A new health risk assessment (HRA) for the senior population combines a variety of measures including frailty, probability for repeated hospital admissions, depression and health service usage to categorize risk in individuals 65 years and older. The SrHRA™ from DSS Research combines a variety of established measures regarding physical and mental health, preventive care and current healthcare usage into an integrated survey tool to categorize members from low to high risk on a number of dimensions including overall health, mental health, frailty, probability of hospital readmission and other general risks based on existing conditions and lifestyle.

The online reporting system provides a comprehensive set of reports that gives a complete picture of the overall health of members, results for individual members and the ability to search the member health risk database on a wide range of criteria. Results can be summarized for any subpopulation of interest, and individuals can be selected for intervention based on criteria established and entered into the reporting tool. Summary reports can be printed for case managers, and personalized reports can be mailed to individual members or given to their healthcare providers for patient follow-up.

"We have enough evidence and science to know that HRAs are valuable. It’s important to start the process. The longer the HRA and targeted interventions are delayed, the more people will suffer the consequences of unhealthy lifestyles.”
                                        — Wesley Alles, Ph.D., director of the Stanford University Prevention Research Center.

According to the 2009 Health Benefits Survey recently released by the Kaiser Family Foundation, 16 percent of employers give their employees the option of completing an HRA to help identify potential health risks. Within this group, 11 percent of employers offer financial incentives such as lowering the worker’s share of premiums or offering merchandise, gift cards, travel, or cash to their workers. Large firms are more likely than small firms to offer both HRAs and financial incentives.

The survey also found that more than half (58 percent) of employers offering health benefits offer at least one of the following wellness programs: weight loss program, gym membership discounts or on-site exercise facilities, smoking cessation program, personal health coaching, classes in nutrition or healthy living, Web-based resources for healthy living, or a wellness newsletter. Forty-eight percent of firms offering health insurance and wellness benefits offer the benefits to spouses or dependents.

Among firms offering health benefits and at least one wellness program, 81 percent of employers report that most of the wellness benefits they offer are provided through the health plan.

Question: Which factors keep people from enrolling in health coaching once they have taken an HRA?

Response: In a comprehensive program, individuals who come to health assessment are getting fairly tailored feedback about their risk level. Depending on the type of tool you’re using, this feedback might be paired with stages of change, stages of readiness or other learner preferences or motivational variables to help the participant make a decision about what type of intervention is right for them. For example, our organization and many others provide quite a menu of intervention options. There might be Web-based online interventions that are fairly tailored to the individual’s needs, materials-based programs, educational campaigns, contests, onsite options, (sometimes onsite coaches) and also telephonic coaching. When you think about this uptake of 30 to 60 percent of people who are selecting coaching, you have to put that in the context of the fact that they had a lot of other choices to make regarding other interventions that might make sense.

(Paul Terry, Ph.D., is president and CEO of StayWell Health Management.)

HIN's Health & Wellness Promotion Benchmarking Series is a two-volume series with benchmarks on health coaching and health and wellness incentives, from health coach case loads to effective incentive design. Healthcare payors and purchasers can use this detailed data to compare their incentives and coaching offerings to others in the marketplace and defend their efforts to budget-conscious C-suites.

HealthCoach Huddle subscribers can use ordering code HCH to purchase this resource at a special price!

How do healthcare organizations use health coaching, and on which key behaviors do coaching interventions focus? By which modalities do they administer and monitor health coaching in their populations and how do they measure its effectiveness? The Healthcare Intelligence Network set out to answer these questions and others during its annual Health Coaching e-survey. This just-published executive summary of responses from 212 healthcare organizations identifies emerging trends in the field of health coaching and its effect on healthcare utilization and spend.