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Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
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The person's health status fluctuates continually, varying from being in good health to becoming ill and returning to being healthy. To understand the concept of illness prevention, there are two models. First, the health-illness continuum model is a graphic representation of an individual's wellness. It states that a person is considered healthy in the absence of physical disease and the presence of good emotional health.
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Health & Wellness Coaching Services: Making the Case for Reimbursement.

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Health and Wellness Coaching (HWC) services are now temporarily on the 2024 Medicare Telehealth list. This achievement resulted from a collaborative advocacy effort targeting key U.S. healthcare policymakers.

Keywords:
advocacydelivery of health carehealth and wellness coachinghealth care costshealth policyhealth promotionhealthcare reimbursement

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Area of Science:

  • Healthcare Policy
  • Health Services Research
  • Behavioral Health

Background:

  • A consortium led by the National Board for Health and Wellness Coaching (NBHWC) formed in 2020 to advocate for Health and Wellness Coaching (HWC) reimbursement.
  • The NBHWC and Veterans Health Administration (VHA) collaborated in 2023 to engage reimbursement policymakers.

Purpose of the Study:

  • To detail the advocacy efforts for HWC reimbursement.
  • To provide a framework for stakeholders to support HWC reimbursement advocacy.

Main Methods:

  • Formation of a multi-stakeholder consortium.
  • Targeted engagement with influential reimbursement policymakers, including the AMA's CPT® Panel and CMS.
  • Documenting the advocacy process and outcomes.

Main Results:

  • Centers for Medicare & Medicaid Services (CMS) announced the temporary inclusion of HWC services on the 2024 Medicare Telehealth list.
  • Successful advocacy led to a significant policy change recognizing HWC services.

Conclusions:

  • The advocacy initiative represents a major advancement in healthcare policy for HWC.
  • A shared understanding of the advocacy framework is crucial for broader participation and continued success in securing reimbursement.