Why health risk assessments (HRAs) are more important than ever for employee health and wellness

Employers are evolving how they use HRA data to help manage impacts of the COVID-19 pandemic, such as mental illness, chronic disease and work-life changes.

By | 3 minute read | November 10, 2020

Woman with a mask on seated at desk and working on a laptop.

The pandemic is causing significant disruptions to business continuity and driving new costs from COVID-19 cases. The consequences don’t stop there, however, as HR and benefits management teams are realizing other impacts on employee health and wellness, such as mental illness and delayed care for chronic conditions and prevention.

Employers must understand emerging employee health and wellness concerns, so they can prioritize the most valuable employee benefits programs and resources. Thoughtful use of the health risk assessment (HRA) can help employers understand and support the needs of employees and their families during this time of disruption.

4 HRA data types: How COVID-19 is affecting priorities in each area

An estimated 75% of large employers offer an HRA as part of their employee health and wellness strategy.1 A recent benchmarking analysis conducted among IBM Watson Health clients found that, on average, about half of employees use these company-sponsored tools each year.2

As the world responds to and recovers from the COVID-19 pandemic, benefits management teams must review the topics their HRA covers and consider prioritizing additional topics in several areas:

1. Well-being Impact

Typical HRA topics prior to COVID-19 Increasing priority for employers during COVID-19
  • Stress
  • Depression
  • Perceived health
  • Life satisfaction
  • Purpose /­ mindfulness
  • Anxiety
  • Financial wellness
  • Family /­ social support
  • Loneliness
  • Child /­ adult care

More than 40% of U.S. adults are struggling during the pandemic with depression, anxiety, substance abuse and suicidal thoughts, according to recent CDC findings.3  A convergence of factors (e.g., fear of infection, social isolation, new work-life challenges, economic uncertainty, political unrest) are contributing to this trend.

A growing number of employers are incorporating additional HRA items related to personal well-being, ranging from stress and depression to family, social and community support. They’re also recognizing the increasing impact of work-life demands, such as stress for caregivers, and using HRAs to inquire about childcare and elder care challenges.

2. Healthcare Disruption

Typical HRA topics prior to COVID-19 Increasing priority for employers during COVID-19
  • Biometrics
  • Preventive care
  • Chronic conditions
  • Medication­ adherence
  • Health literacy
  • Self-care
  • Health­care­ consum­erism
  • PCP /­ telemedicine

Many employer HRAs assess the level of care and screening for chronic disease, such as diabetes or cardiovascular conditions. Continuing to monitor these issues is important; the IBM Watson Health PULSE® health poll  found that half (48%) of respondents said they have delayed routine healthcare appointments during the pandemic.4 Avoidance of chronic condition care and prevention are expected to impact downstream health outcomes and costs, so identifying and closing care gaps is a high priority.

The pandemic is also changing the way consumers think about utilizing the healthcare system. Telemedicine usage is up, although this varies based on sociodemographic factors.5 As employees are presented with new options for care, employers should prioritize HRA topics that include health literacy, consumerism and self-care.

3. Lifestyle Changes

Typical HRA topics prior to COVID-19 Increasing priority for employers during COVID-19
  • Physical activity
  • Nutrition
  • Sleep
  • Substance use
  • Motivation
  • Home safety /­ ergonomics
  • Sitting /­ standing

Traditionally, employer HRAs have helped employees assess lifestyle behaviors around physical activity, nutrition, sleep, alcohol and smoking. An IBM Watson Health PULSE® health poll in August found that on average individuals have actually improved physical activity and nutrition habits during the pandemic (roughly 40% reporting better habits, vs. around 20% worse). However, some differences were seen across income levels.6

Benefits management teams should continue to monitor these behaviors and reinforce improvements. For those with employee populations who are spending more time at home – because of remote working or local regulations – a growing number of employers are also adding HRA items that cover topics such as home safety or time spent sitting vs. standing.

4. Work Culture

Typical HRA topics prior to COVID-19 Increasing priority for employers during COVID-19
  • Absen­teeism
  • Presen­teeism
  • Job satis­faction
  • Employee engag­ement
  • Employee experience
  • Work culture
  • Manager support

New workplace protocols and work-from-home arrangements have significantly impacted the work experience for many employees. In response, employers are placing increasing priorities on employee engagement, work culture and manager support to help navigate the changes.

This creates new opportunities for organizational functions to work together and align data to allow for a more complete picture of employee support needs. HRA items may be added which better connect stakeholders and objectives (e.g., benefits, occupational health and safety, talent management and leadership development.

Now is the time for employers to take a fresh look at their HRA strategy, align it with other initiatives in the organization related to pandemic recovery and prioritize ways to maximize value to both the organization and the employee.

  1. Kaiser Family Foundation, Employer Health Benefits, 2019 Annual Survey files.kff.org
  2. IBM Benchmarking Survey of 17 employers with annual HRAs, representing engagement from approx. 400,000 employees and 100,000 spouses/domestic partners, across 2017-2019 benefit plan years.
  3. CDC Mental Health Report, August 2020 cdc.gov
  4. IBM PULSE Health Poll represents responses from 3,005 U.S. survey participants interviewed from April 1 – 13, 2020 with a margin of error of +/- 1.8% ibm.com/downloads/cas/98KQ0XEJ
  5. Ibid.
  6. IBM PULSE Health Poll represents responses from 3,007 U.S. survey participants interviewed from Aug 1 – 15, 2020 with a margin of error of +/- 1.8% ibm.com/downloads/cas/81GKOG23