Health Risk Appraisals and Medicare

This report evaluates the potential effectiveness of Health Risk Appraisals (HRA) and programs using HRAs as a health promotion tool, and provides evidence-based recommendations regarding the use of HRAs in health promotion programs for older adults. Health risk appraisals are a systematic approach to collecting information from individuals that identifies risk factors, provides individualized feedback, and links the person with at least one intervention to promote health, sustain function, and/or prevent disease. The key findings from this report are that effective HRA programs have demonstrated beneficial effects on behavior (particularly exercise), physiological variables (particularly diastolic blood pressure and weight), and general health status. Interventions that combine HRA feedback with the provision of health promotion programs are the interventions most likely to show beneficial effects. HRA questionnaires must be coupled with follow-up interventions (e.g., information, support and referrals) to be effective. The HRA questionnaire alone or with one-time feedback in not an effective health promotion strategy. The report recommends a Medicare demonstration be conducted to test the effectiveness and cost effectiveness of administering the HRA questionnaire with tailored feedback and regular follow-up in improving or maintaining senior health.

Reprinted with permission from Office of Research, Development, and Information Centers for Medicare & Medicaid Services.