What is the biggest factor in driving
up the cost of health care in business today? Unhealthy lifestyles and an aging population, according to
Thomas Scurfield, senior vice president of
Aon Risk Services Inc.
“Smoking, poor nutrition, obesity, drinking
or drug problems account for more than 50
percent of health care claims,” he says. As we
age, our lifestyle choices have a significant
impact on our consumption of health care.
What if businesses could do something to
help employees with these problems? They
can, says Scurfield. Health Risk Assessments
(HRAs) are tools that can help employees
evaluate their lifestyles and health histories.
Based on the HRA results, a personal action
plan can be developed to help employees
change their behaviors and improve their
health. As employees become healthier, they
consume less health care services, which
results in lower health plan costs.
Smart Business spoke with Scurfield
about how to obtain HRAs and how to
encourage employees to take the assessment
and implement the results in their lives.
What is involved in HRAs, and where can
businesses get them?
It is usually a question and answer form,
taken online, which focuses on health history and lifestyle. The HRA will ask questions
related to nutrition, physical activity and
smoking, along with specific medical information, such as cholesterol and blood pressure levels. Many companies, as part of their
health and wellness plans, will provide on-site medical screening, which will provide
employees their medical data prior to completing their HRAs. HRAs are typically developed by third-party firms that sell these
assessment programs to health insurance
companies. Businesses can check with their
current health plan administrators for implementation and communication of HRAs for
their employees. Many health plans are
including HRAs in their group health policy.
Are employees always willing to reveal this
kind of personal data?
Some employees can understandably be
reticent to participate, but they need to be reassured that their specific data is never
shared with an employer. There is also a
strict Federal Health Insurance Portability &
Accountability Act of 1996 (HIPAA) that protects employees’ health confidentiality. To
increase participation levels, companies
often create incentives, such as offering
reduced employee contributions or increased medical plan benefits. What is interesting is that studies have shown that the
majority of people don’t hide ailments on
these assessments; there is a high correlation
between what employees report and the condition of their health. The HRA is a good tool
to identify employees who are at risk for significant health care expenses, and who can
benefit from programs that can improve their
lifestyles and overall health.
How can a business go about administering
an HRA?
If your health care plan administrator has
an HRA, it is accessed at the employee password protected Web portal at the medical
plan administrator’s Web site. Employees
simply go to the site and answer questions,
which can take about 20 to 30 minutes to
complete. Once an employee fills out the HRA, recommendations are provided to the
employee to reduce risk factors. In addition,
high risk participants are contacted by a
health care coach to help them understand
their risk factors and to assist them in making lifestyle changes that will improve their
health. One of the recommendations can be
that the employee participates in an educational online course on nutrition, exercise
and alcohol consumption.
Many companies have increased HRA participation significantly by offering incentives
to employees who complete an HRA with
additional incentives for completion of recommended courses. Examples of employee
incentives include reduction in employee
contributions, fitness club stipends or
deposits into Health Reimbursement
Accounts or Health Savings Accounts. By
the way, the HRA is part of a bigger trend
among health insurance providers called
‘consumer tools,’ which include health care
and disease information, and guides to help
employees lead healthier lifestyles. This is a
positive trend in the industry since it
empowers consumers to make decisions
about their own health; some health care
providers even offer Web sites for consumers to compare health care procedures
and costs.
How do HRAs help a business keep premium
costs down?
The goal is to help employees identify their
health status, and then provide resources to
help them change behaviors that will
improve their health. It could be lifestyle
issues that are putting them at risk for problems down the road, or it could be a genetic
predisposition to a disease, such as cancer or
diabetes. The HRA identifies the high-risk
employees so that they can be proactive
about managing their health issues, so down
the road there is less of a chance of a catastrophic claim that will result in increased
plan premiums. If you can get a person to
lose weight, for example, he or she will lower
the risk for Type II diabetes and hypertension, reducing the risk of significant future
health care expenses.
THOMAS SCURFIELD is the senior vice president of Aon Risk Services Inc. Reach him at (216) 623-4126 or
[email protected].