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 comes into play for Medicare beneficiaries.
What is the Health Risk Assessment?
The health risk assessment (HRA), 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 – so, 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.
What is included in the Health Risk Assessment?
The HRA typically includes a series of questions about health conditions, lifestyle choices, mental health, and family health history. These questions are intended to identify potential risk factors that could be detrimental to the patient’s health. For example, if a patient acknowledges a history of tobacco use, low physical activity and high blood pressure, the patient is at a high-risk for stroke. The personalized care plan in this example should encourage health education on blood pressure control, counseling on smoking cessation, and medication management as a path to better health.
The HRA also includes short assessments specific to the elderly population. This can include fall risk assessments, cognitive assessments, and depression screenings (PHQ2). When a patient fails one or more of these assessments, a risk factor is flagged for the patient. Then, the healthcare provider can address the situation and create a plan to reduce the patient’s risk.
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.
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