This past month I completed a health risk assessment (HRA). This is a procedure that more employers are asking employees to complete. What is an HRA and why are they being done? It is no secret that the cost of health care has been rising rapidly over the last 20 years. Employers have traditionally provided health insurance for its employees as a benefit. The health care costs are a large part of the budget. So, employers are trying to find ways to minimize their health care costs. One way is to raise the amount the employee contributes to health care premiums. This is something most employees are experiencing already. The other way is to have a healthier group of employees.
One way to improve the health of employees is to provide opportunities through wellness programs that promote healthy lifestyles. Another strategy is to use financial incentives to improve health. This is where the HRA comes into the picture. Employers figure that generally employees with the highest health risks are going to have higher health care expenses. Health is not easy to measure. The HRA is an attempt to assign a numeric value to health risk based on questions regarding lifestyle and by measuring biometrics. The biometrics generally are lab tests and basic vital measurements. Then the company uses financial incentives to encourage employees to improve their scores. The incentives generally are reduced payments toward health care premiums by the employee or contributions to health savings accounts. Theoretically employees would take on some of the responsibility to help keep their health care costs down and then ultimately keep the costs of health care down for the company.
There are different types of HRAs but commonly the HRA includes a questionnaire about lifestyle, diet, stress, and health issues. The biometric measurements commonly include fasting blood sugar, cholesterol profile, height, weight, blood pressure, and smoking status.
An HRA is not a substitute for a yearly visit with your provider. It is a health screening tool. It does not address cancer screenings, immunizations or management of medical problems. It is a good idea to bring the results to your provider and review them at your visit. It can identify problems like diabetes, high blood pressure, or high cholesterol. It can also identify factors that can lead to medical problems. Just completing an HRA has been shown to make people more aware of their health. The scores can be compared from year to year to measure health risk improvement. The results of the lab tests can be used by your provider and can save you money since the employer generally pays for the HRA.
HRAs are designed to try to identify health risks and help change behaviors. Certain risk factors are given more emphasis in the scoring system. Smoking is a factor that will invariably cause a low score. Most employers will financially reward employees who raise their score. Employers hope that the financial incentives and risk identification will improve health to lower health care costs.
I have seen the use of HRAs increase remarkably over the past several years. Whether this will be an effective strategy in the long run remains to be seen but for now it is common practice. Stay healthy my friends.
By: P. Michael Shattuck, M.D. – Community Health Network Family Physician
