Assessing risk Featured

7:00pm EDT January 29, 2008

Any company is only as good as its people. Loss of key managers or line staff, whether to a short-term hospital stay or permanently, will have a devastating effect on organizational productivity. However, efforts to develop a comprehensive employee health culture can have a dramatic positive impact on reducing health insurance costs and improving organizational effectiveness. The most important first step in heading down the path to employee health and wellness is to assess the health and risk factors of the company’s employee population. This is done by utilizing an assessment tool called a Health Risk Appraisal (HRA).

An HRA allows a company to identify trends related to employee health risks, states Doug Ribley, vice president of health and wellness services at the Akron General Medical Health and Wellness Centers. Programs and services can be introduced that help reduce the identified health risks, thus creating a healthy, cost-efficient work force.

Smart Business spoke with Ribley about the nuances and benefits of HRAs.

Where does an HRA program start?

I like to look at HRAs as the first phase in a two-phase process. HRAs represent the information gathering part of the process, while program implementation and health education represents the second phase. When an organization decides to improve the health of its work force, it starts by administering a health risk appraisal, which provides specific information on the health risks of each individual employee. This information is then combined to provide aggregate data representing health risk trends for the entire organization. These trends may identify common health issues such as low back pain, high cholesterol, obesity, diabetes and stress. Once identified and ranked, the company can build a strategy to reduce or eliminate the causes of these health issues.

What is involved?

Typically, an HRA consists of a series of questions that focus on medical and personal health history. It has three main categories: family history and incidence of disease, the employee’s specific medical history and specific lifestyle choices that impact health, such as exercise, smoking and seat belt use. This information leads to the development of a wide range of results-oriented programs designed to create positive change.

Most HRAs take 30 minutes to complete, however, statistical accuracy is important when the intent is to create change. This part of the process requires honesty, thought and a dedicated time commitment. Many organizations have had success by offering the ability to complete an HRA online. Of course, you can complete an HRA manually, too. Generally, a company’s HRA is completed over a two-week period of time and the results can be back within one to two weeks.

Should human resources handle this?

Typically, an organization that embarks on an employee health initiative assigns a leader and/or committee to develop and administer the program. These people will often contract with third-party employee health professionals to ensure that the effort is designed and administered efficiently and effectively. HR leadership usually assumes the responsibility for this effort since reduced health care costs, employee satisfaction, absenteeism and retention are HR objectives. Companies with employee wellness or exercise programs often have the program manager report to HR. Wherever the program resides, the idea is to motivate employees to improve health and reduce risks.

What is the return?

Numerous case studies report that it’s typical to generate a $3 to $4 return on every dollar invested in a comprehensive employee health program. The challenge is that the return doesn’t come overnight, but over time. Companies focused on quarter-to-quarter returns struggle with this consistent and ongoing commitment. Companies with leadership teams that are insightful and willing to invest over time favor HRAs.

What is the next step?

After a firm completes an HRA, the team puts together health education and screening programs to address results. The HRA is just the starting point. The focus of the applied initiatives are to get employees to embrace lifestyle changes that reduce health risks.

Can we make HRAs mandatory?

Some large companies have taken an aggressive stand on HRAs since they have the potential to lower health insurance premiums. Making assessment and programs mandatory will be challenged in courts over time. Today, there is no definitive answer to mandatory participation.

What does seem to work is individual incentives for program participation. For example, a $100 bonus to employees who complete an HRA. Some companies create rewards by lowering employee contributions toward insurance premiums.

The most important message is that embracing an employee health focus is the right thing to do in today’s world of soaring health care costs and a landscape requiring organizations to produce more with less. Companies that are committed to improving the health of their work force will find that it correlates directly with organizational success. But this is not a quick fix. You have to be in to for the long haul to reap the rewards. <<

DOUG RIBLEY is vice president of health and wellness services at the Akron General Medical Center Health and Wellness Centers. Reach him at