Employer Health Management Consortium

1
Employer Health Management Consortium Doug
Wright THE UNIVERSITY OF MICHIGAN HEALTH
MANAGEMENT RESEARCH CENTER January 24, 2007
2
Health Risk Appraisals (HRA)
3
HRA, aka

• HRQ (Health Risk Questionnaire)
• HPQ (Health Productivity Questionnaire)
• HHQ (Health History Questionnaire)

4
Goals of HRA

• Assess risk factors
• Lifestyle/Biological
• Psychological
• Collect demographics
• Determine lifestyle
• General health
• Are you ready to change?
• Contact info for follow-up

5
Who offers HRAs?Everybody and their
grandmother!!!

• HMRC (of course)
• Wellsource
• WebMD
• Staywell
• Matria
• Winning Habit
• HealthIQ
• Aetna

• Gordian
• Summex
• Kaiser
• Mayo
• CorSolutions
• VieLife
• CHAMP
• FutureHealth

6
Questions to ask

• Is your HRA validated?
• If so, how was it validated?
• Does the validation appear in any scientific
  journals?
• Predict current costs/health or future?
• Can it be customized?

7
Items to consider

• Length of HRA (25 to 100 questions)
• Time to complete
• Type of HRA
• Self-report info
• Measured biometrics
• Combination
• Delivery Web, paper, on-site, combination

8
Items to consider, cont.

• Areas covered
• Nutrition, exercise, smoking, productivity etc.
• Questions that make you squirm
• Population considerations
• Religion, union, job types, reading level
• Type of feedback to the participant
• None, doom and gloom, encouragement, areas of
  concern, resources available?
• Cost

9
Frequently Asked Questions

• Confidentiality
• Disclaimer (legal issues)
• Defaults low risk
• Question choice mortality, productivity, cost
• Updates regular, rigorous, new
  science/interests in health and productivity cost
  drivers literature review, federal guidelines
• Web and paper- HIPAA, identical

10
Profile

• Tailored age, gender, risk, preventive service
  compliance, resources
• Risks in order of their impact to health care
  use
• Wellness score validated to health status,
  health care costs and utilization

11
Health Risks and Behaviors
Health Risk Measure Alcohol Blood Pressure Body
Weight Cholesterol Existing Medical Problem Use
of medication Illness Days Life Satisfaction Job
Satisfaction Perception of Health Physical
Activity Safety Belt Usage Smoking Stress Health
Age Index
High Risk Criteria More than 14
drinks/week Systolic 139 or Diastolic 89
mmHg BMI? 27.5 Greater than 239 mg/dl Heart,
Cancer, Diabetes, Stroke, Chronic
Bronchitis/emphysema Sometimes or frequently 5
days last year Partly or not satisfied Partly or
not satisfied Fair or poor Less than one
time/week Using safety belt less than 100 of
time Current smoker High 4
Overall Risk Levels Low Risk 0 to 2 high
risks Medium Risk 3 to 4 high risk High Risk 5
or more high risks
12
Sample Costs

• Paper HRA (Processing, SH, HRA cost)
• New client without evaluation 10.50 per HRA
• New client with evaluation 10.00 per HRA
• Web HRA
• New client w/ w/o evaluation 3.50 per HRA
• 1500 Set-up fee, 500 per customization
• Evaluation 35,000 minimum
• Ask vendors What does the cost include?

13
Reports

• HRA summary (free w/ or w/o evaluation)
• Risk status
• Participation rate
• Prioritized risks
• Preventive service compliance
• Medical conditions
• Interest to Change
• Evaluation clients
• Risk Cost Report
• Special Reports (Disability, Cost savings, etc.)
• Decision Support
• Special interest questions

14
Thank you for your attention.
Please contact us if you have any questions.
Doug Wright (general questions) Phone (734)
764-3558 Email wrightdw_at_umich.edu Elaine
Schnueringer (Purchasing) Phone (734)
647-2712 Email elaines_at_umich.edu
Website www.umich.edu/hmrc