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HomeMy WebLinkAboutHRA Memo for BOCC 11-25-13 TO: BOARD OF COMMISSIONERS FROM: DAVE INBODY & RONDA CONNOR SUBJECT: HEALTH RISK ASSESSMENTS DATE: 11/22/2013 CC: TOM ANDERSON, ERIK KROPP Background Deschutes County first offered health risk assessments (HRAs) to employees and dependents in January 2011. It was offered to anyone on the health plan over the age of 18. A total of 377 people received HRAs in 2011. The health risk assessment included the following: Online Questionnaire –a series of questions regarding a variety of health-related topics Biometrics – Height, weight and blood pressure was measured for each participant Fasting Blood Work – cholesterol, triglycerides and glucose levels were tested In 2012, HRAs were again offered. Employees were encouraged to make an appointment to review their results with a provider at the Deschutes Onsite Clinic (DOC). In addition, e mployees were given a one-month health insurance premium holiday ($65 value) for taking an HRA. This had a significant impact on participation among employee. Spouse and dependent participation was about the same as 2011. The total number of participants was 582 The incentive for getting a one-month health insurance premium holiday was extended in 2013 to include not only employees, but also spouses. Since the premium had increased to $90 per month, the incentive was increased to $90 as well. In order to qualify for the incentive, an employee needed to not only complete the online questionnaire, biometrics and blood work, but a follow up visit with a health care provider to discuss the results was also required. The additional incentive for spouses resulted in a significant increase in spouse participation. Employee participation was about the same. Another change was a more concerted effort to get patients into the Deschutes Onsite Clinic (DOC) for their blood work. In the previous two years, large events were scheduled at work locations through which the vast majority of blood draws were completed. Although there were a few events in 2013, the majority of blood draws occurred at the DOC. HRA Participation by Year and Participant Type Year Employees Spouses Dependents (18-26) Total 2011 Participants 320 48 9 377 % Participating 31% 7% 5% 20% 2012 Participants 536 40 6 582 % Participating 52% 7% 3% 30% 2013 Participants 532 265 2 799 % Participating 52% 37% 1% 38% 2 2014 Health Risk Assessment For 2014, like 2013, it is recommended that the HRA include completion of an online questionnaire, biometrics, blood draw and follow up visit with a provider. In addition, it is recommended that anyone whose results indicate at least two risk factors be required to meet with either a provider or the wellness coordinator to develop a plan for addressing those risk factors in order to receive the incentive. This is intended to address identified risk factors, which typically lead to high health plan costs if not managed. Last year, the deadline to complete the blood draw was March 31, the deadline for the follow up visit was June 30 and the incentives were disbursed in August and September. It is suggested that instead of a one-month premium holiday, a monthly premium discount be provided. The discount will begin in August and continue for the next 12 months. For those with two or more health risks, they will be required to check in with a provider or the wellness coordinator on a quarterly basis to review their health plan in order to continue receiving the incentive. Each employee premium for the 2015 plan year (August 2014 -July 2015) will be based on the following: Employee Type HRA Participation Premium Rate* Single Employee Employee Participates $74 per month Employee Does Not Participate $82 per month Married Employee Employee & Spouse Participates $74 per month Employee Participates, Spouse Does Not Participate $82 per month Neither Employee or Spouse Participates $90 per month *All rates are based on current plan rates. These rates could be altered for plan year 2015. Why do Health Risk Assessments Matter? The reason for providing HRAs is to encourage participants to pursue a pro-active, preventive approach to health care. The participant is provided a snapshot of their health condition, highlighting any risk factors identified. Early detection and management of potential risk factors can prevent the onset of a chronic condition. Additionally, providing an annual opportunity for employees to meet with a health care provider to discuss their health condition will enable participants to better understand their health. For Deschutes County, a healthier population results in lower health benefits costs. 1. HRAs Save Claims Cost by Detect Conditions Early In the last 12 months, 60% of health benefits expenses were as a result of 284 (10% of covered lives). Many high-value claims are for behavioral-driven conditions. For example, among the 100 members with the highest claims cost in the health benefits plan in the last 12 months, 19% were diagnosed with heart disease (vs. 4% among all covered lives in plan) and 13% were diagnosed with diabetes (vs. 4% in plan). The cost is significantly reduced if these conditions are detected early or avoided completely through preventive treatment. The risk for both of these conditions can be tracked through the testing provided as part of the health risk assessment, such as blood pressure, cholesterol, triglycerides and glucose. 3 2. HRA Participation Leads to Cost Savings People who participate in the HRAS process spend less in the following year than those who do not participate. The greater the level of participation, the lower the claims cost. 4 3. HRA Participants Increases Health-Conscious Behavior HRA participant are more likely to take preventive steps toward detecting and treating chronic conditions. Here are a few examples Preventive Actions Plan HRA National At least one office visit 88.6% 95.1% 78.2% Mammogram (Women 40+) 48.1% 52.8% 33.4% At least one dental visit 73.6% 86.9% 63.5% Conversely, those who do not participate in the HRA process are more likely to pursue more emergency-driven, higher cost actions. Fewer ER by HRA Participants Fewer Urgent Care Visits by HRA Participants More cases of diabetes and heart disease among HRA participants, but…….. 5 The cost of treating cases of diabetes and heart disease is less among HRA participants.