2022 Employer Health Benefits Survey

HEALTH RISK ASSESSMENTS

Many firms provide workers the opportunity to complete a health risk assessment to identify potential health issues. Health risk assessments generally include questions about medical history, health status, and lifestyle. At small firms, health risk assessments are often administered by an insurer.

• Among firms offering health benefits, 40% of small firms and 55% of large firms provide workers the opportunity to complete a health risk assessment [Figure 12.1]. The percentage of large firms with a health risk assessment program is lower than the percentage in 2019 (65%).
• Some firms offer incentives to encourage workers to complete a health risk assessment.
  • Among large firms that offer a health risk assessment, 50% use incentives or penalties to encourage workers to complete the assessment, the same as the percentage (50%) in 2019 [Figure 12.2].

BIOMETRIC SCREENING

Biometric screening is a health examination that measures a person’s risk factors (such as cholesterol, blood pressure, and body mass index (BMI)) for certain medical issues. A biometric outcome involves assessing whether the person meets specified health targets related to certain risk factors, such as meeting a target BMI or cholesterol level. As defined by this survey, goals related to smoking are not included in the biometric screening questions.

The share of firms with biometric screening fell during 2021, likely due to COVID-19-related disruptions at workplaces, such as employees working remotely and reduced access at on-site health clinics.

• Among firms offering health benefits, 24% of small firms and 45% of large firms provide workers the opportunity to complete a biometric screening [Figure 12.3]. The percentage of large firms with a biometric screening program is higher than the percentage in 2021 (38%). This suggests that some large employers are reinstating or revamping programs that were discontinued or suspended during the pandemic [Figure 12.4].
• Some firms with biometric screening programs offer incentives to encourage workers to complete a biometric screening.

Among large firms with a biometric screening program, 57% use incentives or penalties to encourage workers to complete the assessment, similar to the percentage (58%) in 2019 [Figure 12.5].

• In addition to incentives for completing a biometric screening, some firms offer workers incentives to meet biometric outcomes, such as maintaining a certain cholesterol level or body weight. Among large firms with a biometric screening program, 18% have incentives or penalties tied to whether workers meet or achieve specified biometric outcomes, similar to the percentage (14%) in 2019 [Figure 12.5].
  • The size of the incentives firms offer for meeting biometric outcomes varies considerably. Among large firms offering a reward or penalty for meeting biometric outcomes, the maximum reward is valued at $150 or less for 16% of firms and more than $1,000 for 21% of firms [Figure 12.6]. Nineteen percent of these firms combine the reward with incentives for other activities. This may include employers who ask employees to complete several health screening, disease management, wellness/health promotion activities in order to qualify for incentives.

HEALTH SCREENING PROGRAMS

Among firms offering health benefits, 48% of small firms and 65% of large firms offer workers a health risk assessment, biometric screening or both screening programs [Figure 12.8].

WELLNESS AND HEALTH PROMOTION PROGRAMS

Large shares of employers continue to offer educational and other programs to help workers engage in healthy lifestyles and reduce health risks. Wellness and health promotion programs may include exercise programs, health education classes, health coaching, and stress-management counseling. These programs may be offered directly by the firm, an insurer, or a third-party contractor.

• Among firms offering health benefits, 43% of small firms and 74% of large firms offer programs to help workers stop smoking or using tobacco, 39% of small firms and 65% of large firms offer programs to help workers lose weight, and 38% of small firms and 76% of large firms offer some other lifestyle or behavioral coaching program. Overall, 54% of small firms and 85% of large firms offering health benefits offer at least one of these three programs [Figure 12.11] and [Figure 12.12].
• Forty percent of large firms offering one of these wellness or health promotion programs offer an incentive to encourage workers to participate in or complete the programs [Figure 12.13]

INCENTIVES FOR WELLNESS AND HEALTH SCREENING PROGRAMS

Firms with incentives for health risk assessments, biometric screenings, or wellness or health promotion programs were asked to report the maximum reward or penalty a worker could earn for all of the firm’s health promotion activities combined. Some firms do not offer incentives for individual activities, but offer rewards to workers who complete a variety of activities.²² Among large firms offering incentives for any of these programs, the maximum value for all wellness-related incentives is $150 or less in 21% of firms and more than $1,000 in 20% of firms [Figure 12.15].

EFFECTIVENESS OF WELLNESS AND HEALTH SCREENING PROGRAMS

Large firms (200 or more workers) offering one or more health promotion or health screening programs were asked whether they believed the programs were effective in meeting certain objectives often offered as reasons to have these programs. Firms offering these programs may have different objectives for different programs, so we offered respondents the opportunity to say that a specific objective was not a goal of their programs.

Among large firms offering one or more of these programs:

• Reducing the firm’s health care costs – Only 9% said that their programs were “very effective” at reducing health care costs, 23% said that they were “moderately effective”, 42% said that they were “only slightly effective” or “not at all effective”, 11% said that reducing health care costs is not an objective of their programs, and 16% did not know [Figure 12.17].
• Reducing health care utilization – Only 6% said that their programs were “very effective” at reducing the use of health care, 25% said that they were “moderately effective”, 34% said that they were “only slightly effective” or “not at all effective”, 19% said that reducing health care use is not an objective of their programs, and 16% did not know [Figure 12.17].
• Reducing employee absenteeism – Only 4% said that their programs were “very effective” at reducing absenteeism by employees, 18% said that they were “moderately effective”, 36% said that they were “only slightly effective” or “not at all effective”, 26% said that reducing employee absenteeism is not an objective of their programs, and 17% did not know [Figure 12.17].
• Improving the health and well being of enrollees – Fourteen percent said that their programs were “very effective” at improving the health and well being of enrollees, 35% said that they were “moderately effective”, 27% said that they were “only slightly effective” or “not at all effective”, 7% said that improving the health and well being is not an objective of their programs, and 17% did not know [Figure 12.17].
• Being valued as a benefit by employees – Nineteen percent said that their programs were “very effective” at being valued as a benefit by their employees, 35% said that they were “moderately effective”, 22% said that they were “only slightly effective” or “not at all effective”, 7% said that being valued as a benefit is not an objective of their programs, and 17% did not know [Figure 12.17].

DIGITAL CONTENT FOR WELLNESS PROGRAMS

Sixty-one percent of large firms with a wellness program, including 72% of those with 5,000 or more employees, have added digital content to one or more of their wellness programs in the last two years [Figure 12.19].

• Among large firms that added digital content to a wellness program, 8% say that employees have engaged “a great deal” with the digital content, 39% say that employees have engaged “somewhat,” 22% say that employees have engaged “very little” or “not at all,” and 31% do not know [Figure 12.20].