Health Risk Assessment Guide: Importance & Benefits for Your Medical Practice

Medicare patient completing an HRA

Chronic conditions impose a significant financial burden on the healthcare system while taking a toll on patients’ physical and emotional well-being. The CDC reports chronic illnesses and mental health conditions contribute to a staggering 90% of the annual $4.1 trillion spent on healthcare.

One invaluable tool to combat this growing crisis is the Health Risk Assessment (HRA). HRAs go beyond biometric screening data, offering healthcare providers a comprehensive understanding of their Medicare patients’ health. These assessments provide self-reported data, offering insights into lifestyle choices and social factors influencing patient health. HRA data enables providers to identify risk factors, bridge gaps in care, and offer personalized preventive measures.

By conducting HRAs during Annual Wellness Visits and addressing risk factors early, you can empower Medicare patients to take charge of their health, make informed decisions, embrace healthier lifestyles, and access timely interventions. This preventive approach also shifts healthcare resources from expensive treatments to proactive preventive measures.

This guide will explore Health Risk Assessments in-depth, examine their significance in healthcare, and provide insights for their seamless integration into your practice workflow. We will also introduce ChartSpan’s HRA tool for Medicare Annual Wellness Visits, designed to help your practice simplify Health Risk Assessments and streamline your workflow.

What is a Health Risk Assessment?

A Health Risk Assessment (HRA) is a patient questionnaire that covers personal and family medical history, lifestyle factors, Social Determinants of Health, and other relevant health information. The assessment helps healthcare providers evaluate a Medicare patient’s overall health status and identify risk factors based on the patient’s self-reported responses. 

Health Risk Assessment software is used by various organizations, including primary care practices, wellness programs, health insurance companies, and employer-sponsored health initiatives. All HRAs include similar questions on lifestyle and behavior choices, but additional questions may vary based on the type of healthcare setting and patient population. 

HRAs in the Medicare Annual Wellness Visit

HRAs during Annual Wellness Visits (AWVs) are vital to preventive care and are required for an AWV to be billed for Medicare patients under the Affordable Care Act. Medicare patients should have an AWV within 90 days of enrollment and continue them annually. 

AWVs are 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.

The AWV and HRA focus on delivering preventive care rather than examining physical health. Patient-reported information from the HRA supplements the biometric screening data gathered during the AWV for a more holistic view of a patient’s health status. 

Once completed, the HRA helps providers create a personalized health plan for each patient based on their identified risk factors so that the patient can avoid functional decline and future health problems. In addition, the risk factors identified in the HRA create opportunities for follow-up and tertiary services, like screenings, social services, or physical therapy. This keeps the patient engaged with improving their health and drives additional revenue to the practice.

What is the purpose of the Health Risk Assessment? 

To a patient completing a Health Risk Assessment, it may seem like a simple questionnaire. However, the underlying goal of this assessment is remarkably significant for value-based care models. The HRA’s primary objective is identifying specific risk factors that healthcare providers might not otherwise discover. This information is critical for proactively safeguarding patients’ health.

Providers who effectively identify and manage risk factors can significantly reduce the number of chronic conditions that develop, which improves patient outcomes and decreases healthcare costs significantly. 

Consider a patient taking medications not listed in their chart who forgets to inform their provider due to factors such as the topic not arising in conversation or memory loss. Or think of a patient who is easily confused and experiences loneliness but appears fine during their office visit. Many potentially hazardous scenarios may go unaddressed during a brief medical appointment, highlighting the critical role of the Health Risk Assessment (HRA) in the care of Medicare beneficiaries.

HRA requirements

According to the Affordable Care Act Section 4103(b), providers must follow specific requirements and guidelines when administering an HRA. These include:

1. Chronic diseases, urgent health needs, and risk factors should be identified.

2. The HRA may be administered over the phone, online, or through a web app.

3. A healthcare professional may administer the HRA during the visit.

4. Other means of conducting the HRA for greater accessibility are permitted as long as they ensure patient privacy. 

According to this Act, a physician, healthcare practitioner, or medical professional may conduct an HRA or review it after the patient completes it online. Additionally, accommodations like Braille or large print formats must be offered to patients with physical, sensory, or cognitive limitations. Questions should be formulated at around a sixth-grade reading level to ensure broad accessibility.

What does a Health Risk Assessment include?

The first part of an Annual Wellness Visit is the Health Risk Assessment, which can be administered to patients electronically, via phone, or on paper at home, in the waiting room or by medical personnel during an appointment. 

The HRA is tailored to address Medicare beneficiaries’ unique needs and requirements. 

Here are some elements typically included in an HRA for Medicare patients during an AWV:

  • Health history: Providing information on the patient’s medical record, including past illnesses, surgeries, hospitalizations, and chronic conditions.
  • Family medical history: Providing information about the patient’s family’s medical history, which can help identify genetic predispositions to certain conditions.
  • Medication review: Listing prescription, over-the-counter drugs, and supplements. This helps identify potential medication-related issues, such as drug interactions or non-adherence.
  • Immunization status: Ensuring patients are up-to-date on recommended vaccines, such as flu shots and pneumococcal vaccines.
  • Behavioral risks: Identifying factors such as smoking, alcohol consumption, physical activity, diet, stress, mental health, substance abuse, and social isolation that can impact overall well-being.
  • Functional assessment: Evaluating activities of daily living (ADLs), like housekeeping or managing finances, to assess a patient’s ability to perform essential tasks independently.
  • Social Determinants of Health (SDOH): Identifying social factors that can impact health, such as housing stability, access to transportation, and social support systems, focusing on addressing these determinants.
  • Depression screening: Identifying individuals at risk for mood disorders like depression.
  • Social and environmental factors: Examining the patient’s living situation, social support systems, and environmental factors that may impact their health, such as housing conditions or access to transportation.
  • Falls risk evaluation: Identifying the risk of falls, especially in elderly patients, through questions about balance, mobility, and previous fall history. Falls are a significant concern for older adults. Medicare HRAs may include questions about balance or any previous falls to identify at-risk individuals and recommend interventions.
  • Nutritional assessment: Assessing the patient’s nutritional status, dietary habits, and weight management. This can help identify malnutrition or obesity.
  • Chronic disease assessment: Identifying chronic diseases commonly found in older adults, such as diabetes, hypertension, heart disease, and osteoporosis. This helps in educating and empowering patients to manage these conditions.
  • Self-reported health status: Asking patients to rate their overall health and well-being. This can provide insight into their perception of their health status.

Learn more: How to Increase Preventive Cancer Screening for Medicare Patients

Following the HRA

After a patient completes the questionnaire, a provider reviews the information submitted and determines the patient’s health status. Providers must also consider more complex risks, such as how SDOH may influence a patient’s health in the next several years. 

The information from the HRA guides the provider in creating a long-term, personalized care plan for the patient and generating immediate recommendations for the patient. If you discover a patient is at risk for high cholesterol, you could discuss foods that increase these levels and how to improve their diet. If a patient is exhibiting a depressed mood, you may recommend a therapist or wellness activities to see if they offer mood improvements.

SDOH will also play a role in the personalized feedback provided. If you notice a social concern related to the patient’s health, you can recommend resources to support them. For example, if the patient has difficulty making it to doctor’s appointments, you can connect them with a healthcare transportation service.

The care plan 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. 

Make the most of HRAs during an office visit

All of the necessary steps of the Annual Wellness Visit may seem overwhelming as you try to give patients your undivided attention and address their concerns. Tools like ChartSpan’s AWV software can remove the stress of AWVs. 

Our RapidAWV™ software includes a customizable HRA designed with a senior-friendly interface. After the HRA is complete, the software automatically generates a comprehensive provider report that flags health risks, identifies gaps in care, and suggests a personalized 5–10-year care plan that you can customize for your patients. 

Learn more: Why Many Providers Fail to Capture Annual Wellness Visits

Benefits of a Health Risk Assessment

A Health Risk Assessment (HRA) for Medicare patients can offer several benefits for the patients and the healthcare system. 

Here are some of the key advantages of conducting HRAs for Medicare beneficiaries:

Preventive and proactive care

HRAs help identify potential health risks and issues at an early stage. This allows for timely interventions and preventive measures, which can help prevent the development or progression of chronic diseases and conditions.

Personalized care

HRAs provide a tailored assessment of an individual’s health status and risk factors. This information enables you to create personalized care plans addressing each patient’s needs and risks.

Improved health outcomes

By identifying and addressing health risks and concerns, HRAs can improve health outcomes for Medicare patients. This can lead to better management of chronic conditions, reduced hospitalizations, and enhanced overall well-being.

Cost savings

Timely interventions and preventive care resulting from HRAs can lead to cost savings for patients and the healthcare system. Preventing the progression of diseases can reduce the need for expensive treatments and hospitalizations.

Enhanced patient engagement

HRAs encourage patients to actively participate in their care by providing information about their health status and risk factors. This engagement can lead to better adherence to treatment plans and lifestyle modifications.

Long-term health maintenance

HRAs are not limited to a single assessment; they can be conducted regularly, allowing you to track changes in a patient’s health over time and adjust care plans accordingly. This long-term focus on health maintenance can contribute to a higher quality of life for Medicare patients as they age.

Patient education

HRAs provide an opportunity for patient education. Patients can learn about the importance of preventive care, healthy lifestyle choices, and managing chronic conditions, empowering them to take control of their health.

Quality reporting

HRAs can contribute to quality reporting and performance measurement initiatives. HRA data can demonstrate your commitment to preventive care and meeting quality metrics, which can be necessary for reimbursement.

Alignment with value-based care

HRAs align well with value-based care models, emphasizing improving patient outcomes and reducing healthcare costs. These assessments support value-based reimbursement goals by focusing on preventive and proactive care.

When conducted thoughtfully and integrated into a patient’s overall care plan, HRAs can be a valuable tool for promoting health and well-being among Medicare beneficiaries.

Best ways to implement HRAs at your practice

1. Choose HRA software.

Web-based health risk assessments are the preferred method by CMS. The software you choose should communicate with your EMR so you can access the patient data during the office visit. It should also be HIPPA-compliant to protect patient information. Beyond the fundamentals, your HRA software should have features that make you more efficient. Such features include:

  • Customization: You should be able to customize HRA questions to suit your practice and patient population. 
  • Risk factor identification: The HRA should identify specific risk factors such as smoking, obesity, family history, and chronic conditions. It should also inform you of a person’s risk of developing certain diseases like heart disease or diabetes.
  • Risk factor scoring: HRA software should highlight the most pressing risk factors so you can prioritize appropriate interventions. 
  • Personalized recommendations: Based on the patient’s risk profile, your HRA should generate personalized recommendations for lifestyle modifications, preventive screenings, and healthcare interventions.

2. Use paper HRAs as a last resort. 

Using paper HRAs should be considered a last resort when digital options are not an accessible option for a patient or when internet connectivity is unavailable. Transitioning to electronic HRAs can streamline the process, reduce administrative burden, and improve data accuracy.

3. Conduct HRAs in the waiting room. 

Conducting HRAs in the waiting room can optimize your and your patient’s time. By providing tablets or computers with the HRA software in the waiting area, patients can complete the assessment while waiting for their appointment. This approach minimizes disruptions to patient-provider interaction and allows healthcare staff to review the assessment before the appointment, facilitating more meaningful discussions during the visit.

4. Educate patients and encourage their participation.

Encourage patient participation by explaining the importance of HRAs and communicating that HRAs improve their care and help tailor treatment plans to their specific needs. Make the HRA process as user-friendly as possible, and consider offering assistance to patients who may have difficulty completing the assessment independently. 

5. Automate HRA evaluation and care plans. 

Implement Annual Wellness Visit software to analyze the HRA data and generate comprehensive provider reports quickly. These reports should highlight identified risk factors and recommend appropriate care plans or interventions. Automating this step saves time and ensures you can promptly address patients’ needs and initiate preventive measures.

Rely on an actionable HRA with ChartSpan 

Within ChartSpan’s AWV software, you’ll find an HRA that saves you time and enhances patient interactions and care. 

You can customize questions to align with your practice’s specific requirements and seamlessly integrate the HRA with your EMR system at no additional cost. This flexibility allows you to proactively and holistically address each patient’s unique needs, making preventive care more precise and patient-centered. Your patients can take our senior-friendly assessment from the convenience of the waiting room on Android and iOS devices. 

With ChartSpan, receiving actionable insights is effortless. The HRA doesn’t merely collect information; it generates comprehensive provider reports highlighting gaps in care. These reports include recommendations for necessary screenings and interventions, ensuring a more efficient and informed approach to patient care. 

Our AWV software also analyzes patient data and crafts personalized, preventative care plans that you can review and modify. These plans include actionable goals, interventions, and follow-up strategies to enhance patient engagement and guide them toward healthier living. Patients benefit from clear, concise report summaries outlining their health risks and preventive measures.

ChartSpan’s commitment to simplifying Annual Wellness Visits aligns with your practice’s goals. Our RapidAWV™ solution ensures efficiency, while our HRA and comprehensive provider reports support high-quality care. 

We’re here to help you navigate the complexities of value-based care, improve patient outcomes, and ultimately elevate the well-being of your patients.

Contact an expert today for a guided walkthrough of the ChartSpan AWV software.

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Jon-Michial Carter is the Co-founder and Chief Growth Officer of the largest managed Chronic Care Management (CCM) company in the United States,...

Published: October 23, 2023

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