by Wyn Staheli
September 1st, 2017
The Health Risk Assessment is a voluntary assessment which may be completed by either the patient or a caregiver. It is typically used in conjunction with an Annual Wellness Visit to help promote better health choices and provide disease prevention services. It looks at behaviors and lifestyle choices as well as patient history. The purpose of the HRA is to encourage patients to take an active role in accurately assessing and managing their health, which should help improve their well-being and quality of life.
In 2017, two new codes were created specifically for HRAs: 96160, 96161. It is important to realize that an HRA is NOT the same thing as a Health and Behavior (H&B) service (96150-96155), although performing an H&B service may be appropriate following the review of the HRA.
The HRA uses various risk calculators to help provide information that the health provider can then use to assess possible life-style practices that may lead to disease and other health issues, if not changed. Evidence-based HRAs provide feedback, which can then be used to help motivate patients toward a health promoting lifestyle. These risk calculators are included on the HRA form. They are not the same thing as Medicare's HCC & Risk Adjustment program.
The Centers for Disease Control (CDC) recommends using more than just an HRA. According to their studies (see References), the HRA alone doesn’t produce the long-term behavior change that the CDCs HRA Plus program produces. The additional HRA Plus options are important in helping the patient make life style changes. HRA Plus goes beyond the HRA and adds additional options such as:
- Continual HRAs over time to help patients with the health and risk status
- Health education programs
- Counseling and coaching provided to support behavior change and risk reduction
- Community resources such as fitness facilities, support groups, etc
- Local or national health promotion services such as how to quit smoking and wellness coaches
The HRA is the first step in identifying potential problems. However, according to the CDC, the HRA alone doesn’t produce the long-term behavior change that the HRA Plus produces. The additional HRA Plus options are important in helping the patient make life style changes. It is the feedback and support from providers which helps individuals gain the knowledge and skills to change their health-risk behaviors and incorporate them into their daily routines. There is evidence that suggests that the process of shared decision-making between the provider and the patient creates a teaching moment. This includes discovering what is important to the patient and what motivates them, and setting mutually agreed upon goals to help the patient succeed. Developing a clear plan and setting a timetable for follow-up are important steps to continuing a healthier life style.
See the "References" for a sample Health Risk Assessment.