Employee wellness coaching as an interpersonal communication intervention: exploring intervention effects on healthcare costs, risks, and behaviors

In order to address the rise in healthcare expenditures, employers are turning to wellness programs as a means to potentially curtail costs. One newly implemented program is wellness coaching, which takes a communicative and holistic approach to helping others make improvements to their health. Wellness coaching is a behavioral health intervention whereby coaches work with clients to help them attain wellness-promoting goals in order to change lifestyle-related behaviors across a range of areas. Given the limited amount of research on wellness coaching, this project had four main purposes in order to fill gaps in the literature: to (1) identify whether wellness coaching interventions have an impact on client healthcare outcomes, (2) apply confirmation theory to this context in order to provide an explanatory framework to better understand the communication mechanisms that underlie this intervention, (3) identify the various topics that are discussed during wellness coaching sessions, and (4) test the extent to which a wellness coaching intervention should be targeted to specific clients. To examine these questions, a large employee wellness coaching program was evaluated, which serviced a population of over 14,000 employer insured individuals from several local employers of which almost 500 specifically attended wellness coaching sessions. Secondary data linking the use of coaching services with health claims information such as healthcare costs, risks and behaviors for all employees and their covered dependents were analyzed. By utilizing a statistical tool called propensity scoring, coached participants were matched with noncoached participants on key characteristics in order to create a meaningful comparison group to test treatment effects. Evidence demonstrates that participation in wellness coaching is associated with higher levels of healthcare costs and utilization, which is mediated by increased indicators of patient engagement. Results suggest that initial healthcare costs associated with improved patient engagement with healthcare providers decreases over time. These results are consistent with other research on wellness interventions that find that initial costs show a return on investment over time. These results also support previous research on confirmation theory, indicating that the scope of this theory may be broader than contexts previously studied. Analysis of participant wellness goals reveal that a range of issues are discussed during coaching sessions including physical health and mental, relational and financial/professional wellbeing. Finally, results suggest that this communicative intervention shows comparably broad impact across a range of client characteristics but may work particularly well for clients with chronic disease management goals, weight management goals, and mental wellbeing goals. Clients with multiple wellness goals also showed stronger results than those with fewer wellness goals. Those with smoking cessation goals were the only group that showed results in the opposite direction. The results of this project have theoretical, practical and methodological implications and suggest several areas for future research