Managing chronic conditions well requires more than just periodic medical visits. For people living with diabetes, hypertension, heart disease, and other chronic conditions, daily behaviors play an important role in long-term health. Health coaching can complement primary care by providing consistent support between visits, helping patients establish goals, address barriers, and maintain healthy behaviors over time.
Chronic conditions are a significant health and economic challenge in the United States. Approximately 3 in 4 American adults have at least one chronic condition, and more than half of those have two or more. Chronic diseases are also among the leading drivers of healthcare costs in the United States. The CDC reports that 90% of the nation's $5.3 trillion in annual healthcare expenditures are associated with people with chronic and mental health conditions.
Conditions such as diabetes, hypertension, heart disease, and high cholesterol often require ongoing attention to diet, physical activity, medication adherence, and other health behaviors that occur every day. These behaviors require daily commitment and cannot be addressed fully during a periodic medical appointment. Research supports ongoing behavioral support for people at increased cardiovascular risk. Effective interventions often include multiple contacts over several months.
Primary care is essential to chronic condition management. Primary care providers diagnose conditions, monitor health trends, manage medications, order testing, and establish treatment plans. The challenge comes when much of a treatment plan must be carried out between appointments. Patients may understand what they need to do, but still face barriers to making lasting changes. Motivation may decline. Daily demands can interfere with healthy routines. Progress can also be difficult to maintain without regular support.
Health coaching extends the care team beyond the clinical visit. A health coach provides ongoing support that helps patients apply clinical recommendations in their daily lives. The goal is not to replace primary care, but to strengthen the support surrounding it.
Health coaching is a structured approach that helps patients identify health goals and develop practical strategies to achieve them. Coaching can be provided in person or through virtual and telephone-based models.
A health coach may help patients:
The value of coaching is its continuity. Rather than setting a goal only during a medical appointment, patients have an ongoing resource to help them make adjustments and maintain progress.
Research supports health coaching as a useful component of chronic disease management. A systematic review of 13 studies found positive effects across physiological, behavioral, and psychological outcomes, including weight management, physical activity, and overall physical and mental health.
Evidence is particularly relevant for type 2 diabetes. A 2023 systematic review of nine randomized controlled trials found that health coaching was associated with a statistically significant reduction in A1C, with an average reduction of 0.24 percentage points. It also found smaller improvements in body weight, BMI, waist circumference, and diabetes-related distress. Research also suggests that the structure of an intervention matters. Effective behavioral programs tend to use repeated contacts over time rather than relying on a single educational interaction.
For employers and benefits leaders, health coaching can extend the value of an onsite or near-site clinic. It gives patients access to continued support without placing every aspect of behavior change on the primary care provider.
This approach also supports a more proactive model of care. Chronic conditions are major contributors to healthcare spending, and many are influenced by modifiable health behaviors. Providing support before risk factors progress can help organizations take a more preventive approach to population health.
Health coaching is not a replacement for primary care. It is an extension of the care team. By connecting clinical guidance with ongoing behavioral support, organizations can create a more continuous approach to chronic condition management. For employers investing in onsite and near-site care, health coaching offers a scalable way to help employees make meaningful health changes while strengthening the overall care model.
References:
Almulhim, A. N., Hartley, H., Norman, P., Caton, S. J., Doğru, O. C., & Goyder, E. (2023). Behavioural change techniques in health coaching-based interventions for type 2 diabetes: A systematic review and meta-analysis. BMC Public Health, 23, 95. https://doi.org/10.1186/s12889-022-14874-3
Centers for Disease Control and Prevention. (2026, May 14). About chronic diseases. https://www.cdc.gov/chronic-disease/about/
Centers for Disease Control and Prevention. (2026, May 26). Fast facts: Health and economic costs of chronic conditions. https://www.cdc.gov/chronic-disease/data-research/facts-stats/
Kivelä, K., Elo, S., Kyngäs, H., & Kääriäinen, M. (2014). The effects of health coaching on adult patients with chronic diseases: A systematic review. Patient Education and Counseling, 97(2), 147–157. https://doi.org/10.1016/j.pec.2014.07.026
Sherifali, D., Brozic, A., Aguiar, M., Perl, S., Ploeg, J., & Ali, M. U. (2023). Diabetes health coach in individuals with type 2 diabetes: A systematic review and meta-analysis of quadruple aim outcomes. Frontiers in Endocrinology, 13, 1069401. https://doi.org/10.3389/fendo.2022.1069401
U.S. Preventive Services Task Force. (2020). Behavioral counseling interventions for healthy diet and physical activity in adults with cardiovascular risk factors. JAMA, 324(20), 2069–2075. https://doi.org/10.1001/jama.2020.21749
Wolever, R. Q., Dreusicke, M., Fikkan, J., Hawkins, T. V., Yeung, S., Wakefield, J., Duda, L., Flowers, P., Cook, C., & Skinner, E. (2010). Integrative health coaching for patients with type 2 diabetes: A randomized clinical trial. The Diabetes Educator, 36(4), 629–639. https://doi.org/10.1177/0145721710371523