One of the things I love most about my job is the face to face (or videoconference camera to videoconference camera) time I get with population health professionals, learning about their challenges and discussing opportunities for a quality health risk assessment (HRA) within their programs.
After countless conversations with the true boots-on-the-ground population health pros, you start to notice some patterns to our conversations. So what are the top concerns I encounter in these conversations, across regions, from corporate wellness plans to health system, no matter how large or how small the organization?
Topping the list these days is budget. How much does a health risk assessment cost?
The short answer is that cost will vary. There are stripped-down free HRA solutions out there, and there are feature-rich built out HRA solutions that cost large health systems or wellness plans hundreds of thousands per year. The difference in pricing will come down to the size of your population, and the features you need from your HRA. (The sales guy in me feels inclined to point out that in a recent case study, Wellsource client Welltok helped one of their groups realize $85,000 direct return on investment from their HRA). Some select features will contribute to what you can expect to spend on an HRA—costs associated with regulatory compliance, integration needs, how evidence-based and scientifically valid the question set is, and how you’re planning to use the data. Each of these factors will contribute to your HRA program results, and ultimately health improvements you are hoping to see as a result from your population health programs.
The real question when budgeting for a health risk assessment is this: how do you know you’re getting a quality product for the cost?
In this post, we’ll take a look at some of high-level cost considerations you may encounter when selecting an HRA.
Third-Party Certified Quality
When you administer an HRA, what you’re really trying to do is gather data that will inform you about your population. You can learn a lot from looking at aggregate data—but only if the data is reliable and collected in a way that you can trust. When it comes to data integrity, the old adage is true: garbage in, garbage out. But how do you know you can trust the quality of your data?
This is where third-party certification can help you evaluate the quality of your HRA vendor. Getting an HRA certified by a national accreditation body such as NCQA is no easy feat – it take years of development and a significant investment to meet the list of requirements in order to become a certified solution with NCQA. It’s also an ongoing commitment – recertification is required every two years. This process is rigorous and ensures your HRA solution is of high quality. This also means quality outcomes for your organization—and can help your organization achieve health plan accreditation.
Research and Development
Did you know that last year alone over 956,000 new research articles on health, fitness, nutrition, lifestyle medicine, chronic disease, and prevention were published in scientific journals? That’s a lot of information to sift through, evaluate, and incorporate into your HRA’s algorithm and scoring.
A quality HRA will be grounded in solid science, be evidence-based, and produce scientifically valid results based on the most current research from the best health and medical organizations available. The Wellsource Health and Research team, for example, continually reviews new scientific research, and turns those outcomes into evidence-based algorithms and educational content. Some of their sources for research include:
- National Institute of Health (NIH)
- Centers for Disease Control and Prevention (CDC)
- U.S. Preventive Services Task Force (USPSTF)
- American Heart Association (AHA)
- American Cancer Society (ACS
This work is a critical component in getting quality data. And quality data informs population health initiatives and provides end users with educational content they need to make lasting changes in their health habits.
Readiness to Change
Identifying where populations and individuals need to change is one thing; identifying which areas they are READY to change is entirely another. We’ve all witnessed this (and potentially been there ourselves)—someone has a habit that they know is not healthy, but that individual is unwilling to change. Trying to force a change in this circumstance can feel akin to Sisyphus rolling the boulder up the hill, using persuasion, knowledge, and genuine caring to get all the way to the top—only to see the boulder come crashing back down because they are not genuinely ready to make those healthy habit changes!
Asking readiness to change questions is one thing that sets Wellsource HRAs apart. Our readiness to change questions are based on Prochaska's Transtheoretical Model, which evolved through studies examining the experiences of smokers who quit on their own and what circumstances helped them do so. Their findings? Simply put, when people are ready to change habitual behaviors, they will go through a cyclical process of intentionally changing said behaviors.
Including these questions in an HRA helps to target at-risk individuals and populations in areas not only where they need to make a change, but where they are READY to make a change. This can dramatically increase the efficacy of implementing a health and wellness plan that produces measurable results, reduces the cost of claims to payors, and creates a more engaged, healthy, and productive population.
Privacy and Security
An HRA collects highly sensitive, protected personal information—and must keep that information safe in order to meet HIPAA standards and avoid costly fines. In 2019, the average cost of a data breach for healthcare entities was $6.45 million—or $429 per record. Think about the number or people taking your HRA, and what multiplying that number by $429 could mean. The sobering reality is that you cannot afford to take privacy and security concerns lightly. That’s why it’s important to ensure your HRA is compliant with HIPAA-HITECH, GINA, and adheres to high standards security practices.
It’s also a good idea to protect your HRA data with additional security considerations such as Single Sign-On (SSO), and ensure any API data integration is encrypted and includes multiple redundant layers.
Customer support is an all-too-often overlooked component in a lot of software as a service (SaaS) purchases. At the end of the day, once your purchase has been made, who will be there to walk you through implementation? How much dedicated support will you receive? Do you know who to contact if you have a question – and will a real person pick up the phone if something goes wrong? When purchasing a software solution you are also entering into a close partnership with a company. At Wellsource we have seen the benefit of this kind of strong customer relationship, resulting in a true partnership where our customers help inform future development, provide ongoing feedback, and generally work in a cohesive way that benefits both organizations. So be sure to carefully consider your program needs and the level of support – or partnership – you may require from your HRA vendor.
Next Steps in HRA Pricing
When budgeting for your HRA, clearly there are a lot of considerations to be made beyond one-time implementation costs or recurring annual licensing fees.
Interested in learning more about HRA pricing? I wouldn’t be a true Director of Sales if I didn’t use this opportunity to encourage you to set up a free consultation with our Wellsource team. Otherwise, I encourage you to consider your program needs and how they align with the capabilities of your HRA. Here’s a great place to start: use this free checklist resource to evaluate your HRA vendors across issues of security, integration, and user experience.