Fannie Mae Partnership for Healthy Living (2000)

Evaluation Summary

This application was reviewed and approved for release by representatives from Health One and Fannie Mae¹. Health One compiled individual data on health outcomes to preserve confidentiality. Data sets are available to evaluators.

Participation

Health Assessment (HA) participation is paramount because it provides data to plan, set and measure goals. It is frequently an employee's first exposure to the PHLP and initiates the Partners In Health cycle.

• To date, 5,067 employees have taken 13,472 HA.
• 60-70% of employees participate in a HA each year.
• 80% of employees who attend one HA will repeat.
• 90% of employees who take a HA also attend a group feedback session.
• 55% of the eligible employees enter the high-risk program, and 55% who start also complete.

Health Data

Snap Shots

The "health age" improved steadily from 1994 to 1999, despite the steady rise in the average age of participants¹.

Certain risk factors show positive correlation with medical costs.³ From 1994 to 1999, the percentage of employees with few risk factors has increased from 38% to 52%, while the percentage of employees with many risk factors has decreased from 16% to 9%.

High-risk program eligibility is based on five clinical measures.⁴ In 1994, 18.6% of HA participants were high risk. Using the same criteria, the percentage has steadily declined to 10.3%. Correspondingly, the average number of risk factors per HA participant has decreased from 0.77 to 0.50.

Progressive Individual Tracking

• 53% of all high-risk employees drop at least one risk factor by their third annual HA.
• 44% of all high-risk employees drop enough risk factors by their third HA to become non-high risk.
• 94% of all non-high risk employees stay non-high risk through three HAs.

High-Risk Program Outcomes

• The post assessment results at the completion of the 12 week program over three years:
  • 54% graduate to non-high risk
  • 32% significantly improve but are still high-risk
  • 14% do not improve
• 67% of the successful graduates of the 1997 high-risk program, are still non-high risk in 2000
• Of the non-successful enrollees in the high-risk program in 1997, 28% are now non-high risk, 36% are significantly improved but still high risk, and 36% remain high risk without significant improvement

Cost-Benefit

An analysis of 1994-1996 sick leave and medical costs of 1,650 employees indicated that:

• High-risk employees use more sick leave and have higher medical costs than non-high risk employees.
• Average sick leave utilization and average medical costs declined from 1994—1996.
• Program cost-benefit ratio estimated at 1:1.09 to 1:1.26 (based on sick & medical cost data only).

The marginal cost of a high-risk program graduate is $1,213. The cost of a coronary bypass: $30,000.⁵

Survey

• 1998 Fannie Mae employee satisfaction survey indicated that 80% of employees thought the wellness program met their needs well.
• 1996 Working Woman ranked Fannie Mae #1 company for women citing wellness program explicitly.

¹ Judith Dale, Fannie Mae Director of Health and Work/Life Center; Helen Irving, RN, Fannie Mae Health Services Manager; Eileen Douglas, RN, Fannie Mae PHLP Project Manager; Mark Quave, MBA, Health One Program Manager; Martin Chase, MS (Mathematics), Health One Director of Information Systems; Kristina New, MS (Electrical Engineering), MBA; Health One Director of Marketing.

² Health Age source: Breslow, L et. al. The Relationship Between Vitamin C Intake, General Health Practices, and Mortality in Alameda County, California. American Journal of Public Health, 1986.

³ Journal of Health Promotion, Vol. 6, No. 1. Associations Between Health Risk Appraisal Scores and Employee Medical Claims costs in a Manufacturing Company.

⁴ Smoker; LDL 160 or over; TC/HDL > 4.7 or over for female, or 6.0 or more for male; BP over 160/100; BMI > 30.

⁵ Healthy People, 2000, page 5.