Trawling through the internet for health information can quickly turn a mild sniffle into the bubonic plague. But, for a growing number of health insurance providers, using the internet to give customers a snapshot of their health through an online health risk assessment is the latest must-have product development.
“There’s a real growth in interest around wellness, especially in the workplace,” says Stephen Hackett, head of health and risk at Bluefin Corporate Consulting. “These online health assessments can work as the first stage to getting individuals really engaged in their health.”
And, although they are usually added as a freebie alongside the more traditional benefits found on cash plans and medical insurance, online health assessments potentially offer a lot of benefits. In exchange for five minutes inputting details such as height, weight, cholesterol level and smoking and drinking habits, these programmes will identify health problems and suggest ways to make improvements. “It’s good for self improvement,” says Lara Rendell, marketing manager at Health Shield, which offers an online assessment through First Assist on its cash plan. “It’ll highlight your health risks and provide information to help you make improvements. For instance, if your answers indicate you have a fairly sedentary lifestyle, it will recommend an activity plan, which could include videos of exercises, and set you a fitness goal to motivate you.”
Even where motivation is low, online health assessments can work in another way. By providing anonymous management information to the employer, the results can be used to identify any common problems that could be targeted with a health campaign. Depending on the size of the organisation, this could be broken down by location or job type to enable even greater tailoring of an employer’s health initiatives. “It’s a valuable benefit for an employer,” says Jill Davies, chief executive of Westfield Health. “If they want a healthy workforce then this is a good way to make employees aware of their health issues while also helping the employees to identify where to spend the health budget most effectively.”
This combination of increasing an individual’s awareness of the need to make changes with a targeted health campaign from the employer can lead to a significantly healthier workforce, changing health behaviours and bringing benefits such as reduced sickness absence and improved productivity. As an example, research from vielife found that an employee with five or more health risk factors, for instance smoking, an unhealthy weight or drinking too much alcohol, will be 18% to 20% less productive than a healthy employee.
Let down by take-up
But while they do offer the potential to improve health, there is also plenty of scepticism about the success of these services. For starters, while the opportunity to access management information can be a major bonus, the quality of this information isn’t always guaranteed. Often these types of test appeal to the healthier employees who don’t need to change their behaviour. This means that results can be unrepresentative.
There is also a rather large question mark over take-up generally. Tom Ford, senior marketing manager at PruHealth, has seen online health assessments in use both within the PruHealth model, where health improvement is central to its offering, and at Standard Life Healthcare where it was more of a me-too add-on.
“Without any follow up plan to help members make lifestyle changes it was more of a tick-box exercise at Standard Life Healthcare and this was reflected in the take-up. It only had around three or four per cent take-up across the board,” he says. “In comparison, because we drive a lot more people towards taking the assessment, more than 50% of people covered on the group side at PruHealth have taken it.”
Other providers also claim take-up way above the single digit level recorded at Standard Life Healthcare. For instance, Jessica Colling, product director at vielife, says that although some schemes will only get take-up of around 10%, others get rates of between 80% and 90%. She says the numbers can be increased through management buy-in and incentives.
“Incentives such as a prize draw or charity donation can increase take-up but if employees see it’s supported by management, who give them time to fill it in and then make changes based on the results, you’ll get much more engagement,” she explains.
But Chris Tomkins, head of personal health risk management at AXA ICAS, questions whether, even with plenty of support and incentives, these high levels of take-up are really achievable. He believes that these figures probably stem from the early days of online health assessments, when the novelty factor meant that people bothered to fill them in.
“The model’s more mature now and you’ll likely to get more cynicism from employees now,” he says. “If someone’s filled in an online health assessment and nothing happened, the chances of their completing another one are very slim. Why would they be bothered to give their employer health statistics if they’re unlikely to do anything with them? What’s’ the benefit for them?”
One of the cash plan providers, BHSF, has even ditched the management information side of the online assessment proposition. Brian Hall, sales and marketing director at BHSF, says that although the management information can be valuable to an employer, it is a major turn-off for employees.
“Even though the information is anonymous, employees don’t like the fact that it’s fed back to their employer. Provide feedback and turn up reduces,” he explains, adding that he considers a 10% take-up a good result.
As well as poor take-up, another criticism of these services is that some of them can have little effect on actually changing health behaviour. This is certainly the view of Jack Briggs, sales and marketing director, intermediary at Simplyhealth. Unlike its competitors, it doesn’t offer an online health assessment on its cash plans, although it expects to introduce one as part of an e-health strategy later this year.
He says: “Providing these types of assessments is becoming a hygiene factor but I do think some of them are of dubious value so we’ve spent the last 18 months looking at what’s available in this market as we want to be confident that whatever we introduce works.”
Even those with decent levels of take-up admit that, on their own, online health assessments are fairly pointless.
“They have to be part of a bigger health and wellbeing proposition, supported by other health promotion activities to get employees really engaged and motivated in changing their health behaviours,” says Melvyn Measures, head of product at First Assist, part of the Capita Group.
For example, he works with one client with a well-developed health and wellbeing programme. It uses the online assessment periodically to get an idea of where there are any health problems but then supports this through targeted campaigns and health and wellbeing champions to encourage other employees.
vielife’s Colling also stresses the importance of integrating the online assessment within the general health and wellbeing strategy. This could include links to other products, for instance the employee assistance programme if someone’s assessment highlights problems with stress as well as support from health information and improvement programmes.
The software’s getting smarter too. For instance, Bluefin’s Hackett says that one provider is developing a more intuitive system that will generate personalised content based on the employee’s health assessment whenever they log in. This means they are constantly reminded of the changes they need to make and are, therefore, more likely to take the necessary action.
Another cash plan provider, Medicash, says that rather than use it as the starting point for improving health, it promotes online health assessments as a way to monitor change. It promotes its assessment after an employee takes a face to face health screen on its plan.
“We find it works really well after a health screen,” says Paul Gambon, head of sales at Medicash. “If someone’s been told they have high cholesterol for example and they need to make improvements to their diet, the online assessment will allow them to see how the changes they make affect their score. Without this, they can lose interest and fall back to their old ways.”
But, even when integrated within a well thought out programme, some feel the benefits of online health assessments are limited. Tomkins of AXA ICAS says that in their current format, they’re unlikely to change the health behaviours of more than a small percentage of the workforce.
“Telling someone they need to lose weight isn’t enough,” he says. “I believe the industry can do better when it comes to engaging and motivating people to improve their health. This is a market space that needs innovation.”