Skip to main content
Top
Published in: Journal of General Internal Medicine 10/2010

01-10-2010 | Original Research

Experience with Health Coach-Mediated Physician Referral in an Employed Insured Population

Authors: Karen Donelan, ScD, Sowmya R. Rao, PhD, Robert S. Rogers, BA, Johanna R. Mailhot, MSc, Robert Galvin, MD

Published in: Journal of General Internal Medicine | Issue 10/2010

Login to get access

Abstract

BACKGROUND

Given increasing interest in helping consumers choose high-performing (higher quality, lower cost) physicians, one approach chosen by several large employers is to provide assistance in the form of a telephonic “health coach” — a registered nurse who assists with identifying appropriate and available providers.

OBJECTIVE

To evaluate the health coach’s influence on provider choice and the quality of the user experience in the early introduction of this service.

DESIGN

Cross-sectional survey of 3490 employees and covered dependents of a large national firm that offered health coach services to all employees and covered dependents. The survey began in September 2007 with proportionate stratified sampling of 1750 employees and covered dependents who used the services between October 2007 and February 2008, and 1740 non-users.

PARTICIPANTS

Insured adults (ages 21–64) employed by a large national firm or covered dependents of employees.

MEASUREMENTS

Awareness of the service, reason for using service, visits to providers recommended by service, use of health advice provided by service, user satisfaction.

MAIN RESULTS

The primary reason for using the service was to obtain provider referrals (73%). Fifty-two percent of users sought a specialist referral, 33% a PCP referral and 9% a hospital referral. Eighty-nine percent of users seeking a provider referral were referred in-network; 81% of those referred visited the referred provider. Measures of satisfaction with both the service and the care delivered by recommended providers were over 70%.

CONCLUSIONS

Customers largely follow the provider recommendation of the health coach. Users express general satisfaction with existing health coach services, but differences in performance between vendors highlight the need for the services to be well implemented.
Appendix
Available only for authorised users
Literature
1.
go back to reference Cherry DK, Hing E, Woodwell DA, Rechtseiner EA. National ambulatory medical care survey: 2006 summary. National Center for Health Statistics: National Health Statistics Report 6 Aug 2008; 3 (Table 7). Cherry DK, Hing E, Woodwell DA, Rechtseiner EA. National ambulatory medical care survey: 2006 summary. National Center for Health Statistics: National Health Statistics Report 6 Aug 2008; 3 (Table 7).
2.
go back to reference Blumenthal D. Employer-sponsored insurance - riding the health care tiger. N Engl J Med. 2006;355:195–202.CrossRefPubMed Blumenthal D. Employer-sponsored insurance - riding the health care tiger. N Engl J Med. 2006;355:195–202.CrossRefPubMed
4.
go back to reference Hibbard JH, Peters E, Slovic P, Finucane ML, Tusler M. Making health care quality reports easier to use. Joint Comm J Qual Patient Saf. 2001;27:591–604. Hibbard JH, Peters E, Slovic P, Finucane ML, Tusler M. Making health care quality reports easier to use. Joint Comm J Qual Patient Saf. 2001;27:591–604.
5.
go back to reference Schaufler HH, Mordavsky K. Consumer reports in health care: do they make a difference? Annu Rev Public Health. 2001;22:69–89.CrossRef Schaufler HH, Mordavsky K. Consumer reports in health care: do they make a difference? Annu Rev Public Health. 2001;22:69–89.CrossRef
6.
go back to reference Hibbard JH, Stockard J, Tusler M. Does publicizing hospital performance stimulate quality improvement efforts? Health Aff. 2003;22:84–94.CrossRef Hibbard JH, Stockard J, Tusler M. Does publicizing hospital performance stimulate quality improvement efforts? Health Aff. 2003;22:84–94.CrossRef
7.
go back to reference Hibbard JH, Stockard J. TuslerM. Hospital performance reports: impact on quality, market share, and reputation. Health Aff. 2005;24:1150–60.CrossRef Hibbard JH, Stockard J. TuslerM. Hospital performance reports: impact on quality, market share, and reputation. Health Aff. 2005;24:1150–60.CrossRef
8.
go back to reference Hibbard JH, Harris-Kojetin L, Mullin P, Lubalin J, Garfinkel S. Increasing the impact of health plan report cards by addressing consumers' concerns. Health Aff. 2000;19:138–43.CrossRef Hibbard JH, Harris-Kojetin L, Mullin P, Lubalin J, Garfinkel S. Increasing the impact of health plan report cards by addressing consumers' concerns. Health Aff. 2000;19:138–43.CrossRef
9.
go back to reference Longo DR, Land G, Schramm W, Fraas J, Hoskins B, Howell V. Consumer reports in health care: do they make a difference in patient care. J Am Med Assoc. 1997;278:1579–84.CrossRef Longo DR, Land G, Schramm W, Fraas J, Hoskins B, Howell V. Consumer reports in health care: do they make a difference in patient care. J Am Med Assoc. 1997;278:1579–84.CrossRef
10.
go back to reference Abraham J. Employee awareness of provider quality information: the BHCAG experience. Research Practice; 2005. Abraham J. Employee awareness of provider quality information: the BHCAG experience. Research Practice; 2005.
11.
go back to reference Schneider E, Epstein A. Influence of cardiac surgery performance reports on referral practices and access to care: a survey of cardiovascular specialists' surgery. N Engl J Med. 1996;335:251–6.CrossRefPubMed Schneider E, Epstein A. Influence of cardiac surgery performance reports on referral practices and access to care: a survey of cardiovascular specialists' surgery. N Engl J Med. 1996;335:251–6.CrossRefPubMed
12.
go back to reference Schneider E, Epstein A. Use of public performance reports: a survey of patients undergoing cardiac surgery. J Am Med Assoc. 1998;279:1638–42.CrossRef Schneider E, Epstein A. Use of public performance reports: a survey of patients undergoing cardiac surgery. J Am Med Assoc. 1998;279:1638–42.CrossRef
14.
go back to reference Harris KM. How do patients choose physicians? evidence from a national survey of enrollees in employment-related health plans. Health Serv Res. 2003;38:711–32.CrossRefPubMed Harris KM. How do patients choose physicians? evidence from a national survey of enrollees in employment-related health plans. Health Serv Res. 2003;38:711–32.CrossRefPubMed
15.
go back to reference The Midwest Business Group on Health. Finding doctors in Chicago: a project to improve online physician directories. The Commonwealth Fund; Mar 2005. The Midwest Business Group on Health. Finding doctors in Chicago: a project to improve online physician directories. The Commonwealth Fund; Mar 2005.
16.
go back to reference Abraham J, Feldman R, Carlin C. Understanding employee awareness of health care quality information: how can employers benefit? Health Serv Res. 2004;39:1799–815.CrossRefPubMed Abraham J, Feldman R, Carlin C. Understanding employee awareness of health care quality information: how can employers benefit? Health Serv Res. 2004;39:1799–815.CrossRefPubMed
22.
go back to reference Rosen M, Liebowitz A. Health advocacy: saving time and money for employers and employees. Employee Benefits, Society of Financial Service Professionals; Aug 2004: 6–7. Rosen M, Liebowitz A. Health advocacy: saving time and money for employers and employees. Employee Benefits, Society of Financial Service Professionals; Aug 2004: 6–7.
23.
go back to reference Fronstin P, Collins SR. Findings from the 2007 EBRI/Commonwealth Fund consumerism in health survey. The Employee Benefit Research Institute and The Commonwealth Fund, March 2008. Fronstin P, Collins SR. Findings from the 2007 EBRI/Commonwealth Fund consumerism in health survey. The Employee Benefit Research Institute and The Commonwealth Fund, March 2008.
24.
go back to reference Chen LA, Santos S, Jandorf L, et al. A program to enhance completion of screening colonoscopy among urban minorities. Clin Gastroenterol Hepatol. 2008;6:443–50.CrossRefPubMed Chen LA, Santos S, Jandorf L, et al. A program to enhance completion of screening colonoscopy among urban minorities. Clin Gastroenterol Hepatol. 2008;6:443–50.CrossRefPubMed
25.
go back to reference Ferrante JM, Chen PH, Kim S. The Effect of patient navigation on time to diagnosis, anxiety, and satisfaction in urban minority women with abnormal mammograms: a randomized controlled trial. J Urban Health. 2008;85:114–24.CrossRefPubMed Ferrante JM, Chen PH, Kim S. The Effect of patient navigation on time to diagnosis, anxiety, and satisfaction in urban minority women with abnormal mammograms: a randomized controlled trial. J Urban Health. 2008;85:114–24.CrossRefPubMed
26.
go back to reference Freeman HP. A model patient navigation program. Oncology Issues Sep–Oct 2004: 44–46. Freeman HP. A model patient navigation program. Oncology Issues Sep–Oct 2004: 44–46.
27.
go back to reference Freeman HP. Patient navigation: a community based strategy to reduce cancer disparities. J Urban Health. 2006;83:139–41.CrossRefPubMed Freeman HP. Patient navigation: a community based strategy to reduce cancer disparities. J Urban Health. 2006;83:139–41.CrossRefPubMed
Metadata
Title
Experience with Health Coach-Mediated Physician Referral in an Employed Insured Population
Authors
Karen Donelan, ScD
Sowmya R. Rao, PhD
Robert S. Rogers, BA
Johanna R. Mailhot, MSc
Robert Galvin, MD
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 10/2010
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-010-1428-4

Other articles of this Issue 10/2010

Journal of General Internal Medicine 10/2010 Go to the issue

Clinical Practice: Clinical Images

Leriche Syndrome