The Value of a Health Risk Assessment

When a patient visits his or her healthcare provider, it’s typically because of a sickness or an ailment. The provider will perform a series of short examinations and will ask questions about current symptoms. The purpose of the visit is to address the sickness or ailment — but most likely will not cover a thorough assessment of overall wellness. This commonly occurs since visits are often reactive in nature versus preventative.

We see this challenge frequently in today’s healthcare environment, especially with the elderly population. What about the patient who is taking medications that are not listed in his chart but he forgot to tell his provider? It just didn’t come up in conversation — or maybe he has memory loss. Or the patient who sometimes gets confused and feels very lonely but seemed fine during the office visit — how would the provider know? There are numerous hazardous scenarios that may not be discussed during a short visit, which is where the Health Risk Assessment (HRA) comes into play for Medicare beneficiaries.

What Is the Health Risk Assessment?

The Health Risk Assessment, sometimes referred to as the health risk appraisal, is a self-reported patient questionnaire that patients complete as part of the Medicare Annual Wellness Visit (AWV). The AWV is a preventive service that helps providers identify risk factors and evaluate the overall health status of the patient based on the reported health information. AWVs are specifically for Medicare beneficiaries and are intended to drive conversation between the patient and their provider about all facets of their health. The AWV and HRA are focused on preventive health, not examining physical health — very different from the commonly known “annual physical.” Once completed, the HRA helps healthcare providers create a personalized health plan for each patient based on their identified risk factors so that they can avoid functional decline and future health problems.

In addition, the risk factors identified in the HRA create opportunity for follow-up and tertiary services. This not only keeps the patient engaged with improving their health but also drives additional revenue to the practice.

Who Takes a Health Risk Assessment?

HRAs can be taken by health plan populations to assess how much care they may need in the future. Employers may request their employees to undergo HRAs to determine overall population health and create health plans that address their needs. However, these patients are only a fraction of those who take an HRA. Medicare and Medicaid recipients must undergo a Health Risk Assessment as part of the program.

For Medicare recipients, the Health Risk Assessment is an integral part of the Annual Wellness Visit. This approach to preventive care is essential for reducing the costs of care. Medicaid beneficiaries must take HRAs within 90 days of enrollment to mitigate health risks.

What Is Included in the Health Risk Assessment?

Health Risk Assessments include three core pieces — a questionnaire, a health status assessment and personalized feedback.

The Questionnaire

The questionnaire can vary based on the practice and the patient taking the assessment. These questions are often delivered to the patients over a computer or tablet, but they can also be done over the phone and in person. Basic questions may involve health history and lifestyle behaviors like smoking and drinking. This initial step will also account for physical health, like weight, cholesterol levels and blood pressure.

With many factors affecting an individual's health, these questionnaires are often more in-depth than basic health information. Other information addressed in this step includes:

• Mental and emotional wellness, such as cognitive assessments and depression screenings (PHQ2)
• Willingness to change behavior for health improvements
• Ability to perform care activities independently
• Social determinants of health (SDOH) such as income, housing, food and access to healthcare

Health Status Assessment

After the questionnaire is complete, a care provider reviews the information submitted. From there, they can determine the patient's health status. This assessment will consider risks for certain diseases or conditions given current health and lifestyle behaviors. For instance, a patient who smokes frequently is more at risk for lung cancer.

Physicians also have to consider more complex risks, such as how SDOH may influence a patient's health in the next several years. Generally, the information discovered in the health status assessment will guide a long-term care plan for the patient.

Personalized Feedback

Once a care provider has assessed a patient's health status, they make tailored recommendations for improving their health. A physician who discovers a patient is at risk for high cholesterol will discuss foods that increase these levels and how to improve diet. If a patient is exhibiting a depressed mood, the physician may recommend a therapist or wellness activities to see if they offer mood improvements.

SDOH will also play a role in personalized feedback. If a physician notices a social concern related to the patient's health, they can recommend resources to support them. For example, if the patient has a hard time making it to doctor's appointments, the care provider can connect them with a healthcare transportation service.

The feedback provided in this final step of the HRA is essential for adjusting a patient's habits and responding to risks to improve their health outcomes.

Why Is the HRA important?

To a patient completing a Health Risk Assessment, it may just seem like a simple questionnaire. However, the purpose behind this questionnaire is significant and should not be underestimated. As healthcare shifts heavily to value-based care, preventive services hold more and more importance. Being able to identify risk factors that providers may not know about is crucial to keeping patients healthier in the future.

If preventive services are able to effectively identify and manage risk factors, they can significantly reduce the amount of chronic conditions that come to fruition, which not only will keep patients healthier, but will decrease health care costs significantly. The AWV, which requires the HRA to be completed as the main component, is proven to produce improved patient outcomes and decrease total healthcare costs. Medicare claims data shows total costs decrease by nearly 6% per patient, per year, following an HRA led AWV.

Currently, 90% of the United State’s $3.5 trillion in annual healthcare expenditures are spent on people with chronic diseases and mental health conditions. Imagine if we were able to drastically reduce that number, by administering something as simple as Health Risk Assessments.

Learn More About Annual Wellness Visits With ChartSpan

Annual Wellness Visits are an essential aspect of preventive care for Medicare recipients. Determining eligibility, conducting HRAs and creating reports are all vital parts of the process, and RapidAWV™ can help.

RapidAWV™ is designed to facilitate Annual Wellness Visits so providers can ensure eligibility, conduct thorough HRAs and create customized reports that drive insights for care providers. The platform is intuitive and senior-friendly with telehealth compatibility and custom HRA questions.

Learn more about RapidAWV™ and reach out to ChartSpan today.