Partnerships have successfully linked clinical and community organizations to address the four conditions of pediatric asthma, hypertension, older adult falls, and tobacco use. The program reached a large number of community residents and built the capacity of many clinical and community organizations in communities with significant health burden and health disparities. In some cases, such as older adult falls, the Partnership Program built from scratch health and public health initiatives. In others, such as hypertension, the Partnership Program expanded existing efforts to reach larger numbers of people at risk for poor health. Partnerships had several years to implement clinical and community interventions that typically require three to five years, or more, to demonstrate results. An independent evaluation by Harvard Catalyst only had data for two years of implementation. Even at this early stage, the independent evaluation found encouraging results.
Harvard Catalyst’s independent evaluation of the Grantee Program found:
Health Outcomes and Costs
Major accomplishments include:
- Partnership communities had significant improvements in systolic blood pressure with an overall reduction 2.21 – 3.30 mmHg from baseline to the two year mark. If these improvements are sustained over the lifetime of clinical patients, they could result in 1,938 to 2,931 fewer heart attacks and strokes per million residents, and lead to 564 to 864 fewer deaths due to cardio-vascular disease per million residents treated. The hypertension interventions are cost saving – on par with the influenza and pneumococcal vaccine – and more cost effective than 80% of covered preventive services.
- The asthma interventions had promising results with decline in overall healthcare costs in Partnership communities when compared to comparison communities. The data suggests that asthma interventions may give very good value and may result in net costs savings.
- Significant infrastructure was developed to address the growing public health concern of older adult falls and more than 1,800 falls were prevented averting 110 medical emergencies in two years of the Clinical-Community Partnership Program. The interventions are cost effective.
- Approximately 6,500 public housing units went smoke free protecting non-smokers from second-hand smoke, decreasing smoke rates among youth and increasing the number of quit attempts.
- Important systems changes occurred in all nine partnerships for all four conditions resulting in significant infrastructure and capacity development.
Working on Wellness Results
The Working on Wellness program has successfully reached and delivered services to organizations that previously had no formal wellness program and few wellness policies or environmental support. In particular, this program has reached a large number of small and moderate-size employer organizations, and a substantial number of low-wage, non-college educated, and racial/ethnic minority workers. A substantial proportion of these employees had moderate to high health risks, especially being overweight or obese and not consuming the recommended amount of fresh produce per day. The independent evaluation of the PWTF Massachusetts Working on Wellness Program found an estimated savings for medical care ranging from $0.76 million to $4.07 million for the combined top three health behaviors (diet and nutrition, leisure-time exercise, and stress reduction) targeted by the programs.
For the full independent evaluations, refer to Appendix A and B in the PWTF final report.