quest diagnostics is the leading provider of diagnostic testing, information and services. recently, quest conducted a study to answer the question many employers and employees ask: why do we need lab tests? “as a physician,” explained harvey kaufman, M.D., one of three study authors and senior corporate medical director at quest, “i come across employees who say, ‘i’m great, i’m healthy, haven’t seen a doctor in 10 years.’ i say great, but you don’t really know what’s going on in your body. the only way to find out is to get tested.”
so, to find out what’s going on in people’s bodies, quest conducted a study that included analyzing the results of more than 50,000 first-screening participants at 15 employers between 2003 and 2010. the study, “value of laboratory tests in employer-sponsored health risk assessments for newly identifying health conditions,” discovered that:
- 59% of those at high risk for high cholesterol were newly identified
- 28% of those at high risk for diabetes were newly identified
- 89% of those at high risk for kidney disease were newly identified
all of these individuals discovered their risk through their employer’s lab-based wellness program. those not newly identified had reported in their health risk survey that they were aware of their condition. “an enormous number of people were unaware they have these risks for common chronic diseases,” commented kaufman. this was particularly true for chronic kidney disease, the study authors found.
as expected, older participants had a higher prevalence of risk for all three conditions, but the study authors were surprised to find that one in four 29-year-olds had a newly identified condition. “our 20- to 29-year-olds are unhealthier than previous generations,” said fred r. williams, quest’s director of health management strategies and another study author. “they’re heavier and less active, but they’re also more plugged in, which means they’re more likely to feel they’re empowered in their health.”
the trick is to get them active in their health—and knowledgeable about it too. quest is hoping their study will be a call to action for both employers and employees. “26 million americans have chronic kidney disease,” explained williams. “by the time people score at a high risk, they may have lost 50% of their kidney function.” quest believes that their results will underscore the cost/benefit equation for lab tests as part of an overall approach to employee wellness—and that if they can “train” younger people to routinely get annual physicals, we won’t see the same rise in risk we currently see with today’s older generation.
besides reducing the health risk to the individual, there is also the opportunity to reduce the cost of health care. fewer and lower risks mean less health services needed, something that won’t be lost on employers. quest’s emphasis on lab results over self-reporting also won’t be lost on employers who are increasingly interested in an outcomes-based approach to wellness. “it’s easier to be ‘in denial’ based on self report,” said helen darling, president and CEO of the national business group on health. “we know people underestimate weight, overestimate height and underreport on unhealthy habits. with biometric screenings—you can’t distort or make yourself look better. employers would do well to have wellness programs with an emphasis on accuracy and data.”
my two cents: employers are rapidly adopting outcomes- or results-based wellness approaches. a towers watson study (see page 15) found that 33% of respondents plan to adopt this approach where incentives are tied to results, like lowering one’s BMI or cholesterol levels. in this vein, lab tests are a useful and necessary tool. they are a more costly approach than self-reporting, but a worthwhile investment, quest says, when you consider the cost of health care for those whose diseases have gone undetected. one thing employers will need to consider is the frequency of lab tests, particularly as our understanding of when preventive health screenings are useful and when they’re not evolves.
read the full study.