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Ron Goetzel and Co-Authors Claim Workplace Wellness Evidence That a CSI Couldn’t Find

Questions for Ron Goetzel and co-authors based on September 2014 article

Category:  Wellness

Short Summary of Goetzel Article’s Marketing Claim:

“Evidence accumulated over the past three decades shows that well-designed and well-executed programs that are founded on evidence-based principles can achieve positive health and financial outcomes.”

(This study was paid for by American Specialty Health, a successful and well-regarded company in the alternative network business that also, not surprisingly, has a wellness subsidiary.)

Materials Being Reviewed:

The study in question appeared in a recent issue of the Journal of Occupational and Environmental Medicine.

Most of these questions were originally asked by Jon Robison of Salveo Partners, in this post.

Questions for Ron Goetzel (who has not answered any relevant follow-up question asked of him about his Koop Award either, meaning now he has forfeited $2000 in honoraria)

Is it ethical to claim “no conflict of interest” in writing this article when a wellness company paid you for it and when you and most co-authors make their living in the wellness industry?

ANS: Refused to answer

Can you explain your reasoning for listing (see below) the Koop Award-winning State of Nebraska as a “best practice wellness program” after they admitted lying about saving the lives of cancer victims who never had cancer, and after it turned out their savings figures were clinically and mathematically impossible, and after it was exposed that the state’s wellness vendor sponsors the Koop Award?

list of best practices

ANS: Refused to answer

Why didn’t you disclose that literally none of these “best practice” programs (especially Nebraska’s, which deliberately waived all age-related cancer screening guidelines) follow US Preventive Services guidelines and therefore companies that follow these best practices on balance are more likely to harm their employees through overdiagnosis than benefit them?

ANS: Refused to answer

You describe (among others) a Procter & Gamble study from two-decade-old data as “recent”. Can you define “recent” ?  Can you name anyone at Procter & Gamble who even remembers this “recent” study?

ANS: Refused to answer

Why do you still cite Larry Chapman’s 25%-savings-from-wellness-programs allegation even though readily available online government data below shows wellness-sensitive medical events account for only 8.4% of a typical employer’s hospital cost (about 4% of total employer spending), thus making it impossible to save 25%?

hcup8point4percentslide

ANS: Refused to answer

Why are you still citing Prof. Baicker’s article when she herself has backed off it three times, it’s never been replicated, and all attempts to replicate it, including the most recent attempt to replicate it (in the “American Journal of Health Promotion”), have shown the opposite and she herself says “there are very few reliable studies to confirm the costs and the benefits”?

ANS: Refused to answer

How can you cite RAND’s negative article as supporting the conclusion that “wellness can achieve positive financial outcomes”  even though the author Soeren Mattke has specified that the modest health improvements among active participants produced no “positive financial outcomes”?

ANS: Refused to answer

Likewise, how can you cite the Pepsico health promotion study in Health Affairs in support of that same conclusion when that study concluded exactly the opposite: that health promotion had a negative ROI?

pepsico

ANS: Refused to answer

Guest question submitted by Dr. Jon Robison:  On p 931 you say that the RAND study found weight reduction — of course, only on active participants, excluding dropouts and non-participants — that was “clinically meaningful” and “long-lasting.”  How does that square with this slide from that very same RAND study showing exactly the opposite? (Since this chart may be difficult to read,we’ll highlight the key finding, which was that by the 4th year the average active participant had sustained weight loss of only a few ounces.)

randweightslide

ANS: Refused to answer

Orriant publishes wellness data in Journal of Workplace Health Management and no one cares

Orriant, Ray Merrill

Category:  Wellness

Short Summary of Company’s Marketing Claim:

“A New Scientific Study Proves Wellness Works”

Materials Being Reviewed:

http://www.orriant.com/File/4072ee6c-2bcd-43a5-83b6-e9035c8c0f1a

Questions for Orriant and Ray Merrill:

When you say “a new internationally-published study proves wellness works,” are you taking into account that the “international” journal publishing the work has a Zero impact factor, meaning that essentially no one believes anything they publish has enough value to cite?

ANS: Refused to answer

Are you attributing the fact that “participants had fewer health claims than non-participants” to your program, rather than to the obvious non-observable variable that participants are motivated whereas non-participants are not?

ANS: Refused to answer

Are you familiar with Health Fitness Corporation’s demonstration that participants will outperform non-participants even in the absence of a program? (See the year 2005 below — no program but participants outperformed non-participants nonetheless.)

total savings chart

ANS: Refused to answer

You also note that “those with the greatest health risks” had the most improvement.”  Are you familiar with Dee Edington’s work that says those with the greatest health risks will improve the most even in the absence of a program, due to the natural flow of risk?

Dee Edington's Diagram

ANS: Refused to answer

Non-participants’ medical costs were “2.9x greater” (about $4000 vs. about $1400).   This, of course, is the record for the hugest savings ever claimed from a wellness program.  Since government data shows that wellness-sensitive medical events account for only 4% of total costs or about $200/person, where did the other $2400/person in savings come from?

ANS: Refused to answer

Why didn’t the authors plausibility-check the entire population using a wellness-sensitive medical event analysis?

 ANS: Refused to answer

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