?by?Jason Burke
First posted on Forbes on 7/12/2012
Jason Burke, Managing Director of CHAI
Faced with rising health costs and an increasingly unhealthy employee pool, employers are examining the role they should play in analyzing employee data for purposes of health interventions and programs.
I was recently asked to speak at a conference for employer benefit executives where we talked about the role of advanced analytics in benefits design and employee engagement.? After listening to the questions that were top of mind for these professionals, one thing was clear: employers are starting to ask different questions about health data.
Given the current path is unsustainable, the discussion of health is moving beyond ensuring competitiveness in attracting and retaining talent. Health is hitting the employer bottom line in premiums, absenteeism, disability, productivity and many other aspects of the business.? And employers are facing the stark reality that they are one of the primary constituents in the debates on health care.
Most employers share three common health-related perspectives:
- ?They see health coverage as a competitive asset in recruiting and retaining a talented workforce, but are unsure how health insurance reform will impact that.
- They are concerned that the escalating costs of health care are compromising their profitability, competitiveness, and in some cases even viability.
- They are open to new ideas on what they can do to help, but are very unsure what ?the rules? should be in terms of employer role, employee role, individual privacy, and ethics.
The Case in Obesity
If your employer offered to help you personally lose weight, what would you think?
As highlighted in HBO?s recent documentary series?The Weight of the Nation, the US obesity epidemic is linked to type 2 diabetes, high blood pressure, high cholesterol, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, cancer and liver disease.? It is estimated that the obese workforce costs American business nearly $74 billion a year.? Since the employer is bearing much of the brunt of this financial impact, should they intervene?? And if so, when and how?
After physician, family, and health plan, an individual?s employer might be one of the best entities to intervene on health risks:
- they see the individual almost every day
- their daily time with the individual covers at least one meal
- they can typically offer access to a broad array of helpful resources
- many aspects of an employee?s lifestyle ? a huge determinant for health risk ? intersects with his/her job.
In the extreme, employers may even see a fiduciary responsibility in health risk management ? controlling escalating costs and protecting the interests of performance-seeking shareholders.? When employers offer direct incentives to employees that successfully mitigate health risks and costs, doesn?t everyone win?
As uncomfortable as it might be to acknowledge, employers have one more advantage as agents of health management: they have a lot of data about employees that can be put into the service of improving health.
The Opportunity in Data
Data and analytics are?top drivers for improving health?today.? Beyond providers and health plans, though, initiatives such as?Target?s use of consumer data?to?predict pregnancy?illustrate both the opportunity and risks in using non-healthcare data to predict health issues.? And it raises a question probably not top of mind for many consumers: what if the information that best characterizes an individual?s health is not covered by HIPAA?
Many employers regularly seek assistance from plans, providers, and business consultants in understanding the health issues of their employee populations.? But the opportunities in finding health relevance in nontraditional sources of data change how we formulate and answer questions.? As?Wired?s?Chris Anderson?wrote?in 2008, the world of ?big data? means that ?correlation is enough.?? We can directly observe health patterns, whatever they might be.
But what sorts of data do employers have that might be relevant to health?? The list of the obvious includes health expenditures and in some cases claims history (medical, pharmacy, etc.).? But consider the following potential indicators and predictors of health as well:
- Health and wellness program participation (fitness, disease management, weight loss, integrative medicine)
- Absentee history (sick leave, vacation utilization, family medical leave)
- Workers compensation, disability and ergonomics data
- Environmental exposure (e.g., risk factors)
- Insurance coverage (e.g., available vs. consumed health care services)
- Meal content (e.g., onsite cafeterias, onsite storefronts)
- Time on premise (e.g., badge reader data, work/life balance)
- Expense report items (e.g., restaurant and bar utilization, travel and geography history)
- Credit reports (e.g., employment screening)
- Performance evaluations (e.g., work quality, job satisfaction)
Though many employers use descriptive statistics on their data to understand ?what has been happening,? the real opportunity is in prediction: mining the data for undetected or unanticipated patterns that correlate to specific health issues, outcomes, and/or costs.? If employers can more accurately predict these issues, they have the opportunity to intervene and influence.? And those interventions can add up to millions in cost avoidance and returned productivity.
A Matter of Trust
Should employers and employees try to get comfortable with the idea of employers becoming more actively and transparently involved in the health lives of their employees?? Consumers trade privacy for benefits every day in things like loyalty programs (e.g., grocery store cards) that give retailers access to tremendous amounts of behavioral and preference data: what you buy, when you buy, where you buy, how loyal you are, how price conscience you are, how responsive to promotions, etc.? Amazon and Netflix cannot offer those ?recommended for you? items without knowing a lot about what you watch, read, browse, and purchase.? If they can use information to push consumer products, why shouldn?t employers be able to use comparable information to improve your health?
The reason of course is that health is different: it is personal, and it is undoubtedly best administered by medical professionals.? That won?t change as employers learn more about the intrinsic health value in their own data.? But what could change ? what maybe should change ? is consumer awareness of and ownership in their health risks and decisions.? And with that, employers can help.ent: they have a lot of data about employees that can be put into the service of improving health.
The Opportunity in Data
Data and analytics are?top drivers for improving health?today.? Beyond providers and health plans, though, initiatives such as?Target?s use of consumer data?to?predict pregnancy?illustrate both the opportunity and risks in using non-healthcare data to predict health issues.? And it raises a question probably not top of mind for many consumers: what if the information that best characterizes an individual?s health is not covered by HIPAA?
Many employers regularly seek assistance from plans, providers, and business consultants in understanding the health issues of their employee populations.? But the opportunities in finding health relevance in nontraditional sources of data change how we formulate and answer questions.? As?Wired?s?Chris Anderson?wrote?in 2008, the world of ?big data? means that ?correlation is enough.?? We can directly observe health patterns, whatever they might be.
But what sorts of data do employers have that might be relevant to health?? The list of the obvious includes health expenditures and in some cases claims history (medical, pharmacy, etc.).? But consider the following potential indicators and predictors of health as well:
- Health and wellness program participation (fitness, disease management, weight loss, integrative medicine)
- Absentee history (sick leave, vacation utilization, family medical leave)
- Workers compensation, disability and ergonomics data
- Environmental exposure (e.g., risk factors)
- Insurance coverage (e.g., available vs. consumed health care services)
- Meal content (e.g., onsite cafeterias, onsite storefronts)
- Time on premise (e.g., badge reader data, work/life balance)
- Expense report items (e.g., restaurant and bar utilization, travel and geography history)
- Credit reports (e.g., employment screening)
- Performance evaluations (e.g., work quality, job satisfaction)
Though many employers use descriptive statistics on their data to understand ?what has been happening,? the real opportunity is in prediction: mining the data for undetected or unanticipated patterns that correlate to specific health issues, outcomes, and/or costs.? If employers can more accurately predict these issues, they have the opportunity to intervene and influence.? And those interventions can add up to millions in cost avoidance and returned productivity.
A Matter of Trust
Should employers and employees try to get comfortable with the idea of employers becoming more actively and transparently involved in the health lives of their employees?? Consumers trade privacy for benefits every day in things like loyalty programs (e.g., grocery store cards) that give retailers access to tremendous amounts of behavioral and preference data: what you buy, when you buy, where you buy, how loyal you are, how price conscience you are, how responsive to promotions, etc.? Amazon and Netflix cannot offer those ?recommended for you? items without knowing a lot about what you watch, read, browse, and purchase.? If they can use information to push consumer products, why shouldn?t employers be able to use comparable information to improve your health?
The reason of course is that health is different: it is personal, and it is undoubtedly best administered by medical professionals.? That won?t change as employers learn more about the intrinsic health value in their own data.? But what could change ? what maybe should change ? is consumer awareness of and ownership in their health risks and decisions.? And with that, employers can help.
Jason Burke is the?Managing Director & Chief Strategist ? SAS Center for Health Analytics & Insights (CHAI)
Source: http://www.thedoctorweighsin.com/would-you-trade-privacy-for-better-health-2/
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