Healthy status Featured

7:00pm EDT November 25, 2009

Getting your employees involved in their health care can help establish a healthier workplace and also save on health care costs. One way to encourage involvement is through the completion of health risk assessments.

This tool asks employees a series of questions regarding their current health status, risk factors, and prior and family history. It can then be used to develop a specific care management model for that employee around their health issues, such as stress management, weight loss, smoking cessation and certain diseases.

“It’s used as a wonderful baseline to develop a care management plan for your employees,” says Kirk Cianciolo, D.O. MBA, senior vice president and chief medical officer with AvMed Health Plans. “The unfortunate part is that there is only a small percentage of people who actually take the time to fill it out.”

Smart Business spoke with Cianciolo about how to make a health risk assessment an integral part of your health plan and encourage employees to complete it.

How can you make a health risk assessment an integral part of your health plan and encourage employees to complete this form?

It should be provided in as many modalities as possible. It can be done through the Internet, over the phone or through hard copy in the mail. Larger employer groups may want to consider installing kiosks in their buildings where employees can complete the form. It’s all about offering as many different modalities as possible, so you cover the spectrum of employees and their individual comfort levels.

The assessment can then be used to develop a care management plan for each employee and used in future health care. For example, let’s say you find someone who has the indications of diabetes, such as frequent urination and headaches. The health care provider would have a case manager call that patient and gather some more information, then collaborate with the family doctor or even arrange for a doctor visit with that member. Health plans are really engaging and collaborating with that member and physician to develop that care plan together.

How often should health risk assessments be completed?

You should complete the assessment at least once to be able to establish a baseline. Employees are encouraged to continue to update it in case there is a change with any medical information. These changes can then be updated in the health provider’s database. At a minimum it should be completed at least twice a year.

This information is then used in a predictive modeling tool to determine which members might need help with their case or disease management. For instance, the provider may find a 50-year-old male who hasn’t had a colonoscopy. The provider would reach out to him and tell him that it’s time for the test. This information is used to develop preventive care plans and also remind employees about preventive care tests and procedures.

How do you handle employees who do not want to share this type of information with you?

This is a concern a lot of employers have, because you can’t force someone to take the assessment. Employees are concerned about who will get the information and in what way it will be used. Health plans will install multiple firewalls and password protections if you are completing the assessment online, so the information is secure. It will then be put into the health plan’s database, which is confidential.

Protections are also in place through privacy acts if the assessment is filled out over the phone or through a hard copy. But these means are certainly more risky. Employees just want to know what will be done with this information, but there’s no other intent than just to discover their current health status.

How can recognition and rewards play a role in getting employees to complete health risk assessments?

Recognition is very important to employees. You should provide some sort of incentive or reward for employees who fill out the health risk assessment. You may want to provide incentives in the form of premium reductions or additional funding of health savings accounts.

There’s no real silver bullet of recognition or else there would be 100 percent participation across the board. In general, if there’s a perceived value by the member or patient of at least $200, employees will be more motivated in completing the assessment. Some employers are reluctant to make that investment, but some are beginning to change. They realize that if you can find employees with health issues sooner, and can get them actively engaged in their issues, you can mitigate a hospital admission or an emergency room visit. The information provided in a health risk assessment is important to a company.

What are the benefits of completing a health risk assessment?

It provides safety, early identification and prevention. Many assessments have a pharmacy piece, where you can determine if an employee’s medications might have competing side effects or adverse effects.

Health risk assessments also develop a baseline for what employees’ health statuses are and provide earlier identification of those employees who need additional help. They also provide earlier identification of employees who have not received the necessary preventive studies or tests.

Kirk Cianciolo, D.O. MBA, is a senior vice president and chief medical officer at AvMed Health Plans. Reach him at (352) 337-8709 or