Don’t Get Left Behind By People Analytics

in Data

Employers are getting serious about HR Analytics (aka People Analytics). At the same time, many of our wellness industry colleagues demonize data, often cloaking their anxieties behind advocacy of humanization

We’ll hear wellness leaders denigrate data because, for example, “it reduces people to numbers” (which could be the slogan for the International Society of Dataphobes).

But if we let our fears, insecurities, or aversions get the better of us, resisting data as a primary language of business, we’ll get left behind in a world where employers, even their HR departments, increasingly see the promise of analytics. Continue reading »

Health Risk Assessments: The Baby and the Bath Water

in Commentary, Employee Wellness Programs, Uncategorized

 

There may be some employees whose health has benefited based on some feedback they got on an HRA, but not enough to warrant the investment you are making in the HRA (that investment includes your organization’s money; your time; and, perhaps most importantly, your participants’ time, energy, and goodwill). But don’t listen to me. Your employees will also tell you that your HRA doesn’t make much difference to their health. That’s why some employers pay employees up to $500 just to complete an HRA.You wouldn’t have to pay employees to complete a simple form if they actually saw any value in it to begin with.

A series of blog posts about HRAs  has deconstructed HRAs with an eye toward better understanding their value or lack of value. Here are the cliff notes:

  • The conventional framework of employee wellness programs is predicated on the principle that improvements in the health risk profile of a population can lead to reductions in healthcare costs and improved employee productivity.
  • HRAs are techniques or processes of gathering information to develop health profiles, using the profiles to estimate future risks of adverse health outcomes.
  • HRAs are dependent on self-reported data, which is valid for effective use in population health management intervention, although its value at the individual level is questionable.
  • Importing clinical screening values — such as blood pressure and cholesterol — to an HRA does not add much validity to the HRA on an individual basis, but, like the self-reported data, should be sufficient to measure the health risk of a population.
  • HRAs may help steer individuals towards more intensive programs based on the position of the individual in the strata of the population’s health risk and predicted health care costs.

These findings point to the same thing: Health risk assessment is a population health tool. HRAs’ primary utility is in helping employers identify the health risks that deserve the most attention in order to achieve positive health and financial outcomes. The same tool can then be used to measure a program’s success in shifting the health risk of the population.

Unfortunately, employers have been using HRAs, a population health measurement instrument, as a behavioral intervention. No wonder you are disappointed. Be honest with yourself and with your employees: The HRA is for you — a potentially useful tool in the administration of your program. It’s not an employee benefit, and your employees know it.

Part of the reason employers have mistaken HRAs with a full-fledged health intervention is that vendors have marketed them as such. As a measurement tool, you should reassess whether your HRA is worth what you are paying.

But don’t rush to throw the baby out with the bath water. If you decide that your HRA’s capacity to measure risk in your employee population justifies its use, your next step is to reconsider whether you truly need to have all your program participants complete an HRA every year. Your vendor doesn’t want to hear it, but you may be able to realize the measurement potential of your HRA more cost effectively by having a sample of your employee population complete it every two or three years.

I’m not making a case for or against health risk assessments, just encouraging you to make a well informed and critical decision. What do you want your HRA to do? What does your HRA do? Is your organization getting its money’s worth?

[This article was originally posted on the InTEWN blog July 11, 2012].

The (Theoretical?) Framework of Employee Wellness

in Employee Wellness Programs, Uncategorized

tape measure, notebook, appleHow is employee wellness supposed to work?

For starters, here’s the prevailing rationale that serves as the framework of most employee wellness programs today:

  1. Most health problems, and their associated costs, are preventable.
  2. Modifiable health risk factors — such as tobacco use, sedentary lifestyle, and unhealthful eating habits — are precursors to many of these health problems.
  3. Many modifiable health risks are predictive of higher healthcare costs and decreased worker productivity.
  4. Employer sponsored wellness programs can reduce modifiable health risks.
  5. Improvements in the health risk profile of a population can lead to reductions in healthcare costs and improved employee productivity.

Important to this understanding of employee wellness are a few other learnings about health risks and their impact on health and productivity:

  • The number of health risks an individual has may have greater impact on financial outcomes than the severity of any one health risk. This is especially true for clusters of health risks related to heart disease, stroke, or psychosocial disorders (such as depression and anxiety).
  • Keeping low-risk employees low-risk may be a more direct route to health care cost containment compared to trying to improve the risk profile of high-risk employees. This focus on the low-risk, advocated by Dee Edington, is counter to a commonly accepted approach in which high-risk employees are targeted — based on the theoretical efficiency of targeting the 20% highest risk individuals believed to incur 80% of health care costs.
  • While it is unsurprising that risk is an indicator of future health problems, risk also is correlated — via mechanisms not fully understood — to near-term health care costs. In other words, one might expect that someone with cardiac risk factors is likely to incur higher health care expenses when they have, say, a heart attack, studies by Goetzel, Anderson, et al have shown that risk factors are associated with higher health care costs even in the near term, before the emergence of full-blown disease.
  • In employee wellness, absenteeism and presenteeism are the most common productivity metrics.

The model described by Goetzel and Ozminkowski is not the only rationale for conducting employee wellness programs. It may not even be the best rationale. But as we move forward in the next few posts to understand health risk appraisals — what they do, what they don’t do, and how they are perceived by wellness managers — it is essential to understand modifiable health risk and its role in the proliferation of employee wellness programs.


This post originally was published on Bob Merberg’s InTewn blog on May 27, 2012.