Lifestyle Management Coaching

This is an excellent program to offer Members who do not meet specific care plan criteria but could benefit from education and healthy behavior techniques.

Lifestyle Coaching provides continuous support for Members who recently graduated from a care plan by mitigating the risk for those with challenging lifestyle issues, offering continued education and support for chronic condition management and connecting them to trained coaches and clinicians for support.

CareFirst Members are identified for Lifestyle Coaching based on their unique health status, such as biometrics, claims data, health assessment, etc.

A Member may also be identified for Lifestyle Coaching upon care plan graduation from the Care Coordination Program. This program is ideal for Members not in a care plan or who have recently graduated from the care plan but continue to manage their chronic condition(s). Members can participate in lifestyle coaching while participating in TCCI and/or LCC/CCM/BHCC care plans.

If the Member has chronic conditions and is eligible to participate in disease management, the coach can address lifestyle behavior change with the Member as it relates to their conditions. Members must be 18 years or older to participate in Lifestyle Coaching.

Members may self-refer to the program by calling 877-260-3253 and pressing option #7.

The ideal referral is made once the Member is ready for graduation from their care plan. The Member and PCP should agree to Lifestyle Coaching before the referral is submitted which should be documented within the care coordinator's notes.

Best practices when making a service request hub referral: 

• Check Benefits (“CareFirst Wellness Benefit”) on Benefits Page in iCentric before making a referral.
• Advise the Member to expect a call.
• Current phone numbers are critical for telephonic outreach, as well as best day and time to call.
• Toll-free number should present on the caller ID (877-260-3253), however, we cannot control how the Member’s phone carrier chooses to represent the number within their system.

• Regularly scheduled coaching sessions,
• Calls every two weeks for the first three months and then once every month for the last three months, depending on Member need, preference and availability,
• For missed appointments, coaches will call Members at least once per week for up to six weeks to attempt to re-engage,
• Regular visits to the well-being plan to update action steps and access resources,
• Mailed educational materials in support of coaching call topics,
• Mailed introductory letter for targeted Members sent within one week,
• Coaching sessions which are individually tailored to meet the Members needs and goals,
• Proposed action steps which are Member-centric and appropriate for their stage of readiness, and Coaches tailor their approach to Member need and expectation, accommodating a variety of learning styles and personality types.

All coaching is offered Monday through Friday 8:30 a.m. to 8:30 p.m. Eastern time and Saturday 8:30 a.m. to 5:30 p.m. Eastern time.

After a service request has been sent to Sharecare, Inc., the Member will be called telephonically by their personal Lifestyle Coach. If a Member is identified for both Lifestyle Coaching and disease management coaching, due to the likelihood of the presence of multiple conditions, the disease management coach will provide both services to eliminate confusion.

Once the Member is enrolled in the program, the coach then contacts the Member and provides the designated coaching services within the context of the Member's care plan (if applicable). The Member should be contacted within three business days following the service request submission, with a minimum of three attempts at contact over 10 business days (unless documented refusal is in the system).

The WDM Program begins with an initial health assessment (RealAge® test) and biometric screening:

• A health assessment questionnaire is accessed by the Member through the Sharecare wellness platform and looks at eating, physical activity and sleep habits, along with family dynamics, behaviors and existing conditions to show the physical age of the body. These results arm Members with real-time information on how their lifestyle choices are helping them stay younger—or making them age faster—than their calendar age.
• A biometric screening takes place at the employer worksite (if applicable), through a visit to the Member's PCP or at a CVS MinuteClinic®. The screening includes basic measurements including weight, height, body mass index (BMI), cholesterol, blood pressure, nicotine, blood glucose levels and flu shot status. Tobacco status and flu shot information may not be available for certain populations depending on how the screening was conducted. When health screenings are performed at the Member’s worksite, screening results are automatically loaded into the Member health record in iCentric. If the Member completes a health screening through his/her PCP, the PCP completes the screening form and the Member manually enters the screening results into their health profile within their Sharecare wellness account.

The Initial phone interaction will consist of:

• Obtaining participation consent,
• Establishing defined goals,
• Discussing call frequency, and
• Reviewing duration of future coaching sessions.

Thereafter, depending on Member need, preference and availability, the Member will be called every two weeks for the first three months and then once every month for the last three months. After the initial six months of coaching, Members have the option of a one- to three-month extension, with one call per month during that extended coaching period (up to three months of additional coaching). On every call, Members will be asked to:

• Verify first name, last name, full mailing address, and date of birth.