Ultimately any company looking to invest in the health and well being of their employees through a prevention program will want to know if the program achieved worthwhile results. There are many different ways companies in this field report their results and many different levels of validation.
One of the more common measures is engagement. How many of the eligible employees enrolled, completed an HRA and biometrics and then participated throughout the year. Did smokers engage in a smoking cessation program. Beyond these and other process measures, some vendors will show outcomes, the number of smokers that quit (was this self reported or validated) and changes in cholesterol levels are a few examples. Further outcomes can include other measures such as absenteeism rates, and even the use of survey tools to measure presenteeism. Finally, based upon Dr. Edington’s research, if health risks are the precursors to health costs and the goal is to keep the healthy, healthy in order to bend trend, did the program result in a reduction in health risks in your workforce? Did the low risk, healthy individuals remain low risk? Did moderate and high risk individuals move to a lower risk level?
All of these and others could be important indicators of the value the program brings to your company. So what should one consider as a base?
Here are some some of the ideas and key statistics you should be looking for from your vendor and ones you should ask about before you select a company?
- Is the measurement methodology used by the vendor a valid approach? The Care Continuum Alliance has released guidelines concerning the various ways to measure outcomes. From their website, Outcomes Guidelines Report Volume 5:
represents the latest product of a research initiative launched in 2006 to bring consensus, transparency and sound science to measuring clinical and financial outcomes in wellness and care management.
The report is free and can be downloaded here.
- What are the companies historical engagement rates at various points in the program; enrollment, HRA completion, lab and biometrics, program participation, re-enrollment for year 2. Low engagement and participation rates have been the bane of the industry and one of the reasons why most employers do not see results when they look at their entire employer group.
- Does the vendor report on important results from the HRA, lab and biometrics and provide detailed HIPAA compliant reports? Are the results all self reported or are some validated third party results such as lab results that are signed off by an MD or received directly from the lab to the vendor?
- Are the risk levels analyzed at baseline and each year thereafter as per the Natural Flow model by Dee Edington?
- Does the analysis of risks show a net reduction in risks when compared to the natural flow model, or more strongly do they show a net, net reduction in risks?In other words, did more individuals move to a healthier level as compared to baseline versus just showing an improvement as compared to the Natural Flow model?
- What were the changes in the individual risks used within the Natural Flow model?
- Does the company produce their own results, have outsiders validate them, publish them in a peer reviewed journal? Each of these provides their own level of independent scrutiny and should be considered.
- Does the company conduct a satisfaction survey and report the results.
- Do the results of any and all measures include statistical significance measures to show whether or not the results are truly meaningful?
For a more detailed discussion of outcomes and measurement, please feel free to contact me. In the next post I will review a published study looking at risk flows in a population.