post the pandemic has resulted in high rates of mental illness and substance use and the role of health coaches in these scenarios has been inevitable.

Share of Adults Reporting Symptoms of Anxiety and/or Depressive Disorder During the Covid-19 Pandemic, 2020 (%)

Source: U.S. Census Bureau, Household Pulse Survey

Note: Percentages provided above are from the total adult population (18+)

Share of Adults Reporting Symptoms of Anxiety and/or Depressive Disorder During the Covid-19 Pandemic, By Age, 2020 (%)

Source: U.S. Census Bureau, Household Pulse Survey

Note: Percentages provided above are from the total population in respective age groups.

The Need for Health Coaching:

According to Global Wellness Summit, despite the of spending $8.3 trillion on healthcare annually and $4.4 trillion on wellness, we are still unable to stop the spread of chronic diseases. The most difficult problem to solve is behavior change. The fact that coaches who have been specially trained to assist people in changing their behaviors for the better haven't been at the forefront of everything, is therefore the most perplexing aspect of both healthcare and wellness. According to Sage Journals publications in August 2021, as co-morbidities and other chronic illnesses associated with COVID-19 deteriorate owing to dual factors, adding the help of professional health coaches to create trust, give more access to address vaccine reluctance, and dispel myths is an effective means of enhancing health and wellness. For decreasing the burden of chronic disease and addressing social determinants of health (SDoH), group coaching and one-on-one coaching can be used in conjunction with public health programs. 

Risk Factors and Coaching Strategies

Percentage of People Suffering from Diabetes Around the World, 2021 

Source: International Diabetes Federation (IDF)

Average Number Of Daily Deaths In The United States From Leading Causes, 2021

Source: KFF analysis of CDC mortality and KFF COVID-19 Tracker data

The Growing Demand for Health Coaching:

As per YourCoach, Healthcare expenses for treating obesity, autoimmunity, diabetes, cardiovascular disease, and other illnesses are anticipated to reach $47 trillion by 2030 on a global scale. It is obvious that there is a greater need than ever for health coaches. By 2025, the current primary care physician deficit is anticipated to worsen. Moreover, according to Annals of Family Medicine, in order to deal with population increase, aging populations, and insurance expansion, we would require an additional 50,000 primary care physicians. For instance, according to millions of survey findings collected by habits expert and author of The Four Tendencies, Gretchen Rubin, Obliger personality types account for roughly 40% of the population and thrive on external accountability since they struggle to self-motivate. Coaching raises a client's perception of their own efficacy, which spurs action. The perceived competence of clients in relation to their health behaviors can be increased by health professionals and one-on-one treatments like health coaching are particularly helpful, according to a 2019 meta-analysis of motivating strategies for health behavior change.

• Rigorous training and certification programs are in place and growing worldwide.

The National Board for Health & Wellness Coaching (NBHWC) is the most important organization in the United States and growing throughout the world. So that these coaches can be incorporated into therapeutic settings, they have established standardized training criteria. Training programs are expanding quickly as a result of the high demand for coaches, as an example, the Institute for Integrative Nutrition (155,000 graduates from 175 countries) recently introduced the next generation of its training program, which includes new faculty who are subject matter experts, an expanded curriculum and a new virtual learning platform.

• New primary care start-ups and public health initiatives are making the coach as central as the doctor.

The trend describes how primary care start-ups like Vera Whole Health, Parsley Health, Firefly Health, and Lora Health as well as public health initiatives like the ambitious new "Personalized Care" plan of the United Kingdom National Health Service are pioneering new "care team" models where integrated teams of doctors, nurses and HWCs deliver "whole-person" care. More doctors now argue that these coaches need to be central to all primary care. 

• "Personalized health coaching" is at the forefront of the onslaught of new digital health platforms. 

The trend looks at how a flurry of digital health market are now concentrating on behavior change, from virtual solutions for managing chronic conditions, like Lark Health or Virta, to platforms for behavioral psychology-based weight loss, like Noom and Optavia, to mental wellness and coaching apps for employees, like BetterUp. Through the partial or complete automation of the coaching process, these platforms hope to revolutionize behavior modification. 

Impact on Health Improvement Based on the Provision of Coaching, 2022

Source: Nudge Coach

Impact on Medical Cost Based on Provision of Coaching, 2022 

Source: Nudge Coach

• More insurance providers are beginning to pay for coaching, (from United Healthcare to Aetna)

The American Medical Association in the U.S. has the necessary coverage codes in place, all they need to do is be activated. The U.S. Department of Veterans Affairs has been actively monitoring the use of these codes to determine the efficacy of this coaching and to compile data for insurance reimbursement. A project to track HWC use data has just been unveiled by the NBHWC and the University of California San Diego to support the AMA's request for complete insurance coverage. There might soon be covered. 

New Trends in Health Coaching:

• Wearables: As smartwatches, fitness trackers, movement-focused phone apps and similar products gain popularity in the digital health market, health coaches will be able to read and understand the data produced by these gadgets. Clients have the option to participate in programs that give health coaches access to data from their wearables, so that the coaches can get in touch with them when data point to a problem, such as when a client's wearable device indicates that they haven't slept in two nights or are experiencing blood pressure spikes.
• FitBit and other health tracker websites provide a membership option that enables users to work one-on-one with specialized health coaches and also fuel digital health market growth. Coaches collaborate with customers to develop inpidualized strategies that meet their lives and needs using data gathered from the app. 
• Moreover, according to the website, YourCoach is a practice management platform that links clients with all various kinds of licensed health coaches working in the gig economy. By the year 2030, they hope to make health coaching available to 8.5 billion people worldwide.
• In order to promote free coaching and have a greater social influence on the world, the International Coaching Federation (ICF) and ManyHopes.org jointly launched the Ignite Initiative. ICF Foundation believes that via expert coaching, social system change organizations can become more effective on a worldwide scale. The Foundation collaborates with groups to work toward constructive, long-lasting social change, with the goal of achieving one of the Sustainable Development Goals of the United Nations for 2030. 
• According to a recent patent from Apple in January 2021, the company is experimenting to include health coaches in its upcoming Health+ subscription service for iOS devices boosting the digital health market. According to a patent (20210020316) granted on January 22, 2021, Apple is looking into new user interfaces that will motivate people to take an increased interest in their health without placing an undue cognitive strain on them and enable the business to offer high-quality health coaching.

Recent Developments in the Industry: 

Limitations of Health Coaching:

Working with a Health Coach is way too expensive which is one of the big issues for most clients. A typical coach will charge between $200 and $500 a month, plus a free initial consultation to "hook" the client.

Some Examples of health coaching packages are:

Coach 1: $199/month plus $99 for an initial consultation

Coach 2: $50 to 120 per week, based on the offer, or $200 to 480 each month

Coach 3: charges $300 monthly for a six-month commitment.

The average coach offers two sessions each month, lasting between 45 and 60 minutes. New coaches typically charge between $50 and $75 for each session. Coaches with more experience bill between $100 and $200 every session. There is a wide range of prices as some coaches also charge by the package ($1,200 - $2,400). However, due to a lack of awareness, people who are more likely to have health issues spend more time and money on frequent doctor visits. Consequently, healthcare expenses go up. Personalized coaching for health and wellness supports a person's transformation into a healthier and more conscious version of themselves. According to NCBI, for those who signed up for high-risk plans, health coaching has resulted in a considerable decrease in outpatient and overall costs. To determine the cost-effectiveness of health coaching in certain populations, further research examining both health outcomes and claims data are required.

Conclusion:

Certified professional health coaches can help behavior change and mindset shifts toward healthier choices and activities by building supportive coaching relationships with people and families who are most at risk. The client-focused, non-directive, encouraging and empathic coaching conversation may prove to be a successful strategy for helping people deal with the anxiety of protracted social isolation, the perplexing condition of long-haul COVID, addictions, and vaccine hesitancy. Also, it is not surprising that studies have consistently shown that coaching interventions improve health outcomes for several chronic diseases including diabetes, obesity, heart disease, and cancer and this is not a small effect. Therefore, as the paradigm of healthcare’s response to chronic diseases endures to shift, the doors are swinging wide open for the health coaches for gaining opportunities to integrate into wellness teams. The meteoric intensification of telehealth is accelerating prospects for health coaching to be delivered virtually and in turn rising current and future opportunities for the industry. 

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