Online tools take care of everything from our banking and groceries to shopping for luxury goods and finding a partner. But the latest initiatives from the medical insurance industry suggest the internet could also hold the key to motivating employees to lead healthier lifestyles.
In exchange for 10 to 15 minutes in front of a computer, an online health risk assessment can provide an employee with an insight into their health, showing them where improvements could be made and giving them the advice and support to make the changes.
It certainly makes sense to motivate employees to make improvements. Healthier employees offer organisations a number of benefits including reduced sickness absence and increased productivity. Tim Smithers, healthcare manager at Healthcare Partners, says the concept is sound. “If an employee maintains a healthy lifestyle, they’ll make fewer medical insurance claims. This can help to reduce the cost of cover,” he says.
Benefit bonanza
Given these benefits, many of the insurers now include an online health risk assessment alongside their medical insurance offering. For instance PruHealth has an online health review as the gateway to its Vitality programme, Bupa offers its Positive Health product and Axa PPP Healthcare recently launched its Health Age Calculator as part of its Healthcare Pathway product.
These online tools are also a common feature on many of the corporate cash plans including those from Westfield Health and Health Shield. Additionally they can be obtained from some of the specialist health and wellbeing companies such as Vielife, SISU Wellness and EnergiseYou.
Although they are offered through different brands they all work in a similar way. By answering a series of questions on areas such as diet, exercise, alcohol consumption and general wellbeing, an assessment can be made of the employee’s health. The tool can then highlight any areas where improvements can be made and recommend ways to do this.
How this information is presented varies. For instance the Q Score system, which is used by Westfield Health and Aviva UK Health, places employees in a queue of 100 people of the same age, sex and race, ranking them according to their health. Vielife uses a series of traffic lights to show which areas of an employee’s health are good and where work is needed.
Age is another popular means of portraying the state of an employee’s health. Many, including Bupa, give employees a figure showing them what their health age is based on the average population.
Axa PPP Healthcare has taken this a step further, using the life expectancy of an average healthy UK person rather than an average population. This means healthy employees won’t see as much of a reduction in their years as with the other age-related tools but Dr Chris Tomkins, head of personal health risk management at Axa PPP Healthcare, believes it is a more accurate way to assess health. He explains: “The average population includes a lot of unhealthy people so by basing our assessment on average healthy people we may be being harsher but it does generate more searching appraisals of employee’s health age as well as setting more demanding targets for improvement than on other models.”
Data download
As well as different ways of ranking results, the follow up provided can vary too. Some services, especially those provided as added value benefits on other products, provide a report once the test is completed, while others set up ongoing email support to help keep the employee on track with their health improvements.
For example, Katy Cherry, product director at Vielife, says that with her service, employees receive regular emails to make them aware of health improvements they could make.
“As well as a general health risk assessment, employees might also take a more targeted one to triage them to the right solution. This will generate further information to help them make changes,” she explains. “We also send regular emails to employees if they’re taking part in one of our behavioural change programmes, such as a six week weight loss programme, to keep them motivated.”
But while some services are very proactive, Charles Alberts, senior employee benefits consultant at Lorica Employee Benefits, believes this is an area where careful selection is essential. “On some of these services the follow up information needs to be more customised, practical and positive to make it drive change,” he says. “For some, completing the questionnaire will be enough to remind them they need to make changes but some of the follow up information can be negative.”
The employer can also receive information about the results with many of these services. Although the data is anonymised to ensure employees’ confidentiality is maintained, this can highlight the greatest health risks in the workplace. This insight can be taken a step further for larger organisations, with some of the services enabling employers to customise the questions they ask employees.
Although not all services provide this management information, Alberts believes it is one of the most important elements of a health risk assessment. “It’s worth investing the time and effort to encourage employees to take the assessment as this will generate useful data to show the employer where they’ll get the biggest return on investment,” he explains.
Barriers to change
But while offering such a service can deliver personalised health information to inform change, the success of health risk assessments is far from guaranteed. In particular average take up is low. For example, Paddy Watt, director of corporate at Bupa Health & Wellbeing UK, says that even where a scheme is well communicated, take-up is only between 20 and 30 per cent.
Further, those who do take the assessment can often be the ones least likely to benefit. Smithers explains: “These assessments tend to appeal to employees who are already healthy. The ones that would benefit from making improvements to their health are often too scared to complete them.”
This can significantly reduce the probability of improving employee health across the workforce but can have wider ramifications too. Sharon Harwood-Davis, consultant manager at Advo Group, says that if the pool of people completing the assessment is skewed towards those who are already healthy, the data an employer receives can be completely worthless. “Any health improvement programme based on the management information will be focused on the healthy employees, which could further alienate those who would benefit most from making changes,” she explains.
Increasing take-up is possible. Competitions, where employees who complete the health risk assessment are entered into a prize draw, can work well. Cherry says she’s seen prizes used to good effect but also suggests creating some excitement in the office around the health programme. “Have health champions throughout the organisation who promote the programme. It will help to create a buzz and make it a fun, social experience,” she explains.
It’s also important to explain why the health risk assessment is important. Letting employees know the employer is keen to help them become healthier and launching a few simple, instant win initiatives such as free fruit, can help gain support for the assessment.
But, although it’s important to explain the employer’s reasons for introducing the assessment, Alberts cautions against branding it as the organisation’s. He explains: “If they think they’re providing this information to the employer, rather than confidentially to an independent organisation, they may become suspicious and this will reduce the numbers who complete it.”
Compulsion could also be introduced. As an example, in the US, membership of the medical insurance scheme is dependent on completing a health risk assessment but this is unlikely to translate well on this side of the Atlantic. “It’s unlikely we’ll get to this point in the UK but we would like to integrate it more into our medical insurance product so employees are well aware of it,” says Watt. ” We’re working on the engagement side, looking to take this beyond the launch phase when the employee completes the assessment. It shouldn’t be something that just sits on the shelf.”
As well as raising the profile of the health risk assessment and encouraging more employees to complete it, Harwood-Davis says employers should regard it as part of a longer term initiative. Her firm is launching a health and wellbeing division this month to provide consultancy services to employers looking to improve employee health. “Employers can’t rely on a health risk assessment alone as a means of changing employee behaviour,” she says. “It needs to be part of a much broader package that involves using the management information to design a programme that suits employees. To change behaviour you need to take baby steps.”
The employer also has a very significant role to play in the success or failure of a health risk assessment. Smithers says it’s essential for the employer to buy in to the concept of health improvement. He has two clients in the City who had medical insurance through PruHealth. One embraced the concept and encouraged employees to take advantage of all the health related elements; the other bought it because it was the cheapest and no one really noticed when he switched at the end of the year. “If the employer doesn’t buy into it, any health and wellbeing campaign will be flawed,” he explains. “To make it win, they’ve got to want to help employees make changes.”
