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Increasingly, health coaches are the designated hitters for health plan and employer health management teams reaching out to individuals with identified risk behaviors. Tapping health coaches to empower at-risk individuals to adopt healthier lifestyles via telephonic, Web-based or other coaching support is scoring improved outcomes and reduced healthcare costs. However, launching an effective and sustainable health coaching initiative requires planning, training, education and evaluation on the part of healthcare organizations not to mention creative use of incentives This report is based on two conferences on the role of health coaching in disease management and population health management, as well as a 2008 update from two Mayo Clinic thought leaders on the shift in focus of Mayo's health coaching initiatives, its increasing integration of Web 2.0 technologies and innovative use of incentives to encourage repeat and long-term participation. PLUS get a bonus interview with Mayo clinical health psychologist Dr. Kristin Vickers Douglas on the merits of motivational interviewing in health coaching, including its value in the coaching of individuals with multiple health risks or chronic illness.