1129His­tor­i­cal­ly, employ­ers have uti­lized health risk assess­ments (HRAs) as one mea­sure­ment tool in well­ness pro­gram design. The main goals of an HRA are to assess indi­vid­ual health sta­tus and risk and pro­vide feed­back to par­tic­i­pants on how to man­age risk. Employ­ers have tra­di­tion­al­ly relied on this type of assess­ment to eval­u­ate the over­all health risk of their pop­u­la­tion in order to devel­op appro­pri­ate well­ness strategies.

Recent­ly, there has been a shift away from the use of HRAs. Accord­ing to the 2016 UBA Health Plan Sur­vey, there has been a 4 per­cent decline in the per­cent­age of employ­er well­ness pro­grams using HRAs. In con­trast, the per­cent­age of well­ness pro­grams offer­ing bio­met­ric screens or phys­i­cal exams remains unchanged – 68 per­cent of plans where employ­ers pro­vide well­ness offer a phys­i­cal exam or bio­met­ric screening.

One expla­na­tion for this shift away from HRAs is an increased focus on help­ing employ­ees improve or main­tain their health sta­tus through out­come-based well­ness pro­grams, which often require quan­tifi­able and objec­tive data. The main issue with an HRA is that it relies on self-report­ed data, which may not give an accu­rate pic­ture of indi­vid­ual or pop­u­la­tion health due to the fact that peo­ple tend to be more opti­mistic or biased when think­ing about their own health risk. A bio­met­ric screen­ing or phys­i­cal exam, on the oth­er hand, allows for the col­lec­tion of real-time, objec­tive data at both the indi­vid­ual and pop­u­la­tion level.

Includ­ing a bio­met­ric screen­ing or phys­i­cal exam as part of a com­pre­hen­sive well­ness pro­gram can be ben­e­fi­cial for both the employ­er and employ­ees. Through a bio­met­ric screen­ing or phys­i­cal exam, key health indi­ca­tors relat­ed to chron­ic dis­ease can be mea­sured and tracked over time, includ­ing blood pres­sure, cho­les­terol lev­els, blood sug­ar, hemo­glo­bin, or body mass index (BMI). For employ­ees, this type of data can pro­vide real insight into cur­rent or poten­tial health risks and pro­vide moti­va­tion to engage in pro­grams or resources avail­able through the well­ness pro­gram. Beyond that, aggre­gate data col­lect­ed from these types of screen­ings can help employ­ers make informed deci­sions about the type of well­ness pro­grams that will pro­vide the great­est val­ue to their com­pa­ny, both from a pop­u­la­tion health and finan­cial perspective.

One suc­cess sto­ry of includ­ing a phys­i­cal exam as part of a well­ness pro­gram comes from one of our small man­u­fac­tur­ing clients. From the ini­tial pop­u­la­tion health report, the com­pa­ny learned that there was a large per­cent­age of its pop­u­la­tion with lit­tle to no health data, result­ing in the inabil­i­ty to assign a risk score to those indi­vid­u­als. It is impor­tant to note that when a pop­u­la­tion is not uti­liz­ing health care, it can result in late-stage diag­noses, result­ing in greater costs and a bur­den for both the employ­ee and employ­er. In addi­tion, there was low phys­i­cal com­pli­ance and a high per­cent­age of adults with no pri­ma­ry care provider. In order to cap­ture more infor­ma­tion on its pop­u­la­tion and bet­ter under­stand the cur­rent health risks, the com­pa­ny shift­ed its well­ness plan to include annu­al phys­i­cals as a method for col­lect­ing bio­met­ric data for the 2016 ben­e­fit year. Employ­ees and spous­es cov­ered on the plan were required to com­plete an annu­al phys­i­cal and sub­mit bio­met­ric data in order to earn addi­tion­al incen­tive dollars.

By includ­ing annu­al phys­i­cals in its well­ness pro­gram, pos­i­tive results were seen for employ­ees and spous­es and the com­pa­ny was able to make an informed deci­sion about next steps for its well­ness pro­gram. After the first phys­i­cal col­lec­tion peri­od, the per­cent­age of indi­vid­u­als with lit­tle to no infor­ma­tion was reduced from 31 per­cent to 16 per­cent (Fig­ure A). Annu­al phys­i­cal com­pli­ance increased from 36 per­cent in 2015 to over 80 per­cent in 2016 (Fig­ure B), which means more indi­vid­u­als were see­ing a pri­ma­ry care provider. As a result of increased bio­met­ric data col­lec­tion and one year of Vital Incite report­ing, the com­pa­ny was able to deter­mine next steps, which includ­ed address­ing chron­ic con­di­tion man­age­ment, specif­i­cal­ly hyper­ten­sion and dia­betes, with health coach­ing or a dis­ease man­age­ment nurse.

Fig­ure A – RUB Dis­tri­b­u­tion 2014 — 2016

RUB Distribution 2014-2016

Fig­ure B – Pre­ven­tive Screen­ing Compliance

Preventive Screening Compliance

Employ­ers that are still inter­est­ed in col­lect­ing addi­tion­al infor­ma­tion from employ­ees may con­sid­er includ­ing alter­na­tives to the HRA, such as cul­ture or sat­is­fac­tion sur­veys. These tools can allow employ­ers the oppor­tu­ni­ty to eval­u­ate pro­gram engage­ment and fur­ther under­stand the needs and wants of their employ­ee population.

 

Orig­i­nal­ly pub­lished by Unit­ed Ben­e­fit Advi­sors — Read More