Arkansas Center for Health Improvement

State Employee Health Risk Assessments & Wellness Strategy

The state-financed health insurance program serving Arkansas state and public school employees, retirees, and their dependents covers approximately 130,000 lives. To help those enrolled in the plan lead healthier lives, ACHI was asked to evaluate and propose health promotion and disease prevention strategies the health insurance plan could implement that would ultimately increase employee productivity and health, and manage the ongoing rise in related health care costs. Beginning in the Fall of 2004, ACHI’s work with EBD considered three critical and sequential components to garner support for linking financial incentives to premium payments: (1) awareness, (2) support, and (3) engagement.

Awareness: ACHI initially developed a Health Risk Assessment (HRA) for the State and Public School Life and Health Insurance Board for use within the state employee plan population. The HRA was used to increase member awareness of health-related lifestyle behaviors. Members voluntarily self-report lifestyle behaviors in areas such as, tobacco use, obesity, physical inactivity, safety belt use, and binge drinking.

Support: Upon completion, a wellness summary report was generated and provided members with important health information to assist in moving the member along a path of personal health management. The report provided resources within the health plan and across the state that the member could access if they chose to take a step toward improving their health. The HRA also provides a means for compiling data to determine which unhealthy behaviors are most prevalent, and through aggregated analyses, documents costs incurred to support further investment in prevention and wellness initiatives. Additionally, in an effort to provide a supportive environment for improved health behaviors, the Board began covering evidenced-based preventive screenings at a $0 out-of-pocket cost to its membership.

Engagement: To engage members in actively participating in this process, EBD provided financial rewards for healthy behavior.  Members' monthly insurance premiums were reduced $10 per month for completing the health risk assessment (HRA) and additional discounts were offered to individuals with low-to-no health risks, as identified on the HRA.  These financial incentives were not tied to the actuarial estimates of direct medical cost (i.e. indirect and direct medical cost of tobacco use).  Instead, incentives were set to offer nominal financial incentives to those leading healthier lifestyles and thus assisting the plan in minimizing its future health care liabilities while enhancing the potential of engaging the members in managing their own health.


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Arkansas Center for Health Improvement
1401 West Capitol
Suite 300 (Victory Building)
Little Rock, AR 72201