title: Costs for a health coaching intervention for chronic care management.
abstract: Health coaches can help patients gain knowledge, skills, and confidence to manage their chronic conditions. Coaches may be particularly valuable in resource-poor settings, but they are not typically reimbursed by insurance, raising questions about their budgetary impact.
  
  
  
  The Health Coaching in Primary Care (HCPC) study was a randomized controlled trial that showed health coaches were effective at helping low-income patients improve control of their type 2 diabetes, hypertension, and/or hyperlipidemia at 12 months compared with usual care.
  
  
  
  We estimated the cost of employing 3 health coaches and mapped these costs to participants. We tested whether the added costs of the coaches were offset by any savings in healthcare utilization within 1 year. Healthcare utilization data were obtained from 5 sources. Multivariate models assessed differences in costs at 1 year controlling for baseline characteristics.
  
  
  
  Coaches worked an average of 9 hours with each participant over the length of the study. On average, the health coach intervention cost $483 per participant per year. The average healthcare costs for the coaching group was $3207 compared with $3276 for the control group (P = .90). There was no evidence that the coaching intervention saved money at 1 year.
  
  
  
  Health coaches have been shown to improve clinical outcomes related to chronic disease management. We found that employing health coaches adds an additional cost of $483 per patient per year. The data do not suggest that health coaches pay for themselves by reducing healthcare utilization in the first year.
authors.affiliation: 795 Willow Rd (152-MPD), Menlo Park, CA 94025. E-mail: twagner@stanford.edu.
authors.forename: Todd H
authors.initials: TH
authors.lastname: Wagner
authors.forename: Rachel
authors.initials: R
authors.lastname: Willard-Grace
authors.forename: Ellen
authors.initials: E
authors.lastname: Chen
authors.forename: Thomas
authors.initials: T
authors.lastname: Bodenheimer
authors.forename: David H
authors.initials: DH
authors.lastname: Thom
mesh_terms: D002908:Chronic Disease / Q000191:economics / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D005260:Female; D017048:Health Care Costs; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D006973:Hypertension / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D008297:Male; D000071252:Mentoring / Q000191:economics* / Q000458:organization & administration; D017063:Outcome Assessment, Health Care; D011203:Poverty; D011320:Primary Health Care / Q000191:economics* / Q000458:organization & administration; D000073278:Self-Management / Q000191:economics* / Q000193:education*; D014481:United States