Health Assessment Toolkit: A Road Map for Employers

Identifying risk factors in an employee population is the first step toward improving overall health and controlling health care costs. Perhaps the most effective way for employers to gauge the overall health status of their employees is to offer questionnaires commonly referred to as health assessments (HAs) to their employees and dependents.

The National Leadership Committee on Consumerism and Engagement developed the Health Assessment Toolkit: A Road Map for Employers as a resource for all Business Group members interested in offering HAs or modifying their approach to HA administration. The toolkit outlines some of the most frequently asked questions and concerns from our members regarding HA implementation. It describes the basic functions, capabilities and benefits of HA administration.

In 2010, the toolkit was revised to reflect new thinking in the field. The information in the original toolkit was reshaped and new information was added based on interviews with key experts in the health assessment field. In addition, interviews were conducted with vendors that produce HA products, and profiles based on those interviews have been incorporated into the toolkit. We would like to thank the following people for sharing their insights about health assessments. Their feedback is reflected in many of the components of this toolkit.

Geoff Alexander, Onlife Health
David R. Anderson, Ph.D., L.P, StayWell Health Management
Allison London Brown, Healthways
Mike Casey, Mayo Clinic Health Solutions
Jessica Colling, vielife
Dee Edington, University of Michigan
Dan O'Flaherty, TRALE, Inc.
Philip Hagen, M.D., Mayo Clinic Health Solutions
Zorianna Hoyworon, Wellness Checkpoint
Bruce Kelley, Towers Watson
Wendi Mader, Quest Diagnostics, Inc.
Nico Pronk, Ph.D., JourneyWell HealthPartners
Michael Taitel, formerly of Alere
Michael Traylor, WebMD Health Services
Michael Wood, Towers Watson

Toolkit Components

Getting Started: Health Assessment (HA) Basics

• What is an HA?
• Why do Employers Offer HAs?
• What are the Evidence and Recommendations for HA Use?
• What Form Will the HA Take?
• How Often Should an HA be Offered to Employees?
• What is an Appropriate Length of the Questionnaire?
• What Methods of Feedback do HAs Provide?
• What are the Different Methods of Follow-up to an HA?
• What are the Typical Costs Associated with an HA?
• What Should Employers Look for When Selecting an HA Vendor?

Optimizing Health Assessments

• Are Employers Just Looking to Save a Dime?
• Health Assessments: Tools for Employees and Employers
• Specific Data Points Required for Best-in-Class Planning
• Is the Program Working? Other Elements to Consider

A Look at Biometrics

• Are Biometrics Worth it or Can Employers Get By with Self-Reported Data?
• What is the Evidence Concerning Self-Reported Data vs. Measured Biometrics?
• Metrics: Basic Physical Measures and the Growing Importance of Behavioral Data
• Cost of Biometric Screening Represents 70%-90% of a Health Assessment
• It is Possible to Get the Data without the Finger Stick!
• Good Data Mean Good Stratification: Biometrics and Behavioral Measurement Together are Ideal
• Those Without Primary Care Physicians (PCP) Need Biometric Screening the Most

Gaining Employee Trust and Participation

• Ongoing Communication, Assurance of Privacy and On-Target Incentives
• Privacy Guarantees are Crucial for Employee Participation
• How will the Information be Used? Transparency Key for Employers and Vendors
• Incentives Alone Cannot Drive Participation: Senior Management Needs to “Talk the Talk” and “Walk the Walk”
• One Size Does Not Fit All: Tailoring the Message to Different Audiences
• The Health Assessment Communications Strategy Should Take Place Over Time
• Health Assessment Needs to be Viewed as Part of an Overarching Organizational Culture of Health
• "What's in it for me?" Employees Need to Know

Building Momentum for Health Assessments

• Strategies for Engaging Employees
• Best Deployment Techniques: It’s not just a “One and Done”
• Selection Bias Should not be a Main Concern for Employers
• From the Submit Button to Program Enrollment: Immediate and Long-Term Follow-up are Both Essential

Trends and Outlook

• The Future of Health Assessments
• Employer Demand for Health Assessments is Growing
• Increased Need for Shortened Health Assessments
• Spouses, Partners and Adult Dependents Becoming a Larger Part of the Health Assessment Strategy
• Primary Care Physicians not Currently Linked with Health Assessments
• The Time for Health Assessment Standardization and Certification is Near
• Little Movement Toward Cohort-Based Health Assessments
• On-Site Medical Clinics and Health Assessments: Potential for Partnership

Health Assessments and Regulatory Issues

• Potential Legal Pitfalls
• The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
• The Genetic Information Nondiscrimination Act of 2008 (GINA) Title I
• GINA Title II: Employers and the Equal Employment Opportunity Commission (EEOC)
• Future Regulatory Outlook
• Final Recommendations

Information About Health Assessment Vendors

A chart listing vendors currently producing health assessment products.

Vendor Profiles

A more detailed look at a sample of companies developing health assessment products. The descriptions provide a quick overview of the different options currently available.

Appendices' and References

National Leadership Committee on Consumerism and Engagement (NLCCE)  

The National Leadership Committee on Consumerism and Engagement is part of the National Business Group on Health’s Institute on Health Care Costs and Solutions. The committee was established in April 2006 and provides a leadership forum to focus on finding and evaluating effective solutions to the health care benefits challenges of large employers.

Members of the National Leadership Committee on Consumerism and Engagement

Diane Avellar, Chair, Raytheon Company; Jim Dwyer, American Express; Celine Stricoff, Assurant, Inc.; Mark Talluto, Blue Cross and Blue Shield Association; Terry Wolf, The Boeing Company; Kendell Sherrer, Cardinal Health; Will Giaconia, CIGNA HealthCare; Nancy Blair Bonk and Elizabeth Casteel, J.D., FedEx; Lee Belniak, Fidelity Investments; Erick Shrauger, Healthways; Jeanne Denz, General Mills, Inc.; Mary Egan, Honeywell; Marianne Semenetz, IBM Corporation; Tom Curtin Jr., Kaiser Foundation Health Plan, Inc.; Kathy McAlpine, Kraft Foods, Inc.; Theresa Monti, The Kroger Co.; Hugh Devlyn, Liberty Mutual Insurance Group; Bob Ihrie, Lowe’s Companies, Inc.; Jill Berger, Marriott International, Inc.; Joe Marabito, Medco Health Solutions; Roger Chizek, Medtronic, Inc.; Tracy Watts, Mercer; Robert Hollenbach, Merck & Co., Inc.; Greg Heaslip, PepsiCo, Inc.; Mary Bradley, Pitney Bowes, Inc.; Fred Williams, Quest Diagnostics Incorporated; Robin Belk, Safeway Inc.; Melissa Metzgar, Starwood Hotels and Resorts Worldwide, Inc.; Ted Nussbaum, Towers Watson; Meredith Baratz and Vincent Kerr, M.D., UnitedHealth Group; Cliff Feldman, Verizon Communications; Ruth Dust and Beth Moore, Visant Corporation; Steve Hunter, Steve Lampkin and Sally Wellborn, Wal-Mart Stores, Inc.; Razia Hashmi, M.D., WellPoint, Inc.