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On-site Blood Tests Raise Privacy Issues

A growing number of companies are offering an accurate--if potentially controversial--addition to health-risk assessments: an onsite blood test.

January 20, 2006
Related Topics: Benefit Design and Communication, Health and Wellness, Compensation
Companies are increasingly asking employees to fill out health-risk assessments as the first step toward controlling such chronic and expensive health problems as diabetes, obe­sity and tobacco addiction. A key to an accurate assessment is a recent checkup, but that’s some­thing that most employees skip, relying on a visit that might be several months old.

    "That can create a large margin of error," says Lale Iskarpatyoti, health care practice leader in the Philadelphia office of Watson Wyatt Worldwide.

    To address this, a growing number of companies are offering an accurate--if potentially controversial--addition to the health-risk assessments: an on-site blood test.

    Snap-on, a Kenosha, Wisconsin, manufacturer of power and hand tools, started offering the tests in 2005 and has seen a 50 percent increase in sign-ups for 2006.

    At first, Paul Prickett, director of corporate benefits, worried about how his 5,500 U.S. employees would react to the program. Would concerns about their privacy, and the fear that their DNA would be logged in some company database, keep them from participating?

    So Prickett made sure, through meetings and mailings, that employees understood what they were being tested for and that Snap-on would never see the results. The blood tests, which are conducted by American Healthways, a Nashville, Tennessee, well­ness provider, screen for cholesterol, diabetes, hypertension, body fat, liver function and nicotine. Employees fill out their health-risk assessments and get their results within a month so that they can see how their blood work compared with their own assessments. The employer only receives aggregate data about its employees.

    Snap-on also offered an incentive: Participants get a $20 monthly discount on health care premiums for agreeing to the full assessment process, including the blood test. But Prickett decided to also offer a $10 monthly discount last year for participants who only took the health-risk assessment. "We wanted to offer that flexibility," he says. But the company found that even those who had only signed up for the assessment were willing to do the blood tests when testing day arrived. For this year, however, Snap-on is requiring that employees take both the blood test and the assessment to receive a monthly discount.

    In 2005, the first year of the program, 1,200 employees and 1,800 spouses took the blood tests, and only about 200 did just the health-risk assessment. The company was surprised to find that more than half of its employees had moderate to medium health risks--higher than had been expected. An employee with slightly high cholesterol may fall into the moderate risk category, while an overweight employee with high cholesterol would fall into moderate to high risk.

    While Snap-on has just begun this year’s tests to see if employee health is improving, American Healthways’ average results are heartening. Employers using the blood tests have seen between a $300 and $1,440 decrease in health care costs per participant, depending on what kind of incentive they offer to participants. Employers see 80 percent to 85 percent participation rates and a 100 percent retention rate in following years. Fifty percent of eligible people who do not participate during the first year do so in the second year.

    Westell Technologies of Aurora, Illinois, which makes broad­band communication equipment, has found that using a penalty approach has been more effective in raising participation rates. In 2003, the company raised the amount employees would have to contribute to their health care plans by 10 percent if they did not take the blood tests. That brought 80 percent participation.

    Gary Hansen, vice president of human resources, says he doesn’t think employees should have to be given an incentive to be healthier. Last year, the company took the pressure a step farther: It started taking an additional $10 out of employees’ paychecks if they did not take the blood test. That produced a 90 percent participation rate.

    It is essential that these blood tests are voluntary, otherwise companies are infringing on workers’ rights, says Jeremy Gruber, a legal director at the National Workrights Institute in Princeton, New Jersey. Gruber advises that employers "tread very lightly" rather than take such a heavy-handed approach as penalizing workers for not taking the tests.

    "This should be seen as a benefit offered by employers, not as a tactic to force employees to succumb," he says.

Workforce Management, January 16, 2006, p. 10 -- Subscribe Now!

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