Monday, April 4, 2011

Health Risk Assessment Findings

We recently completed our first real health risk assessment (HRA) with United Healthcare. United offers health risk assessments as part of their Simply Engaged program. They use a tool from the University of Michigan Health Management Research Center. Covered employees and their covered spouses are each offered a $75 gift card as an incentive for completing the assessment. We had 158 people participate -- 56% of eligible staff and 38% of eligible spouses. 

There were no surprises in the information we received about health conditions. We were able ascertain pretty much the same thing by analyzing reports on our prescription drug usage. In the HRA, people reported the following health problems:
  • allergies - 32%
  • high blood pressure -- 22%
  • back pain -- 21%
  • high cholesterol -- 15%
  • arthritis -- 12%
  • depression -- 11%
  • heartburn/acid reflux -- 8%
  • migraine headaches -- 6%
  • diabetes -- 6%
  • heart problems -- 5%
Three preventive health screenings were flagged for low compliance. This information is new to us and we're talking about what we can do to encourage people to take care of these preventive health screenings. Interestingly, there was a high level of compliance with blood pressure, cholesterol, pap tests and mammograms. 
  • tetanus shot -- 53%
  • rectal exam -- 49%
  • colon cancer screening -- 47%
I'm guessing people avoid rectal exams and colonoscopies because they're unpleasant. Years ago we had a doctor come in and talk about what to expect during a colonoscopy and why it's important to have one. He was funny and engaging. We will see if we can have him come in again. 

HRA participants reported they are planning to change the following behaviors during the next six months.
  • increase physical activity -- 85%
  • lose weight -- 70%
  • reduce fat/cholesterol intake -- 57%
  • cope better with stress -- 56%
Our current plans cover the first three behaviors pretty comprehensively. We are discussing what we can do to help people cope better with stress. This article has me thinking in terms of resilience training. 

We will also be assessing how helpful United's Simply Engaged program is to us and if we want to include it in our contract again next year. I know health risk assessments are included in most model wellness programs, but I'm not sure about the ROI. How valuable is what we learned? 

Related Reading: Uncommon Knowledge: The Value of Health Assessment Data

Update September 21, 2011: I'm continuing to evaluate the value of what we learned from the HRAs as we make a decision about whether or not to include Simply Engaged in our contract with United Healthcare next year. Simply Engaged cost an additional one percent of premium.

The one thing that stood out to me that I learned was that 21% of respondents are experiencing back pain. I just thought to look up the prevalence of back pain. According to the Univesity of Missouri-Columbia School of Health Professions, 80% of people experience back pain in their lives -- 20% to 30% at any given time. So, I guess I should have deduced that back pain was an issue without the HRA.


Nicholas Tolson said...

I'm on the record questioning many aspects of HRA's. They are ineffective if they are the only element in your "wellness" program, and are often seen by employees as being more for the company's benefit than the benefit of the people.

That said, I think HRA's can be useful as benchmarks and indicators of the effectiveness of the other things you're doing to support your workforce's wellness.

As with all data, the important information is in trends. Statistics alone are just trivia. HRA's, when done consistently, can show you the areas that are working and where improvements/changes need to be made.

That said, given the relatively high cost of HRA's, there may be cheaper ways of finding out such information, which would allow you to put more money into actual results-oriented programs.

summit cardiology said...

"high blood pressure -- 22%" I'm not surprised by this since a lot of factors in the office contribute to hypertension.

Dale said...

I'm not an expert when it comes to health care but I think they should focus more on the top two health problems. They're really affecting a lot of people.

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Anonymous said...

I'm 27 years old. I was unaware a need for a rectal exam at this age. Seems to me your assessment is a bit flawed.