Client Report Screening Program Results For: Missouri Western State University October 28, 2013

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Client Report For: Missouri Western State University October 28, 2013

Executive Summary PROGRAM OVERVIEW From 1/1/2013-9/30/2013, Missouri Western State University participants participated in a screening program administered by HealthFitness. Any filters used to create this report are displayed in Appendix B. The HealthFitness screening program typically includes screenings for blood lipids, blood pressure, and obesity, unless customized by the client. The primary goals of the HealthFitness screening were to increase participant health awareness and to evaluate group health status for Missouri Western State University. PARTICIPANT DEMOGRAPHICS A total of 146 unique individuals participated in the screening. TABLE 1: BIOMETRIC SCREENING PARTICIPANT DATA Gender # % Female 90 61.6% Male 56 38.4% Total 146 100.0% Age At Screening # % 18-24 1 0.7% 25-34 16 11.0% 35-44 40 27.4% 45-54 46 31.5% 55-64 36 24.7% 65 and Over 7 4.8% Total 146 100.0% The following pages recap the results from the HealthFitness screenings to assess how well the program met the goals of the program. Specifically, this report evaluates the profile of program participants and the overall outcomes of the assessments. Additionally, the Appendix provides the statistics from the screenings that were used to compile the Outcomes Summary. 2013 Health Fitness Corporation Page 2

Outcome Summary Screening Results The following table (Table 2) illustrates how your population compares to other companies in the HealthFitness database. These are not recommended ranges but an example of which risk factors have been most prevalent in other organizations. Table 2: Comparison to HealthFitness Database Risk Factor High Risk Factor Missouri Western State HealthFitness 2012 Blood Glucose Definition Fasting 126mg/dl Non- Fasting 200mg/dl University Participants Database 2.1% 3.0% Blood Pressure 140/90 6.8% 6.9% HDL Cholesterol <40mg/dl 22.6% 24.7% Obesity BMI 30.0 26.7% 34.6% Total Cholesterol 240mg/dl 8.9% 6.6% High risk individuals typically generate higher avoidable health care costs than individuals with a lower health risk status. The graph below (Graph 1) breaks down participant health risk status based on the screenings included in the assessment. The risk prevalence is broken down into moderate and high health risk status. 2013 Health Fitness Corporation Page 3

GRAPH 1: PARTICIPANT HEALTH RISK STATUS 70 High Risk Moderate Risk 60 50 % of Paticipants 40 30 45.9 40.4 38.4 31.5 20 10 0 22.6 7.5 6.8 2.1 0.7 Blood Glucose HDL Cholesterol Blood Pressure LDL Cholesterol 26.7 Obesity 8.9 0.7 Triglycerides Total Cholesterol Health Risk Prevalence vs. U.S. Norms The following illustrates how Missouri Western State University's screening outcomes compare to the norms for the U.S.: 26.7% of participants had an obese Body Mass Index (BMI) (compared to 34.7% of American adults who are obese according to CDC, 2005-2008) 8.9% of participants had high total cholesterol (compared to a U.S. norm of 14.9% according to the CDC, 2005-2008) 6.8% of participants had high blood pressure (compared to the U.S. average of 17.9%, according to the CDC, 2003-2006) Risk status for cholesterol and blood pressure are important because they are both leading causes of cardiovascular disease, which is the nation's number one cause of death (accounting for 34.3% of all deaths). Cardiovascular disease impacts corporations in the form of lost productivity and high health care costs for those with the disease. An estimated 81 million American adults (more than 1 in 3) have one or more types of cardiovascular disease. 2013 Health Fitness Corporation Page 4

FINANCIAL IMPACT SUMMARY From the corporate perspective, there is significant research available to support substantial health care cost and productivity savings associated with improving participant health. HealthFitness has performed a data analysis that can help assess the excess health care costs associated with high risk participants at Missouri Western State University. Research indicates that reducing participants' high health risk status can lead to health care cost savings for the company. On the subsequent page, the impact of excess health risks on health care costs is depicted. Using industry averages for health care costs, we have combined the HealthFitness screening program data with research and professional medical opinion to help quantify the program's potential return to Missouri Western State University in terms of health care cost savings. This information is for predictive purposes only and is not a guarantee of savings. However, this information may provide a more tangible perspective on the potential financial value of a health management program. One of the most current and widely accepted research models conducted by the Health Enhancement Research Organization was published in the Journal of Occupational and Environmental Medicine. The study tracked over 46,000 employees from various organizations through a health risk assessment and medical care costs. The researchers were able to determine a relationship between health risks and medical care expenses for a working population. Researchers found that individuals who were high risk for certain health risk factors experienced higher medical claims than those at lower risk. Their findings were that a difference in costs exists in nearly all of the compared risk categories between high risk and low risk employees. To apply this study to Missouri Western State University, up to four of the study's ten risk factors evaluated were also assessed based on the components selected in your screening program. The table below outlines the following: The common risk factors between the study and the HealthFitness screening program The average annual medical claims costs for high risk participants, estimated based on an average health care expenditure of $11,188 per participant The number of Missouri Western State University participants that were high risk for each factor The excess care costs associated with each risk factor 2013 Health Fitness Corporation Page 5

Table 3: Excess Health Care Costs Risk Factor High Risk Factor Definition Excess Cost Per Risk # High Risk Participants Excess Health Care Cost Blood Glucose Fasting 126mg/dl Non- Fasting 200mg/dl $3,131 3 $9,393 Blood Pressure 140/90 $1,404 10 $14,040 Obesity BMI 30.0 $2,578 39 $100,542 Total Cholesterol 240mg/dl $980 13 $12,740 Total $136,715 Total excess health care costs represent the estimated additional medical costs for Missouri Western State University participants with respective health risk problems. Not all of the participants with health risks will correct their problems. However, HealthFitness experience shows that many do and that it is reasonably conservative to estimate a risk reduction rate of 20%. It is important to note that the total excess health care cost only deals with excess costs related to up to four biometric risk factors that were evaluated with the screening program. This is potentially a small fraction of the return that can be realized from HealthFitness programming since other lifestyle and behavioral risk factors were not analyzed in the screening. 2013 Health Fitness Corporation Page 6

APPENDIX A HealthFitness Screening: Aggregate Results Total Cholesterol Screenings 60 57 50 46 40 # of Participants 30 20 29 12 10 0 Under 160 mg/dl 160-199 mg/dl 200-239 mg/dl 240-279 mg/dl 280+ mg/dl 1 1 Unknown Category # % Under 160 mg/dl 29 19.9% 160-199 mg/dl 57 39.0% 200-239 mg/dl 46 31.5% 240-279 mg/dl 12 8.2% 280+ mg/dl 1 0.7% Unknown 1 0.7% Total 146 100.0% 2013 Health Fitness Corporation Page 7

HDL Cholesterol Screenings 60 50 51 40 # of Participants 30 29 28 31 20 10 4 3 0 Under 30 mg/dl 30-39 mg/dl 40-49 mg/dl 50-59 mg/dl 60+ mg/dl Unknown CATEGORY # % Under 30 mg/dl 4 2.7% 30-39 mg/dl 29 19.9% 40-49 mg/dl 28 19.2% 50-59 mg/dl 31 21.2% 60+ mg/dl 51 34.9% Unknown 3 2.1% TOTAL 146 100.0% 2013 Health Fitness Corporation Page 8

LDL Cholesterol Screenings Due to a small sample size (<25 participants), this page's charts and graphs are left intentionally blank. 2013 Health Fitness Corporation Page 9

Triglycerides Screenings Due to a small sample size (<25 participants), this page's charts and graphs are left intentionally blank. 2013 Health Fitness Corporation Page 10

Blood Glucose Screenings 140 131 120 100 # of Participants 80 60 40 20 0 11 3 1 Desirable Pre-Diabetes High Risk Unknown Category # % Desirable 131 89.7% Pre-Diabetes 11 7.5% High Risk 3 2.1% Unknown 1 0.7% Total 146 100.0% 2013 Health Fitness Corporation Page 11

Blood Pressure Screenings 80 70 68 67 60 # of Participants 50 40 30 20 10 7 0 Normal High Normal Hypertension Stage I 3 Hypertension Stage II 1 Unknown Category # % Normal 68 46.6% High Normal 67 45.9% Hypertension Stage I 7 4.8% Hypertension Stage II 3 2.1% Unknown 1 0.7% Total 146 100.0% 2013 Health Fitness Corporation Page 12

Obesity Screenings Body Mass Index (BMI) 60 56 50 48 40 39 # of Participants 30 20 10 0 1 Underweight Normal Overweight Obese Unknown 2 Category # % Underweight 1 0.7% Normal 48 32.9% Overweight 56 38.4% Obese 39 26.7% Unknown 2 1.4% Total 146 100.0% 2013 Health Fitness Corporation Page 13

Obesity Screenings - Percent Body Fat Due to a small sample size (<25 participants), this page's charts and graphs are left intentionally blank. 2013 Health Fitness Corporation Page 14

Obesity Screenings Waist Circumference 120 Female Male 100 80 40 # of Participants 60 40 61 13 20 0 26 3 Desirable Range Increased Risk Unknown Female Category # % Desirable Range - 61 67.8% Female (<= 35 inches) Increased Risk - Female 26 28.9% (> 35 inches) Unknown 3 3.3% Total 90 100.0% Male Category # % Desirable Range - 40 71.4% Male (<= 40 inches) Increased Risk - Male 13 23.2% (> 40 inches) Unknown 3 5.4% Total 56 100.0% 2013 Health Fitness Corporation Page 15

Obesity Screenings Waist To Hip Ratio Due to a small sample size (<25 participants), this page's charts and graphs are left intentionally blank. 2013 Health Fitness Corporation Page 16

Cotinine Screenings Due to a small sample size (<25 participants), this page's charts and graphs are left intentionally blank. 2013 Health Fitness Corporation Page 17

APPENDIX B Filters Utilized In Report Creation CRITERIA VALUE STARTDATE 1/1/2013 ENDDATE 9/30/2013 2013 Health Fitness Corporation Page 18