While health risk assessments are one of the foundational measurement tools of an employer wellness program, the actual value of the data from an HRA as it relates to overall health improvement and return on investment is yet to be proven. There are a variety of measurement tools and data storage mechanisms that employers can use to measure the success of their wellness programs.

One of the best ways for an individual to raise their health awareness is to engage in biometric screenings. Biometric screenings don't have to include a complex panel of blood chemistries, but rather a set of discrete, easy-to-execute measures that address the four critical health indicators that drive 75% of today's costly chronic disease: blood pressure, cholesterol (full lipid panel), body mass index and tobacco use. Individuals who have knowledge of these biometric indicators are more likely to improve their health awareness and take action about their health than if they were to only receive a report that provides generalized health risk information from an HRA.

Historically, employers have implemented biometric screening alongside a health risk assessment. However, a health risk assessment is unable to provide that tangible, teachable moment that will most likely have the greatest impact on behavior change. Biometric screenings provide real-time data and therefore should be coupled with a health coach or professional counseling session that can address the individual's identified risk immediately and who can talk with them about creating a personalized plan that will drive them back to the programs and services of the employer wellness program.

Many large employers enjoy self-funding as part of their healthcare affordability strategy and have access to all of their medical cost data to assist them with benefit design and wellness program strategy. It may be for this very reason that some employers recognize that an HRA as part of their overall wellness strategy is a waste time and money - money that can be used for biometric screenings or other programs.

While proponents of the HRA speak to its integration capabilities with health coaching, I've seen limited engagement and limited significant outcome data that support this model. Stratification of biometric data can also be integrated with health coaching, disease management and care management programs to promote timely outreach and intervention. Biometric screening data is reliable because it is not self-reported, and does not come from retrospective claims data. This empowers health coaches, nurses and care management teams to improve case acceptance rates and health outcomes.

Every employer needs to understand both sides of the value equation to determine if an HRA is the right choice for the company, its culture and, ultimately, its budget.

Lisa M. Holland, RN, MBA, is president of the StayFit Plan administered by Simplicity Health Plans. She can be reached at lisaholland@simplicityhealthplans.com.

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