Preventive maintenance Featured

8:00pm EDT June 25, 2008

New trends in employee benefit and prevention plans have led many business owners to implement on-site health screenings. These screenings can range from finger-prick blood tests for cholesterol to sigmoidoscopy for colorectal cancer. Other screenings include tests for diabetes and even stress tests to check for heart disease.

“On-site health risk assessments and screenings are far more than just employee relations gestures,” says Sally Stephens, president of Spectrum Health Systems.

Smart Business spoke with Stephens about the benefits of on-site screenings.

What are the benefits of on-site screenings?

On-site screenings benefit both the employer and employee. It is well documented that early detection can help employees detect health risks of which they might not have been previously aware and avoid health-related complications, therefore saving health care dollars for potential long-term care. In most cases, the employer underwrites the cost of the screening so there is no cost to the employee. In addition, by offering these services on-site, the employer is removing at least two of the barriers for employees participating — cost and time. Business owners also find that they do not have to spend a lot of money to offer on-site screenings. In fact, costs vary greatly depending upon the complexity of the test and how much the company decides to underwrite. Often early detection is far cheaper than treatment.

Are employees usually willing to participate in on-site screenings?

If the screening process is well communicated and managed, on-site screenings can be very effective. Offering incentives to encourage employees to participate can increase participation rates into the high 80th to 90th percentiles.

Today, many employers are tying participation to their health plans by awarding premium discounts to those who complete the process. If the data is properly utilized, then the employer can base future programming on the results. This information can potentially reduce health care costs for a company in the future by reducing unnecessary coverage and increasing coverage in areas that may be lacking.

Why are on-site screenings valuable?

Research shows that screenings improve the health of workers and even improve worker morale. The idea is to detect high-risk employees and help them seek appropriate professional or educational attention. Identifying a health problem early leads to fewer complications, a faster recovery period and fewer health care costs both for the employee and the employer. For example, diagnosing diabetes in the early stages can help prevent complications, such as heart disease, nerve damage, vision problems and kidney disease. In addition, health risk questionnaires can prompt an individual to focus on other health-related issues that need attention, such as getting enough sleep and always using seat belts. Healthier employees lead to increased overall productivity and reduced health care costs.

Are employers permitted to require employees to have on-site screenings?

All employers must comply with the Americans with Disabilities Act (ADA) and Health Insurance Portability and Accountability Act (HIPAA) requirements. HIPAA ensures that personal health information (PHI) shared in a health assessment cannot be used against the individual for insurance coverage or employment consideration. The ADA requires that employers offer a reasonable accommodation to an employee with a known disability, and it prohibits employers from making medical inquiries or requiring medical examinations (unless job-related and consistent with business necessity). It is also unlawful under the ADA to take any adverse employment action based on an individual’s actual or perceived disability.

Offering employees the opportunity to voluntarily participate in health screening programs for high blood pressure and cholesterol monitoring are not likely to violate the ADA, as long as there is no penalty (economic or otherwise) for not participating.

Are there certain procedures of which employers should be aware during and after the screening process?

The most important factor is maintaining complete privacy of the participants and their personal health information. The facility in which the screening takes place should be designed to protect an employee’s privacy. The turnaround time for test results varies depending upon the tests provided. Today, there are simple finger-prick tests that can provide immediate results for cholesterol, glucose and other tests. Alternatively, tests that require blood work can take a couple of days for results. Well-designed programs provide the participant with detailed explanation of results and educational materials to assist them in making appropriate health changes.

Whom should employers contact if they want to implement on-site screenings?

There are numerous resources available to assist employers with implementing on-site health screenings. In addition to local hospitals and national screening vendors, there are also independent wellness companies that offer these separately or as part of a comprehensive wellness program.

SALLY STEPHENS is the president of Spectrum Health Systems. Reach her at