The National Business Coalition on Health (NBCH) says that 60% of large employers are offering Health Risk Appraisals to their employees – that’s good news. But offering an HRA is only one step in a broader program of engaging employees in their own health and wellness choices. Employers that simply offer HRAs without taking additional steps to ensure that employees fill them out and then follow up are not maximizing the potential benefits – either in terms of dollar savings or potential positive health outcomes. According to an NBCH survey, only about 4% of health plan members fill out an HRA annually, and biometric screening (for blood pressure, body mass, cholesterol level, blood sugar, bone density, cardiovascular health) is even less common.
This lack of follow-through is unfortunate because early detection can have the dual benefits of improving outcomes and being less costly. Consider these statistics that demonstrate opportunities for improvement:

  • 33% of breast cancer is not detected until it is late-stage cancer
  • 50% of cervical cancer is detected at a late stage
  • 33% of diabetics do not know they have the disease
  • 70% increase in the prevalence of diabetes since 1990
  • 34% increase in the likelihood that an employee of a small firm will quit smoking if a coworker also quits smoking.

In a recent newsletter article, Purchasing High Performance Health Risk Assessments: What You Don’t Know Can Cost You, Brian Schilling presents various examples of employers that are successfully using HRAs to reduce costs, along with a case history of a municipality that is offering employees cash incentives and an insurer that is using a financial guarantee to try to maximize program participation. Schilling also offers a brief overview of the components of an effective HRA program.
For more in depth information, NBCH and the CDC offer a 22-page buyer “how-to” guide, designed to help users make informed decisions about if, why, when and how to use Heath Risk Appraisals with their work force: Health Risk Appraisals at the Worksite: Basics for HRA Decision Making (PDF).
The Guide includes three main areas of information:

  • Overview – the evolution of HRA, the evidence base for HRA use, common components of an HRA tool, limitations to HRA use, ten basic steps for planning an HRA program, and potential HRA sponsors.
  • HRA Features Prioritization Checklist designed to identify reasons for conducting an HRA at your worksite and what features an HRA tool must include to meet those objectives.
  • HRA Comparison Checklist – help to identify the HRA tool among those you are considering that best meets your workplace objectives.

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