by Susan Kinzler, CFO of Healthstat, Inc. Article first appeared in Employee Benefit News on September 23, 2015.
In the anatomy of a corporate wellness program, the health risk assessment(HRA) with biometric screening is equivalent to the heart. However, many employers who have offered this important health-status indicator are beginning to question its long-term value. A well-executed and outcomes-based HRA keeps the program running smoothly and effectively because all other elements depend upon its accurate assessment and ongoing data. When employers do not experience positive results, including long-term cost savings, positive health outcomes and/or improved productivity promised from the HRA, the result is HRA fatigue.
Truth be told, the biometric screening and data analytics that come with proper HRA execution requires a significant commitment, not only in direct costs to the employer but indirect costs like time away from work that impacts production. Employees, too, are often wary of the HRA process because it can be perceived as an invasion of privacy, which can unnecessarily lead to issues of mistrust. But the benefits to employers and employees are well worth the expense and effort with a properly structured, outcomes-focused HRA.
Prevent HRA fatigue by following these three simple guidelines:
1. Assess and follow through. In sports, the better the follow through the more precise the outcome. Take golf, for example. You can hit the ball perfectly with the club, but if you stop short on your follow through you won’t get the necessary momentum to put the ball anywhere near the hole. With HRAs, completing the initial written questionnaire and physical testing is a critical first step for patients — for without them you have nothing from which to generate an initial assessment. But it’s what happens after the HRA that makes the difference. If employees don’t take action to improve their health, the results of the next HRA screening are going to either stay the same or worsen.
Employers must arm their employees with tools like incentives, group programs, health and fitness challenges, coordinated personal health coaching and more in order to expect employees to change their behavior toward their health. An employer’s health and wellness provider or broker should advise proper tools that will work with their particular employee set. If the provider doesn’t have the skills to accurately identify each patient’s readiness to change and prescribe treatment accordingly, patients will most likely fail to follow through because breaking habits is one of the most difficult things human beings can do. Smoking is a perfect example. Everyone knows that smoking is bad for your health and is the number one cause of lung cancer, but for a long-time smoker, the enjoyment and comfort it brings outweighs intellect. It usually takes years for a smoker to make the decision to quit and once they do, fighting the urge to smoke is a constant battle that often results in surrender. The point is that just because someone recognizes a need for change, and even knows what to do to change, it doesn’t mean they will act on it.
2. Don't assume anything. Many benefit managers believe that supplying employees with information about health conditions and how to reverse or prevent them is enough. Employees must understand the importance of the HRA — not only for themselves but for the overall health of the company. They need to understand the process, why it’s being administered and how it affects the overall outcome of the company wellness program, the benefits that can be realized, and the investment the company is making in its employees. Something that speaks volumes about company commitment is having top executives actively and openly participate in the HRA and ongoing corporate wellness program.
Without knowledge of the HRA process, employees aren’t motivated to act on the information they’re given. Particularly for those who have chronic or persistent poor health conditions, demoralization can quickly set in if their initial attempt at correcting the problem is unsuccessful. This usually results in an attitude of resignation and abandoning treatment altogether.
By the same token, employees should not assume that because they provide HRA data to their primary care provider or to a specialist, he or she is going to do something with it. The traditional health care system is set up to be reactive, so unless a patient is experiencing illness or a severe chronic condition, providers typically don’t have time to see them quickly. Providers can also be demoralized when a patient persistently fails to follow prescribed treatments or fails to achieve successful results. This produces exasperation on the provider’s part and can dis-incentivize them to find new approaches to the problem.
3. Deploy big data. The reasons for one person’s diabetic conditions may be vastly different from another’s, which is why scientific collection and analysis of HRA data is a critical, never-ending part of a successful wellness program. The physical DNA of each patient is as unique as his or her lifestyle, eating and exercise habits, physical surroundings, social network, financial situation and other conditions that play a part in one’s physical health. Taking a deep dive into data with the use of sophisticated analytical tools and reporting systems gives clinical providers the detail they need to prescribe individually tailored treatment for each patient they see.
You as the employer should also have an understanding of what the data means. Your vendor should be able to translate health outcome data for you in a way that clearly illustrates the present state of your workforce health, the challenges that exist, and prescribe realistic custom solutions to produce positive results. Within that translation there should be a clear delineation between health outcome data and the effects it has on the cost of doing business and productivity levels.
If you find yourself experiencing HRA fatigue or are beginning to question the long-term cost savings and/or productivity improvements being delivered by your corporate wellness program, you may want to take a hard look at your vendor. Do they have formally trained clinical staff that knows how to identify patients’ readiness to change? Do they employ the use of sophisticated analytics and reporting tools? If not, that may well be the root cause of your HRA fatigue. So-called “providers” like these give HRAs a bad name because they have no real plan in place to keep the heart of your wellness program in good, working order.