With all the incompetence, innumeracy, illiteracy and downright dishonesty we’ve documented in this field and with all the employee dissatisfaction, revolts and lawsuits, one can’t help but wonder: Why?
Why would any employer do this to their employees?
Why aren’t vendors held to minimal standards of competence?
Why do vendors and consultants caught lying simply double down on the lies and/or ignore questions about their lies–knowing full well they’ll get away with it because workplace wellness has nothing to do with actual wellness so no one cares that it doesn’t work?
Why are benefits consultants allowed to lie about outcomes for their partnered vendors?
Why, after they get caught lying, do they win awards for those very same outcomes?
Why doesn’t anyone care that much of what they say and do is wrong?
Why doesn’t anyone care that poking employees with needles far more than the USPSTF advises produces no savings?
Why put up with the morale hit from disgruntled employees and possible lawsuits?
Bravo to Bravo for admitting the reason: It’s to claw back insurance money from employees by making programs so unappealing and requirements so onerous that many employees would rather forfeit their money than have anything to do with them. Here are Bravo’s exact words:
You might say, they don’t actually “admit” it. Well, obviously they aren’t going to skywrite it. But how else would one interpret this comment? Obviously they aren’t going to save money right away by “playing doctor” and poking employees with needles. Especially because they aren’t even adhering to legitimate preventive services guidelines, such as those from the United States Preventive Services Task Force (USPSTF).
They also still subscribe to the urban legend that 75% of an employer’s spending is lifestyle-related, even though that myth has long since been discredited as meaningless and misleading for employers.
Creatinine and thyroid screens are not recommended by the USPSTF, so they shouldn’t be done at all, let alone provide the basis for claiming savings. So, we have eliminated everything except the obvious: employers get to collect fines for employees who care too much about their health and/or their dignity to submit to Bravo’s offer to play doctor.
This is the classic example of wellness done to employees instead of for them. The Bravo website is sprinkled with discussions of appeals processes for employees who face punishments for the crime of weighing too much and/or other personal shortcomings having nothing to do with work performance (and precious little to do with healthcare spending during the working years)…but everything to do with transfering wealth back to the owners.
As is our policy, we offered Bravo a chance — and $1000 — to provide an alternate explanation in a timely way, which they didn’t. Two differences between that forfeiture and Bravo’s punishments: Bravo lost their $1000 (of our money) for simply being unwilling to jot down a few words, whereas they brag about fining employees $1000 (of their money) for not being able to lose weight and keep it off, which is far harder than writing down a few words. And the other difference about the $1000? Having just raised $22-million, Bravo won’t miss it.
August Update: As a result of this expose, Bravo has taken all this stuff off their website. They no longer brag about fining employees, they no longer discuss their appeals process at length on their site and they no longer pitch their D-rated lab tests like creatinine and thyroid. This is typical vendor behavior after getting caught. Score one for They Said What.
They Said What? 
We are forced to choose between two evils–exposing our personal information to privacy invasion by employers and hackers, or losing money.
LikeLike
This article was very poorly written and was very hard to follow. If your going to publish an article to the public I would have someone with a vocabulary higher than a fifth grade level write your articles.
LikeLike
I’m sorry. By way of explanation, it’s not really an “article.” Our “Smoking guns” consist of questions that we ask vendors and consultants whom we out. We send the questions and leave them a space to answer. If they don’t answer (and Bravo refused to even acknowledge that we were asking these questions) we note that they don’t answer. There are other things on the site that are articles — but this is a smoking gun.
LikeLike
Poorly written? Maybe we aren’t reading the same thing. The outcomes model is not a bad concept – it’s just currently being executed very poorly. The inherent problem is that the model relies on – even REQUIRES – people to fail to meet criteria that have been set. Why? Because that’s how the vendor “proves” savings that are “immediate” and can tout to the employer that the vendor’s program is free because it’s paid for by people who fail to meet the criteria. But this approach fails on numerous fronts, several of which the writer clearly points out. Two of them are: 1) it has all kinds of potential to make health plan members view the employer as foe, not friend, and 2) often the vendors have nothing in place to help people meet the criteria (but that’s on purpose, because some people have to fail to pay for the program and show savings). In the end, the concept isn’t all bad, ie. providing a way for the healthy to quit subsidizing those who aren’t willing to take care of themselves. But it wasn’t well thought out at the federal level/ACA, and it certainly isn’t being executed well in the marketplace. Wellness vendors have a long history of waving pompoms at successes that aren’t really successes – and this is one of them.
LikeLike
I dont know if it was Bravo but this exact thing happened to me. I decided to let the money go (a lot of money!). That was before the big Anthem hack, and now I’m really glad I made that decision. And if you are Highmark (my employer), congratulations on getting your employees to hate you in order to save a few bucks.
LikeLike
Employees are not being “punished” for being unhealthy, they are being “rewarded” for being healthy, there’s a big difference. Unhealthy employees cost their employers way more money than the healthy ones, period. Why should an employer suffer the financial consequences of an employee making poor life choices? And since employers can’t discriminate & only hire “healthy” individuals, they give incentives for being healthy. The “unhealthy” people have the chance to participate & try to improve their health, and if they don’t want to do so, that’s their choice- and they can pay the extra premium. What people don’t realize is that a lot of employers are self funded, meaning they fund the medical claims, so if a personal in poor health has $100,000 in claims, that’s the employers responsibility. So yes, they can foot an extra $1,000 in premium, which hardly puts a dent in what the employer has to dish out. This is government regulated; there are “reasonable alternatives” that an employee can do to get the same discounts as a healthy person. What’s the different between this, and life insurance that is medically underwritten? If you’re unhealthy, you’re more likely to die, therefore your life insurance rates are higher- the same should apply for health insurance.
LikeLike
So Bravo is saying they get employers immediate savings not by punishing employees but rather by not rewarding employees, because the employees have no interest in having these screens that (as you can see) are not USPSTF-approved and therefore on balance are less likely to help them than harm them. So using this logic, the higher the rewards, the greater the savings.Even so, there is no way around the conclusion that their goal is to get employers more money and employees less money–that is what their website says. If you think their website is wrong, you can contact them. (Maybe they will actually write back to you, unlike me.)
Also, it seems like you’re parsing the language a bit. This is like the time my mother was visiting me when I was feeding my 3-year-old. I told my son if he ate his vegetables he could have dessert. My mother said I shouldn’t bribe him like that. I observed she used to do the exact same thing with me. She replied: “No, I didn’t. I would say if you don’t eat your vegetables you can’t have dessert.”
By the way, ignoring the USPSTF guidelines and giving out bad advice on HRAs (as Vik’s Provant experience shows — my experience is also that you take your life in your hands if you are dumb enough to do the things they tell yo uto do, like get prostate tests) is not going to make anyone healthier. And also, if you look at wellness-sensitive medical event rates, you’ll see that an employer only spends a small percentage of their claims dollars on heart attacks and the like. That’s why vendors have to lie all the time — they don’t add any value so they need to make up their savings.
LikeLike
With this logic I’m betting you’re a wellness vendor. Have you looked at life insurance premiums lately? Even for unhealthy people the risk of death during the working years is very low. the difference in premiums between an obese non-smoker and a normal-weight non-smoker is only about $40/month for maybe a $100,000 payout. So the life insurance companies refute your argument. There is precious little additional likelihood of an obese period dying of a heart attack and a normal-weight person dying of a heart attack. What they charge the most extra for are unhealthy hobbies like riding motorcycles and pre-existing conditions. Good luck fixing those with your little program.
And if someone is just overweight and not obese the premium differnetial is lower still. Almost no difference, other things equal
LikeLike
Actually, no, I am not from a wellness vendor; I work for an insurance broker in the employee benefits department. We occasionally work with wellness vendors if we share a client, however I’ve never worked with Bravo so I can’t comment specifically on their processes. I agree that some wellness vendors are completely worthless, but I do think these types of programs are necessary in today’s insurance market to help keep employers afloat. I think if you were the business owner you might look at it in a different light.
Most people don’t utilize their insurance plans for annual check-ups & screenings, and they only go to the doctor when something has already festered long enough to start showing symptoms. By requiring employees to get annual screenings in order to get discounts on their medical premiums, they are able to catch things earlier which can greatly affect the prognosis (one of our clients that required a PSA test most likely saved a man’s life).
The only way of justifying this of course is by having these tests done in house, during work hours & at no cost to the employee. Catching something early is not only going to save the employer money, but also the employee. I think we can all agree that the cost of treating stage 1 cancer is going to be much less expensive than stage 4 for both the patient and the insurance company (or the employer if self-funded).
These types of programs are designed to catch those people that don’t go to the doctor and just assume that they are healthy. I think sometimes it is a wake-up call for people. Once they know that they have high blood pressure, cholesterol, etc, it is up to them to decide if they want to explore treatment options or not. Most of these conditions can be treated with inexpensive generic medications. If you make that decision to not treat your diagnosis, that’s your choice, but you are going to be the one to suffer the consequences. But I also believe that there has to be alternate options for someone who simply cannot meet the requirements no matter what; that’s where the “reasonable accommodations” come into play. If you are extremely obese and clearly aren’t going to qualify for the BMI requirement- enroll in a weight loss program at the company’s expense & still get credit for that parameter.
And also keep in mind that this isn’t the wellness vendor coming up with these stipulations; the employer is the one that designs the program & the wellness vendor just implements and tracks everything.
LikeLike
Actually you aren’t supposed to get annual screens for most things, and if you don’t have a chronnic condition you’re not supposed to go to the doctor for annual checkups. the PSA life-saved number-needed-to-treat is something like 100 (but there will be many false positives and complications and even some hospitalizations among the other 99 to save that life, which is why no one recommends them any more except wellness vendors, who for some reason seem to lack internet connections, to go with their lack of integrity and competence). I might recommend the book Overdiagnosed, by Gilbert Welch. It goes through why early detection is totally overrated and why we should stick to the USPSTF guidelines, which of course no vendor recommends because it would drive the industry right out of business.
LikeLike
[…] to be another more insidious motive: these fines themselves are now major sources of savings, as Bravo Wellness says on its […]
LikeLike
[…] wellness may be to allow employers to levy fines against non-compliant employees. One vendor even brags about doing this, and the Business Roundtable has consistently lobbied for more ability to do fine […]
LikeLike
So this farce of a wellness screening makes no sense to me. Now my employer gets to determine when; or even if, I get to have lunch simply because of my weight? (Wellness Screening scheduled less than an hour before I have to start work, with fasting 12 hours prior.) Since this is done at the workplace office, an I no longer allowed privacy for being weighed or my patient confidentiality? After dealing with weight control issues in the military, the last thing I ever thought I’d be dealing with is workplace discrimination based on my weight.
LikeLike
Welcome to the world of wellness, my friend. Why companies are suddenly more concerned with employee weight than employee performance is one of life’s mysteries that may never be solved, like was there a second gunman on the grassy knoll, or how do they get the stripes into toothpaste. Your frustration at this nonsense is shared by many people. I might recommend http://www.ajmc.com/journals/issue/2015/2015-vol21-n2/employers-should-disband-employee-weight-control-programs. It’s academic but it’s got all the information in it. Push it around your company and maybe, just maybe, you’ll get enough momentum to get them to drop their program.
LikeLike
Our cpny uses bravo wellness and out of 900 employees if you are worse case $36 rollers a week for a year . 11 for smoking 7 for high blood pressure 11 for over weight. The list goes on I did the math and the kick back to our don’t with lets say 500 out of the 900 dose case is just shy of 1 million dollars…what a scam …fred Smith cpny
LikeLike