Thursday, April 19, 2012

Health Care and Health Risk Assessments

When employers are concerned about having a healthy workforce, they offer various incentives in their benefits offerings to employees that can be preventive in nature and increase the potential for healthier living and overall improved health behavior. These wellness measures can be a great Return on Investment, and employees are able to get a reality check concerning their current health status. Using Health Risk Assessments are a great way to capture information about your health status, and show where improvements can be made and also provide feedback for any indicators of chronic health conditions or disease.

A health risk assessment (HRA) is a health questionnaire, used to provide individuals with an evaluation of their health risks and quality of life. Commonly a HRA incorporates three key elements – an extended questionnaire, a risk calculation or score, and some form of feedback i.e. face-to-face with a health advisor or an automatic online report. The Centers for Disease Control and Prevention define a HRA as: “a systematic approach to collecting information from individuals that identifies risk factors, provides individualised feedback, and links the person with at least one intervention to promote health, sustain function and/or prevent disease.” There are a range of different HRAs available, however most capture information relating to:

--Demographic characteristics – age, sex.
--Lifestyle – exercise, smoking, alcohol intake, diet.
--Personal and family medical history (in the US, due to the current interpretation of the Genetic Information Non-discrimination Act, questions regarding family medical history are not permitted if there is any incentive attached to taking a HRA).
--Physiological data – weight, height, blood pressure, cholesterol.
--Attitudes and willingness to change behavior in order to improve health.

The main objectives of a HRA are to:
--Assess health status.
--Estimate the level of health risk.
--Inform and provide feedback to participants to motivate behavior change to reduce health risks.

Once an individual completes a HRA, they usually receive a report, detailing their health rating or score, often broken down into specific sub scores and areas such as stress, nutrition and fitness. The report can also provide recommendations on how individuals can reduce their health risks by changing their lifestye, according to the American Journal of Public Health. In addition to individual feedback, HRAs are also used to provide aggregated data reporting for employers and organizations. These reports include demographic data of participants, highlight health risk areas and often include cost projections and savings in terms of increased healthcare, absence and productivity. Organization-level reports can then be used to provide a first step by which organizations can target and monitor appropriate health interventions within their workforce

According to the Mayo Clinic, motivating and sustaining health behavior change is the key to improving population health and productivity and controlling health care costs. A health risk appraisal can lead to health risk reduction. Health behavior research has shown that helping people identify threats to their health facilitates the process of healthy change.
Extensive research, according to the Journal of Occupational and Environmental Medicine, has shown that HRAs can be used effectively to:

--Identify health risk factors.
--Predict health-related costs.
--Measure absenteeism and presenteeism.
--Evaluate the efficacy and return on investment of health promotion strategies.

There is also recent evidence to suggest that taking a HRA alone can have a positive effect on health behavior change and health status. However, it is generally accepted that HRAs are most effective at promoting behavior change when they form part of an integrated, multi-component health promotion program. Applied in this way, the HRA is used primarily as a tool to identify health risks within a population and then target health interventions and behavior change programs to address these areas.

Often, an HRA will show certain health care issues that require more attention by your primary care physician. After completing a health risk assessment, the report that is generated usually makes certain recommendations. Among them, elevated markers indicating more follow up are encouraged with your doctor. The limitations of a HRA are largely related to its usage and it is important to recognize that a HRA highlights health risks but does not diagnose disease and should not replace consultation with a medical or health practitioner.When consulting with your physician or health care provider, be sure to:

• Listen carefully to what your health professional says. Make sure you understand what you are told about any diagnosis or treatment.

• Ask questions. If you don't understand something your health professional says, ask for it to be repeated in a different way.

• Be honest. If your values, beliefs, fears, or concerns may interfere with a treatment that is suggested, talk with your health professional about it. Other treatment options may be available.

• Take an advocate. Have a family member or friend with you during your appointment, if possible. That person can take notes, ask questions to clarify information, and help you remember what your health professional says.

• Ask for instructions. Before leaving your health professional's office, make sure you know what you are supposed to do to care for yourself. Ask for written information or instructions.

Health Risk Assessments are designed to show you where you are, and they can identify particular medical, and behavioral problems, that need more attention to help improve your health and lifestyle.  The Wellness Councils of America (WELCOA) outlines 10 key benefits of conducting personal health risk assessments. Health risk assessments:

--Provide employees with a snapshot of their current health status.
--Enable individuals to monitor their health status over time.
--Provide employees with concrete information thus preparing them for lifestyle change.
--Help individuals get involved with health coaching.
--Provide important information concerning employees' readiness to change.
--Help employers measure and monitor population health status.
--Provide employers with important information that can help them build results-oriented health promotion programs.
--Can provide employers with important information on productivity.
--Allow employers to evaluate changes in health behavior and health risks over time.
--Engage both employers and employees in the health management process.

One of the best companies in the HRA market is Trotter Wellness, based in Wisconsin, and the company provides services to companies of all sizes, governments, resellers and individuals throughout the world. Having served thousands of clients and hundreds of thousands of members they have developed systems achieving member participation and satisfaction as well as client renewal rates well into the 90th percentile. These results have been achieved through the Trotter Wellness® system having the highest quality and most cost effective programs and services that resulted from the careful integration and coordination of scientifically crafted or selected components that are delivered using proprietary platforms and protocols. These systems drive high participation and satisfaction with a measureable return on investment for the participant and the client buyer. Trotter Wellness has built a national reputation for having the highest level of client service and satisfaction through their exceptional logistics, communications, health risk assessments, web tools, coaching, results reporting and active one on one relationship management.
Health Risk Assessments complement an overall wellness plan; and for any organization or employer, and for individuals, an HRA is an essential tool to provide a path for improved health and lifestyle choices. If your company is considering implementing a wellness initiative, or as an individual you are concerned about your health risks, get a tool in place through an HRA that can give you the peace of mind about your current health. Take the time to find out where you are, so you can figure out where you need to be and get there.
Until next time.


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