Managing Chronic Conditions with an Idea Borrowed from South Africa

Some chronically ill patients in New York City are getting a different kind of house call. Trusted members of the community who are trained as health coaches visit patients at home to make sure they understand their medications and can advocate for themselves during their appointments.
Health coaches have been successful in South Africa by visiting areas where patients have limited access to healthcare and where mistrust of once-segregated clinics is widespread. In the United States, the model has gained traction in neighborhoods facing similar challenges. Organizations like Mount Sinai Health System in New York City have begun piloting health coach programs to evaluate their effectiveness. Early indicators show that patients with health coaches cost $600 less per month than those without, and coaches alerted doctors about urgent needs for half of participating patients.
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