As a Health Coach, What Should My Average Caseload be?

By Melinda Huffman, BSN,MSN, CCNS, CHC, Co-Founder, NSHC

The answer, not surprisingly, is “It depends.”  Health coaching caseloads vary greatly. Consider these seven key factors to determine a reasonable health coaching caseload:

  • Type of coaching vehicle/avenue used: i.e., face-to-face, telephonic, virtual encounters via desktop or smart phone, email, and text.

Calls and face-to-face typically take longer than email and texts. However, millennials often prefer texts/messaging in the interest of “time.”

  • Type of coaching encounter:

(“Admission” versus “regularly scheduled” encounters) Admission and discharge encounters can take longer. Companies using telemonitoring or telehealth may have equipment set-up/supplies involved that require more time. While not health coaching per se; you may or may not count this encounter toward overall health coaching encounters when determining financial outcomes of coaching.

  • Employer’s average length of an encounter

Companies that offer specific healthcare guidance for management of diabetes or other chronic conditions may want to add health coaching services in addition to simply tracking client/patient diagnostic values with intermittent calls to say “hello”. These calls that use behavioral health interventions will take longer. How long? Twenty minutes, give or take, is a reasonable guide.

  • Type of health coaching interventions used

Some use behavioral health interventions while others simply provide health teaching and call it “health coaching”. While “health teaching” alone is not health coaching, health teaching can certainly be integrated into a health coaching encounter. Contact us for more details. 

  • Number of clients/patients who receive health coaching

Physician Offices and Outpatient Clinics: Some clients/patients will not desire or need health coaching. Some “specialty” clinics may have more patients receiving health coaching. Outcomes, both clinical and financial, should help identify the cost to benefit for these patient/client populations.

  • Number of health coaches per physician/nurse practitioner

Some organizations determine a health coaching caseload from the practitioner’s office/clinic caseload or wellness center visits/week or month. For starters, assuming that not all patients/clients need or want health coaching, look at the number of patients with chronic conditions and the outcomes that are being achieved for this subset of patients. Then determine which patients may benefit and offer to these.

Some early adopters started with a ratio of 1 health coach to 1 physician and increased that to 2 health coaches to 1 physician, resulting in the physician being able to see 2-3 more patients per day. This was determined to be financially substantive enough to pay for coaching by medical assistants, who would be under the supervision of the physician.

  • Business Growth

Based on budget, number of clients/patients served overall, number of staff, expected or planned growth, and patient/client population type.

Most who ask this question are interested in some type of benchmark by which to measure their own caseload. Our friends at the Healthcare Intelligence Network continue to provide noteworthy benchmarks for many items of interest to health coaches. Most recently their 2018 Healthcare Benchmarks: Health Coaching publication includes the following benchmarks for caseloads for different types of healthcare organizations that employ health coaches.

Telephonic coaching continues to be the most widely used method by managed care organizations. These of course are mostly large organizations with at or above 1000 employees.

Contact the NSHC for consulting services!

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