2023 Employer Health Benefits Survey

HEALTH RISK ASSESSMENTS

Many firms give their workers the option 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, 36% of small firms and 54% of large firms provide workers with the option to complete a health risk assessment, similar to the percentages last year. The percentage of large firms giving workers this opportunity remains lower than the pre-pandemic level for large firms in 2019 (54% vs. 65%) [Figure 12.1].
  • Among large firms giving workers the opportunity to complete a health risk assessment, firms with 5,000 or more workers are more likely to do so (69%) and firms with 200 to 999 workers are less likely to do so (52%) [Figure 12.1].
• Some firms offer incentives to encourage workers to complete a health risk assessment.
  • Among large firms that offer a health risk assessment, 59% use incentives or penalties to encourage workers to complete the assessment, higher than the percentage (50%) last year [Figure 12.2].

BIOMETRIC SCREENING

Biometric screening is a health examination that measures a person’s risk factors (such as cholesterol, body mass index (BMI), or blood pressure) for certain medical issues. A biometric screening involves assessing whether the person meets specified health targets (“biometric outcomes”) 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.

• Among firms offering health benefits, 15% of small firms and 42% of large firms provide workers the opportunity to complete a biometric screening [Figure 12.3]. These percentages are similar to those last year, but the percentage of large employers with a biometric screening program remains lower than the pre-pandemic level in 2019 (52%) [Figure 12.4].
• Some firms with biometric screening programs offer incentives to encourage workers to complete the screening.
  • Among large firms with a biometric screening program, 67% use incentives or penalties to encourage workers to complete the assessment, which is a larger share, but not significantly different, from last year (57%) [Figure 12.5]. For more information on weighting see the methods.
• 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, 20% have incentives or penalties tied to whether workers meet specified biometric outcomes, similar to the percentage (18%) last year [Figure 12.5].

HEALTH SCREENING PROGRAMS

Among firms offering health benefits, 63% of large firms offer workers a health risk assessment, biometric screening, or both, similar to the percentage last year (65%) [Figure 12.7] and [Figure 12.8].

WELLNESS AND HEALTH PROMOTION PROGRAMS

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

• Among firms offering health benefits, 42% of small firms and 69% of large firms offer programs to help workers stop smoking or using tobacco, 39% of small firms and 61% of large firms offer programs to help workers lose weight, and 46% of small firms and 68% of large firms offer some other lifestyle or behavioral coaching program. Overall, 62% of small firms and 80% of large firms offering health benefits offer at least one of these three programs [Figure 12.9] and [Figure 12.10].
• Forty-six percent of large firms offering one of these wellness or health promotion programs offer an incentive for workers to participate in or complete the program [Figure 12.12].

EFFECTIVENESS OF INCENTIVES

• Among large firms with incentives to encourage participation in a health promotion or wellness program, 29% consider the incentives to be “very effective” in achieving employee participation in these programs, and another 63% consider them to be “somewhat effective” [Figure 12.14].

DISEASE MANAGEMENT

Disease management programs aim to improve health and reduce costs for enrollees with certain chronic illnesses by educating them about their disease and suggesting treatment options. These programs can help enrollees with common health conditions, such as diabetes, asthma, hypertension, and high cholesterol.

• Among firms that offer health benefits, 36% of small firms and 64% of large firms offer disease management programs [Figure 12.16].
  • The likelihood that firms offering health benefits offer disease management programs increases with firm size [Figure 12.16].
• Among large firms with a disease management program, 16% offer incentives or penalties for workers to participate in or complete the programs. Firms with 5,000 or more workers (26%) are more likely than other large firms to have incentives or penalties for their disease management programs [Figure 12.18].

WEARABLE TECHNOLOGY

Some employers and health plans incorporate information collected from mobile phone applications of wearable devices, such as Fitbits or Apple Watches into their health promotion programs.

• Among firms with 50 or more employees offering health benefits, 10% collect information from workers’ mobile apps or wearable devices, such as a Fitbit or Apple Watch, as part of their wellness or health promotion program, similar to the percentage in 2019 (11%) [Figure 12.19] and [Figure 12.20].
  • Firms with 1,000 to 4,999 and firms with 5,000 or more employees are more likely than other firms to collect information from workers’ mobile apps or wearable devices [Figure 12.19].
• Six percent of employers offering health benefits provide their employees with wearable technologies, such as a Fitbit or Apple Watch, as part of a health improvement program [Figure 12.19].