As health care costs have risen, employers have searched for ways to bring these costs under control. When cost shifting and plan redesigns did not bring about desired results, attention turned to ways to engage employees more actively in managing their health. Health risk appraisals (HRAs) are considered by many to be the first step in engaging employees in their health management.
An HRA is a tool for gathering information on various aspects of one’s health and gauging appropriate interventions and follow-up care. An HRA usually consists of a questionnaire, frequently completed online through the health insurer’s or wellness program provider’s Web site, that gathers information on various health aspects: weight/body mass index, nutrition, exercise habits, lifestyle, personal and family medical history, etc. The HRA might be in conjunction with screenings for blood pressure, cholesterol and blood sugar levels. The HRA provides feedback to the employee on health status and suggestions on how to improve. These might include directing the employee into a disease management program, to a nutritionist, or for follow-up care with the employee’s regular physician.
On paper, an HRA seems like a logical way to begin to become more involved in one’s personal health management. Yet, many employees decline to participate when an HRA is available. This reluctance might result from concerns about the employer’s motives in offering the HRA. Employees might wonder whether their answers to the questionnaire and any data gathered about their health will be kept confidential. They might be concerned that if health information is shared with their employer or insurer, they will suffer negative consequences, such as higher insurance rates or even a loss of coverage.
Though these fears are unfounded, employers need to address them head on in order to convince employees of the privacy of the information contained in the HRA. Be sure employees are aware of their HIPAA privacy rights, that personal health information is protected from disclosure, and that the information gleaned from the HRA is for their use and benefit, not for that of the employer or insurer.
Beyond addressing employee concerns about privacy, probably among the most effective communications involving HRAs answer the employee question, “What’s in it for me?” Make sure that your HRA communications include these messages:
- Completing an HRA will give you important information about your health, and knowledge is one of the best tools you can have in staying healthy.
- What you learn from an HRA can alert you to any health issues that you might be prone to or that are in their early stages. This information can lead you to appropriate screenings, preventive care and disease management programs.
- If you stay healthier your health care costs will probably be lower over time. By dealing with a health issue at an early stage your treatment options are likely to be wider and less expensive.
Many employers take the additional step of offering incentives for participation in health risk appraisals. In a survey from Watson Wyatt Worldwide and the National Business Group on Health, more than half of the firms responding (53%) offered employees financial incentives for completing an HRA. Premium or deductible credits were more effective than cash at boosting HRA participation—73% of companies that offered premium credits and 67% that offered deductible credits had at least half of their workforce participate in an HRA, compared with 17% that offered cash and 12% that offered no incentive.
An HRA is an important first step toward engaging employees in their health management and can be the entry point for other wellness programs. By encouraging employees to participate in an HRA, you’ll be helping them to maintain better health and likely saving them, and your company, health care costs down the road.
