Targeting limited health dollars Featured

8:00pm EDT April 25, 2007
Health risk assessments (HRAs) and screenings (measuring health risks associated with your company’s health care costs) are not only valuable for employers, but for employees as well.

“For employers, understanding health risk is vital to targeting their limited health care dollars to get the biggest health improvement impact possible,” says Pamela Peele, Ph.D., vice president of health economics for UPMC Health Plan.

Smart Business talked to Peele about the respective roles of employers and employees in health care expenditures.

What is the value of doing HRAs or biometric screenings?

The cost of bad health for employers is more than just paying for medical procedures — it extends to lost productivity and absenteeism. Further, a growing body of literature is showing a correlation between some health conditions, such as depression, and higher rates of job-related injuries.

An HRA gives employers the opportunity to view the distribution and severity of health risk factors among their employees. This provides an employer-specific measure of health risk, rather than an estimate.

For employees, the HRA is an opportunity to understand their health status and to compare their reported health status and health risk against an age/sex-matched comparison group (national benchmarks).

HRAs can also inform employees about how small changes to their current lifestyle can impact their potential for developing overt disease. Members can retake the HRA as often as they like and use it to track improvements.

Who sees the information and how is it used?

When HRAs are conducted through a trusted third party, such as UPMC Health Plan, they are completely separated and isolated from the employer. The employer never sees any individual information. We have numerous processes in place to ensure that private information stays private.

All members who fill out an HRA have the option of requesting that they not be contacted. But if members wish, their information can be reviewed by a health professional and they may be referred for consultation to a health coach and/or a health care manager.

Does this violate an employee's privacy?

No. Employee information is completely private. Employers have absolutely no access to any individual employee information. An HRA questionnaire is a safe place for employees to review their own health risks and learn what they can do to mitigate those risks.

How does all this matter to employees and their employers?

Understanding what health risks are present in their work force can help employers direct their limited health care dollars toward reducing those risks, with the objective of improving the quality of life for their employees — and increasing attendance and productivity.

HRAs are road maps for employers. For example, employers with a high percentage of employees who are smokers might want to help their employees quit the habit. How to approach that objective will depend on how ready their employees are to quit smoking.

For employees, HRAs are also road maps to better health. They provide information to help members take better care of themselves and to enjoy a higher level of health and a potentially more active lifestyle.

How accurate and realistic are assessments of risk conducted in the workplace?

The literature is robust with the correlation between certain biometric values (such as high blood pressure, high glucose and high LDL, and devastating health outcomes like kidney failure, blindness, stroke and heart attack). Workplace biometric screenings are the perfect opportunity for employees to easily get their own biometric values and have a discussion with a health coach on what these numbers mean, as well as what actions they might want to take. In our experience with work-place screenings, employees have given high marks to the experience.

What are the overall issues of HRAs in terms of HIPAA?

HRAs contain self-reported personal health information and are subject to the full coverage of HIPAA regulations protecting personal health information.

What type of corporate infrastructure is best utilized to accommodate the HRA process and to ensure fair execution?

Support and involvement of senior management in programs to increase the health and welfare of employees is important for engaging employees in the process. An HRA can serve as both the initial step for an employer toward this goal and as an ongoing part of a robust corporate culture of health.

PAMELA PEELE, Ph.D., is vice president, health economics for UPMC Health Plan. Reach her at or (412) 454-7952.