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Risk Assessments: The Picture of Health

These checks can identify potential health problems

Fifth of five stories

FRIDAY, Aug. 26, 2005 (HealthDay News) -- Are you at risk for heart disease? Could you have diabetes and not even know it?

An increasing number of employers are giving their workers a chance to identify health problems like these -- in many cases, even before symptoms arise.

"Health risk assessments" have grown in popularity as more companies shift greater responsibility for health-care decisions to their workforce, a model called consumer-directed health-care.

"By identifying these [health] problems and addressing them, you actually may be able to mitigate or alleviate some of these problems that come up," said Dr. Charles Schutz, chief medical officer of Destiny Health in Oak Brook, Ill.

A health risk assessment may involve an online questionnaire, an on-site health screening or both. The idea is to give employees at least a general idea about their health status and to identify possible health risks. When potential problems or gaps in diagnostic information arise, employees are encouraged to see their own physician for additional screening.

Someone who hasn't had his or her cholesterol checked in years but has a family history of heart disease would be a prime candidate for such a follow-up.

As an incentive for employees to make positive health changes, some companies and health plans offer special rewards. For example, Destiny Health, a provider of high-deductible health insurance, offers such perks as airline travel miles, discounted vacation packages and health club rebates to members who attain healthy lifestyles.

It's not just that employers want a healthier workforce, although that certainly is a major motivation, said Ray Werntz, a senior consultant with HPN WorldWide, a provider of health risk assessments. Another reason for offering these health screenings and risk assessments is to compensate employees for reducing their health insurance benefits, he said.

When companies switch from traditional health insurance to a high-deductible plan, they're essentially taking away some benefits and replacing them with options such as a health savings account, Werntz explained.

"And they're saying to people, 'If you're really clever and financially savvy, you'll be more cost-conscious,' " he added

A health savings account allows consumers to put away pre-tax dollars for out-of-pocket medical expenses not covered by high-deductible health plans.

Werntz isn't convinced, however, that the consumer-directed health-care model can tame ever-escalating health care costs.

For example, once people hit their deductible on a high-deductible plan, then the "consumerism" that HSA proponents so strongly promote goes away, he explained.

What's more, he added, the existence of high-deductible plans doesn't necessarily mean people are going to choose the right care.

The idea that people will somehow make the right choices if you put a price on health care and make them spend more of their money "is flawed," he said.

Proponents of consumer-directed health-care defend the philosophy, insisting that Americans understand their own health-care needs and are in a better position than a managed care plan to call the shots.

If Destiny Health's membership is any indication, the concept has wide appeal. Schutz said the company serves a broad demographic, with members spread evenly from their early 20s to age 65. Medically, its insured population looks much like any commercially insured group, including people with chronic illnesses.

Offering health risk assessments is a key part of Destiny's program. Employers gain a baseline assessment of the health of their workers and can begin to build some enthusiasm for people to make healthy lifestyle changes, Schutz explained.

So if your employer asks you to take a questionnaire or roll up your sleeve for a blood draw, should you do it?

"Absolutely, that's a no-brainer," Werntz said. At least you'll have the knowledge about your health condition and you can take it from there, he said.

"The goal of all of this is to get doctors and patients talking to each other when somebody's got a problem," he added.

More information

The National Heart, Lung, and Blood Institute offers several online health assessment tools. To read the fourth article in this series, click here; to read the third article in this series, click here; to read the second article in this series, click here; to read the first article, click here.

SOURCES: Charles Schutz, M.D., chief medical officer, Destiny Health, Oak Brook, Ill.; Ray Werntz, senior consultant, HPN WorldWide, Elmhurst, Ill.
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