Beating bad habits Featured

8:00pm EDT March 26, 2008

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