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The Predictive Validity of the HERO Scorecard in Determining Future Health Care Cost and Risk Trends

Goetzel, Ron Z. PhD; Henke, Rachel Mosher PhD; Benevent, Richele MS; Tabrizi, Maryam J. PhD, MS; Kent, Karen B. MPH; Smith, Kristyn J. BA; Roemer, Enid Chung PhD; Grossmeier, Jessica PhD, MPH; Mason, Shawn T. PhD; Gold, Daniel B. PhD; Noeldner, Steven P. PhD; Anderson, David R. PhD, LP

Journal of Occupational and Environmental Medicine: February 2014 - Volume 56 - Issue 2 - p 136–144
doi: 10.1097/JOM.0000000000000081
Original Articles

Objective: To determine the ability of the Health Enhancement Research Organization (HERO) Scorecard to predict changes in health care expenditures.

Methods: Individual employee health care insurance claims data for 33 organizations completing the HERO Scorecard from 2009 to 2011 were linked to employer responses to the Scorecard. Organizations were dichotomized into “high” versus “low” scoring groups and health care cost trends were compared. A secondary analysis examined the tool's ability to predict health risk trends.

Results: “High” scorers experienced significant reductions in inflation-adjusted health care costs (averaging an annual trend of −1.6% over 3 years) compared with “low” scorers whose cost trend remained stable. The risk analysis was inconclusive because of the small number of employers scoring “low.”

Conclusions: The HERO Scorecard predicts health care cost trends among employers. More research is needed to determine how well it predicts health risk trends for employees.

Supplemental Digital Content is Available in the Text.

From the Emory University Institute for Health and Productivity Studies and Truven Health Analytics (Dr Goetzel), Bethesda, Md; Truven Health Analytics (Dr Henke), Cambridge, Mass; Truven Health Analytics (Ms Benevent), Santa Barbara, Calif; Truven Health Analytics (Dr Tabrizi), Bethesda, Md; Emory University Institute for Health and Productivity Studies (Ms Kent, Ms Smith, and Dr Roemer), Washington, DC; StayWell Health Management (Drs Grossmeier and Anderson), St Paul, Minn; Wellness & Prevention Inc (Dr Mason), Johnson & Johnson and Johns Hopkins School of Medicine, Ann Arbor, Mich; Mercer (Dr Gold), Minneapolis, Minn; and Mercer (Dr Noeldner), Irvine, Calif.

Address correspondence to: Ron Z. Goetzel, PhD, Institute for Health and Productivity Studies, Rollins School of Public Health, Emory University, and Vice President, Consulting and Applied Research, Truven Health Analytics, 7700 Old Georgetown Rd, Suite 650, Bethesda, MD 20814 (

Funding for this study was provided by the Health Enhancement Research Organization (HERO) Research Partners Charter Members: Alere, HealthFitness, Healthways, Kaiser Permanente, Plus One Health Management, Prudential Financial, StayWell Health Management, and the University of Pittsburgh Medical Center. Our respective organizations are all members of HERO.

The authors declare no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2014 by the American College of Occupational and Environmental Medicine