Medicare Announces Policy Changes to Pay Health Coaches For The First Time
This month the Centers for Medicare & Medicaid Services (CMS) announced policy changes for Medicare payments that are expected to take effect on or after January 1, 2024. This announcement includes an expansion of billable services on a trial basis to include health and wellness coaching services. Previously excluded, health and wellness coaching services, critical to preventative health, are now included in the Medicare reimbursement list for telehealth.
These new rules "reflect a broader Administration-wide strategy to create a more equitable health care system that results in better access to care, quality, affordability, and innovation," according to the CMS website.
Hundreds of thousands of health and wellness coaches are certified each year. They stand to benefit as these policy changes open up new career pathway opportunities within, and adjacent to, the American healthcare system.
If enacted, Medicare’s ruling could good news for Flowell, a Salt Lake City, Utah-based SaaS education app supporting communities of health, fitness, nutrition and wellness coaches, as covered recently by TechBuzz News.
As an advocate and technology provider for health coaches, Flowell welcomes the news of this CMS policy change, says its CEO, Taylor Stull, who said this substantial policy change was not certain when we initially interviewed him two months ago.
"With this policy change, board-certified health and wellness coaches now have a more tangible pathway to be reimbursed by insurance," said Stull. "We expect growth in the number of health coaches being certified each year, as the broader market of fitness professionals grows aware of new financial opportunities the health coaching profession offers.”
“Health coaches can change the narrative in the story of American community health,” said Stull. “Out of the one billion appointments with physicians in the US, 50% of them are primary care visits. A significant portion of these costly appointments can be avoided if patients are properly educated to self-manage and navigate the continuum of care. This is the responsibility of a health coach."
Flowell's membership-based SaaS platform helps health and wellness coaches find and keep clients, so they can grow their private practice, or gain experience to get a job. Their platform offers business courses, coaching and professional community with the tools coaches need to start and grow their business. Flowell aims to help coaches find success in their career, which in turn, can improve family and community health for millions of Americans.
Six in ten Americans have a chronic disease—120 million people. The American healthcare system operates to resolve symptoms and carry out episodic care. Medicare’s policy change positions health coaches to drive new cost savings.
Stull continued, "Broadly speaking, I see this move as an example of the federal government putting their money where their mouth is when it comes to preventative health and wellness. The health innovation community has known there’s enormous opportunity in addressing root causes of chronic disease, which 1 in 5 dollars health care dollars are spent to manage" said Stull. “We hope to play a small part in seeing this healthier future come to fruition by supporting health coaches as they enter a complex industry and start their career.”
Flowell recently received a $400,000 pre-seed investment from Startup Ignition Ventures to develop its eLearning and SaaS platform. In October 2023, it announced partnership with ISSA, the global leader in health, fitness, nutrition and wellness certification courses.