Journal of General Internal Medicine

, Volume 25, Issue 10, pp 1071–1077 | Cite as

Experience with Health Coach-Mediated Physician Referral in an Employed Insured Population

  • Karen DonelanEmail author
  • Sowmya R. Rao
  • Robert S. Rogers
  • Johanna R. Mailhot
  • Robert Galvin
Original Research



Given increasing interest in helping consumers choose high-performing (higher quality, lower cost) physicians, one approach chosen by several large employers is to provide assistance in the form of a telephonic “health coach” — a registered nurse who assists with identifying appropriate and available providers.


To evaluate the health coach’s influence on provider choice and the quality of the user experience in the early introduction of this service.


Cross-sectional survey of 3490 employees and covered dependents of a large national firm that offered health coach services to all employees and covered dependents. The survey began in September 2007 with proportionate stratified sampling of 1750 employees and covered dependents who used the services between October 2007 and February 2008, and 1740 non-users.


Insured adults (ages 21–64) employed by a large national firm or covered dependents of employees.


Awareness of the service, reason for using service, visits to providers recommended by service, use of health advice provided by service, user satisfaction.


The primary reason for using the service was to obtain provider referrals (73%). Fifty-two percent of users sought a specialist referral, 33% a PCP referral and 9% a hospital referral. Eighty-nine percent of users seeking a provider referral were referred in-network; 81% of those referred visited the referred provider. Measures of satisfaction with both the service and the care delivered by recommended providers were over 70%.


Customers largely follow the provider recommendation of the health coach. Users express general satisfaction with existing health coach services, but differences in performance between vendors highlight the need for the services to be well implemented.


health coach physician referral physician performance data employee assistance program survey 



The authors acknowledge with gratitude the contributions of David Blumenthal MD, MPP (formerly of Massachusetts General Hospital), Angela Cafferillo, Margaret Damiano and Ginny Proestakes (General Electric), Roy Crowdis and Diane Downs (Medstat), Michael Chernew (Harvard Medical School) and Amy Schoenfeld (formerly at MGH).

Funding Sources

This research was funded in its entirety by General Electric through a contract with the Massachusetts General Hospital and the MGH Institute for Health Policy.


One of our authors, Robert Galvin, MD, is employed by General Electric, a sponsor of this research. No other author has any conflict of interest to disclose.

Prior presentation

Some data from this research project was presented at the Annual Research Meeting of AcademyHealth, Chicago, IL, June 28–30, 2009.

Supplementary material

11606_2010_1428_MOESM1_ESM.doc (22 kb)
ESM 1 (DOC 22 kb)


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Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Karen Donelan
    • 1
    Email author
  • Sowmya R. Rao
    • 1
    • 2
  • Robert S. Rogers
    • 1
  • Johanna R. Mailhot
    • 1
  • Robert Galvin
    • 3
  1. 1.Institute for Health PolicyMassachusetts General HospitalBostonUSA
  2. 2.Biostatistics CenterMassachusetts General HospitalBostonUSA
  3. 3.General Electric, Fairfield, CTYale School of MedicineNew HavenUSA

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