12 Questions You Should Ask Your HRA Provider

With HRA’s Gaining Momentum, The Key To A Good Experience Is Establishing Expectations Up Front.

Health risk appraisals–or HRA’s as they are commonly referred to in the wellness industry–are rapidly gaining momentum in the employer community. Indeed, according to a recent Hewitt and Associates Survey, employer HRA usage has increased from 29 percent to 41 percent in recent years.

If you are not familiar with HRA’s, they are, in essence, short questionnaires that measure and quantify an individual’s health status. HRA’s (also referred to as personal health assessments)can bedelivered in both electronic and hard copy formats. They generally require about 15 minutes to complete andonce the participant is finished, they’ll receive a short report detailing important findings about their individual health status. For setting up the experience, the employer receives an aggregate report highlighting important findings about the group’s health status–sans any personally identifiable information.

Judging from the number of employer’s that are currently using HRA’s, thereappears to be little question about the value–for both the employer and the employee.

In fact, if theexercise is done right, employees can learna lot of important informationabout their health status and how to protect it. At the same time, employers canunearth thecompany’s major risk factors and identify what health enhancement programs they should be offering in order to improve the organization’s overallhealth and productivity.

But be warned: a lot can go wrong with the HRA process if you are not careful.

Unfortunately, many employers find out about this nasty littlereality on thetail-end of this experience–andthat’s way, way, waytoo late.

If you areconsidering usingan HRA with your employee population, I suggest you ask the following 12 questions of your provider…and get concrete, satisfactory answers before yougo any further.

If you are presently using an HRA, I’d recommend backtracking and getting some of the t’s crossed before administering the next round.

Remember, health risk appraisals are still a brand new phenomenon. As a result, I recommend that every vendor be considered guilty until proven innocent.

Question #1: How long have youbeen in business?
This is a great place to start and will help you cut right to the chase. You’ll want to ask this questionat the outsetbecause, given the newness of HRA’s, there are a lot of”start-up” entrants into the marketplace. You’ll definitely want to proceed carefully with start-ups for two reasons. First,start-ups may notpossess the experience you’ll need to do a good job–and you don’t want to be the guinea pig. Second, if the company fails, you can say goodbye to your data. This is particularly challenging because you’d like to have continuity over time. Certainly, a lot of start-up providers can do a great job, but I’d ask the question anyway.

Question #2: Have you had security breeches orHIPAA violations?
This is a question you won’t want to omit. After all, HRA’s are all about security and confidentiality. The more experienced the provider, the less likely they are to have security issues. It’s important to note that even if the company has had some bumps, it’s important to ask how the issues were rectified.

Question #3: Am I getting your best price?
Because you’ll want to provide HRA’s on an annual basis, price should be a consideration in the equation. But like airline tickets, the prices can vary considerably, even for same-size clients. The usual price for an electronic HRA is between $5 and $12. This is a pretty wide range–I’d ask about the competitiveness of the price you are being quoted.

Question #4: Are there hidden charges?
There’s a big difference between additional charges and hidden charges. It’s perfectly reasonable to expect additional charges if you want additional services like customization and personalization. However, hidden charges are another thing altogether. Aim for complete transparancy. Set-up charges, data-management charges, etc. can be a real surprise and sometimes add as much as 50% to the price of an HRA.

Question #5: How hard is it for me to get my data?
Data exchange/ownershipis one of the real challenges in a customer/provider relationship. A goodHRA providerwill make the process very simple–without a lot of additional charges. After all, it’s your data. I’d also askhow long they planto keep a copy of your data in their database. If you’d like to make time period comparisons, they’ll have to have a pretty robust storage sytem. Lastly, I’d be sure to ask if they plan to use your data for anything other than just storing it for you. I’m not sure I’d be thrilled about it if they say yes.

Question #6: Do you have a list of references?
A reputable company will have this at the ready. And, I’d call enough of the referencesuntil you are satisfied that everything is on the up-and-up. When you check references, don’t be fooled by a commonly used tactic–the reference is another so-called expert in the field. The only people you should count as valid are the actual references of other companies that have used the tool/service. Oh, and by the way, I wouldn’t hesitate to ask the references about price.

Question #7 Who will be my contact person?
This question is very important because what often happens is a company will close the deal with a very charismatic, obliging salesperson. And then when it comes time to implement, you’ll get handed off to a computer geek or a college intern. By asking this question up front, you’ll be way ahead of the game because it’sthe implementation staff-personwho you’ll be spending the majority of your time with.

Question #8: Is theHRA private labeled?
Many providers “private label” an HRA to make it look like their own. If they do private label, I’d ask about who you’ll be doing business with if there is a breach or HIPAA issue. Also, sometimes private labeling can slow the whole process down because you do business with the provider who then hands the task off to the main company and they process the job and send it back to your provider and then on to you. This can be sloooooow. Sometimesprivate labelingis not a big deal. Sometimes it’s huge.Either way, I’d want to know up front who you are doing business with.

Question #9: Do you have online tech support?
Because many people–especially your front line people–are not technologically savvy, they may need help. A good company should have online tech support to handle user issues. If they don’t have a tech line that is immediate, you could be in for some real problems, especially if there is a deadline or incentive associated with the process. If you don’t think this is a big deal, imagine your phone ringing off the hook with frustrated users who want answers pronto. Ask the question.

Question #10: Will you help me with the communications process?
This is another commonly overlooked question–but it’s still very important. HRA’s work well when the process is clearly communicated. Will your provider give you assistance in this area? Are there communication tools that you can use at no charge? Is there a planning matrix? A good company will have asnwers to these questions and materials that you can use at little or no charge.

Question #11: Will someone help me interpret my aggregate report?
As Yogi Berra said, “it ain’t over until it’s over.” And, in this case, the process isn’t done until your aggregate report has been generated and discussed. A good HRA provider will do a lot more than just pdf you an aggregate report and send you a bill.

Question #12 Are you considering selling your company?
Because continuity is important in the HRA process, I’d ask this question. More than one company has been burned when they work with a provider–sometimes for years–and the company gets sold. This can wreak havoc with your longitudinal data needs. Even though you can always find another HRA, you can’t always make “apples to apples” comparisons.

BONUS QUESTION: Who is my emergency contact if something goes south?
This is a big question and should factor heavily into your decision. Your provider should give you a 911 number if something goes seriously wrong. Get that number and contact person up-front.

There you have it–the Big 12, if you will. Plus one for good measure.

In closing, it’s important to reiterate the fact that health risk appraisals or personal health assesments are still relatively new to the workplace. In light of this, it’s definitely in your best interest to ask the aforementioned questions.

By sorting things out up front, you have greatly increased your chances of success in the HRA administration process. And both your employees and employer will be healthier for it.

If you have questions or comments, please donot hesitate to email me at dhunnicutt@welcoa.org.

Yours in good health,

Dr. David Hunnicutt

Copyright 2006, David Hunnicutt.com

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The views and perspectives presented by Dr. Hunnicutt do not necessarily represent those of WELCOA.