News flash: The Wellness Ignorati are ignoring facts for a change
There has to be a limit, even to deception
The Wellness Ignorati got their name by ignoring facts. Facts, of course, are the wellness industry’s worst nightmare. They ignore them In order to avoid creating news cycles that might reach human resources departments despite the best efforts of their consultants and vendors to shield them from actual information.
And they’re at it again.
First, Atul Gawande wrote a scathing article in the New Yorker about massive overscreening earlier this month. As Mitch Collins noted in The Health Care Blog, not a peep in response from the perpetrators of those hyperdiagnostic jihads. Nor has their been any response to Mitch’s article itself. Literally, no one defends wellness industry practices. And yet somehow all the laws are on their side.
Speaking of which, Mitch mentioned the famous Nebraska debacle, in which the vendor, Health Fitness Corporation, lied about making “life-saving catches” of “early-stage cancers.” Since HFC was a sponsor of Ron Goetzel’s Koop Award, Ron naturally gave them that prize for these lies.
However, we’ve thrown down the gauntlet. HFC, come on out and fight. Give us your side of the story. How was this not a deliberate lie designed to score political points in Nebraska? If it was a mistake, why didn’t you change it and apologize? How do those 514 cancer non-victims feel? And Mr. Goetzel, why do you not only keep defending HFC, but have even upped the ante? They’ve been promoted from “best practice” to “exemplar” in your most recent webinar.
As long as wellness vendors are silent, we won’t shut up.
Speaking of non-responses from Mr. Goetzel, where is the correction of or explanation for the massive mistake in Mr. Goetzel’s most recent wellness program evaluation? All those readers have been misled by his blog into thinking Graco’s costs/employee are $2280/year when in reality the cost per employee contract holder — according to Mr. Goetzel’s own blog — is about $11,100, like almost every other company. (That includes spouses and dependents but any reasonable dependent ratio would yield more like a typical $5000 to $6000 per employee rather than $2280.) I know he knows about this mistake because I’ve submitted a comment to his blog, which shockingly hasn’t been posted.
So, please, could someone actually respond for a change, even if it’s just to accuse us of bullying.
Share this:
Ron Goetzel reports on Graco, the company with the country’s most expensive spouses
Talk about “burying the lead.”
Need we say more?
Ron Goetzel just reported on a company called Graco, where employees were subjected to a “pry-poke-prod-and-punish” wellness program. These are line employees in an “old economy” company–exactly the type of company where healthcare spending would be high. And it is high. According to the article, Graco spent $29,000,000 on healthcare for 2600 employees. That’s about $11,100 apiece, roughly what you’d expect. This estimate is with or without a wellness program, since as Ron’s recent HERO report noted, wellness programs have no positive impact on spending.
Yet later on in the article he writes:
In the immortal words of the great philosopher Rick Perry, oops.
$190 per member per month (and we assume that he meant just for employees, not members) is $2280/year/employee. Here are the possibilities:
(1) Graco has the country’s mot expensive spouses, costing about $18,000/year (to bring the average spend to $11,000 per employee contractholder per year) but hasn’t noticed
(2) Graco has some magical special sauce that kept costs way below average even before the wellness program started that Ron failed to tell us about (hence “buried the lead”)
(3) Ron Goetzel made yet another rookie mistake in his math, thus invalidating the entire study, just like most of his Koop Awards.
You can rule out that this $190 had anything to do with the wellness program. Smoking rates (the only thing that really affects spending) remained unchanged, and obesity only fell a few points. And a company can’t save money by overscreening people, paying for their drugs, and making them get unnecessary checkups. In any event, it wasn’t $190/month. It was $11,100/year.
$2280 vs. $11,100… We look forward to Mr. Goetzel’s explanation of how both these figures could be true, since it appears they are completely at odds with each other. In the immortal words of the great philosophers Dire Straits, if two men say they’re Jesus, one of them must be wrong.
And once again, the mantra of Surviving Workplace Wellness holds true: In wellness, you don’t have to challenge the data to invalidate it. You simply have to read the data. It will invalidate itself.
Here’s a Quizzify number that adds up: a 100% guarantee you’ll save money
We will no doubt be accused of “bullying” him for invalidating this study, which he obviously spent a lot of well-compensated time on. So just to show our good intentions, we will offer him our course and certification in Critical Outcomes Report Analysis gratis. It seems he could learn a lot from it and we look forward to announcing his successful completion.
Update: Ron apparently “forgot” to include the actual data in his writeup, which showed that, um, how to put this tactfully, his entire conclusion is wrong. Looks like kids (who had no access to wellness) trended better than the adults who did have access. We added this as the second installment.
Share this:
Measuring Wellness-Sensitive Medical Events: The Grand Finale of the HERO Analysis
The eighth in the series deconstructing the HERO Outcomes Guidelines, covering Page 14. The full series can be found here. This installment in particular should be read in conjunction with installment #4 This Grand Finale will be presented in 3 parts…with a downloadable tool to help you calculated your wellness program savings as part 3.
PART ONE: HERO ACCEPTS OUR METHODOLOGY
In the stock market, no one is as valuable as the person who’s always right, except the person who’s always wrong. Therefore, until now we have greatly appreciated the opportunity HERO’s report has created for us to explain how to measure outcomes correctly.
So imagine our disappointment when one of their methodologies, the sixth of the seven listed, turned out to actually be valid. No surprise — this is the methodology I invented. Also no surprise given the industry’s standards for integrity, they didn’t acknowledge that particular factoid anywhere in their 88 pages. (And yet they accuse us of being impolite.) Here is the screen shot.
The philosophy of #6 is quite straightforward. If you were introducing a flu vaccine program, you’d measure the reduction in number of people who got the flu. If you offered a new program for conservative treatment of meniscal tears, you’d measure the reduction in the number of people who had meniscal surgery. That’s the way experimentation works. You hypothesize an outcome that the intervention should create…and then you measure that outcome to see if the experiment worked.
Except, of course, in population health, where any improvement in anything (cost, trend, utilzation) gets attributed to any wellness program that happened to be in place. The masters of this would be Mercer. Mercer once “found” massive, mathematically impossible, savings for North Carolina Medicaid’s medical home in a cohort that, as luck would have it, wasn’t even eligible for the medical home. And one wellness industry stalwart, Larry Chapman, says the simple act of completing a health risk assessment can reduce total healthcare spending by 50%, even when the information in the HRA is wrong, as is often the case.
And did you ever notice that when a company switches to a high-deductible health plan and adds some needle-poking, they attribute the reduction in spending to the needle-poking, not the fact that everyone in their company suddenly gets socked with a bigger annual deductible?
Enter wellness-sensitive medical event rates (WSMEs). This is the only methodology that tallies hospitalizations for conditions targeted by a wellness program – statistically avoided heart attacks etc. This is the only one of the seven HERO methodologies that would be acceptable to legitimate researchers. Hence, its use both in Health Affairs and by the GE-Intel Validation Institute. The former is the most respected health policy publication and the latter is the most (the only) respected outcomes evaluation organization. Further evidence of its validity is that there is no mention of it in the leading wellness promotional publication, the American Journal of Health Promotion, perhaps because – as HERO has attested – it doesn’t show savings.
History of event rate-based plausibility testing
Even though it isn’t attributed to me in the HERO guidebook, I invented this methodology in 2007. This is incontrovertible. No one else had anything remotely close to it. Unlike the automobile, TV, the computer, etc., this was not one of a series of incremental improvements to or the amalgamation of existing technologies.
And none of the other invention clichés apply either. The Chinese didn’t invent it in 1000 BC. Leonardo DaVinci didn’t sketch it in 1541. The Germans and the Allies weren’t racing to develop it at the end of World War II. By contrast, I’ve been presenting on it and using it for validation since then (meaning 2007). It figured prominently in Why Nobody Believes the Numbers too, before being highlighted in Health Affairs and the Validation Institute. For a modest fee, the detailed how-to can be downloaded from our website, though a Reader’s Digest version appears below.
While a number of employers and health plans use it now, several health plans – more than coincidentally three of the highest-rated in the country (Harvard Pilgrim, Blue Cross of Massachusetts, and Providence Health Plans) – have been measuring hospitalizations for conditions targeted by wellness/DM programs since the methodology’s inception.
So needless to say I was surprised and totally flattered that the 88-page HERO Report contained no attribution to me as the inventor of the WSME plausibility test. As mentioned previously, the strategy of the Wellness Ignorati is to ignore facts (hence their moniker), especially including my very existence. That strategy reduces the likelihood that one of their customers might click through to the site. They aren’t much for our recommending that companies learn our helpful insights, which they call “bullying.”
The wellness industry has had a love-hate flip-flopping relationship with WSME measurement.
Click on the Q to try our demo
First, until 2013, the entire Wellness Ignorati, quite in character, ignored this methodology, which is a powerful testament to its validity.
Then, in 2013, that strategy took a body blow: the exact methodology was used in Health Affairs. You may recall the same thing happened with another epiphany of ours — the expose of the invalid Koop Award-winning Health Fitness Corporation fabricated results. The Wellness Ignorati completely ignored our whistle-blowing expose until it appeared in Health Affairs, when they were forced to admit we were right and the whole thing was made up, or to use Ron Goetzel’s phrase in the passive voice, “was unfortunately mislabeled” for four years.
Just as Ron Goetzel — the leader of the Wellness Ignorati — caved when the Health Affairs light was shined on the Koop-HFC debacle, he caved on WSMEs when the Health Affairs light was shined on them. In this case, “caving” was acknowledging the fact that this methodology existed. He reviewed the aforementioned Health Affairs article that specifically analyzed WSMEs — hospitalizations for conditions targeted by the wellness program. In September 2014, he wrote:
But then he un-caved. Once the Health Affairs storm had passed, he invoked the Sergeant Schultz defense. In December 2014 he said: ,
He may have just forgotten in December that he reviewed them in September. But in March he and his colleagues re-remembered wellness-sensitive event rates, and put them right in the HERO report, for which we are immensely grateful.
Hopefully they won’t re-forget in June. (Their memory appears to be correspond with the change of seasons.) Hopefully instead, to paraphrase the immortal words of the great philosopher George Gershwin, our methodology is here to stay.
How do I feel about HERO rewriting history so that I am no longer the inventor of this methodology? Honestly, having firmly staked out a niche in the small but growing “integrity segment” of the wellness industry, I prefer them staying out of that niche as long as possible. So I’m glad they show no interest in facts.
In part two, which we will post in a few days, we will explain how we do WSME plausibility testing and why it’s the essential method for assessing the impact of your wellness and disease management efforts.
Share this:
Greatest Hits Collection: Staywell
Collaborating with Staywell may not be enhancing the American Heart Association’s reputation.
Occasionally we have to attend to our Day Jobs and can’t post regularly. Fortunately, we have access to a bolus of posts from mid-2014, the posts that went up on this site initially. There were too many stories to highlight, so we decided to inventory them, in order to fill in gaps when we didn’t have time for new posts.
High on that list would be Staywell. First was their collaboration with Mercer, in which they agreed to tell British Petroleum that they found $17,000/person savings. They knew those savings were mathematically impossible since the average person only spends $6000/year. They also forgot that they themselves had said it was only possible to save $100/person.
Following on the heels of that was a collaboration with the American Heart Association to create screening guidelines that (surprise) call for much more screening than the United States Preventive Services Task Force recommends.
In both cases, we welcomed — and in the latter case offered $1000 honorarium for — responses to our questions, but our good-faith offer was met with silence.
Also, in both articles Staywell continued to cite Katherine Baicker’s study that she herself no longer defends, with the added wrinkle of referring to it as “recent” in the hopes that no one looks at the endnotes and sees that it was submitted for publication in 2009 and covered studies from a decade before that. With any luck they’ll have enough integrity to stop citing that study now that RAND has invalidated it. A good rule of thumb is that anyone who cites Baicker’s study without noting that no one (including Professor Baicker) believes that 3.27-to-1 ROI any more is prima facie deliberately misleading people. It is no longer credible to say one doesn’t know that her study has been shown to be hooey and that she is no longer defending it (and actually says she has no more interest in wellness).
Our health benefit education will never break your heart
We recommend click-throughs to both studies. Each raises questions that Staywell refused to answer, after initial conversations which confirmed they knew about these issues. You’ll also see how the American Heart Association was shocked, shocked, that anyone would question their integrity (perhaps they haven’t read The Big Fat Surprise) but then let it go, rather than create a news cycle.
Staywell also helped give British Petroleum a Koop Award. Nice to be on the award committee AND be an award sponsor–makes it easy to give your customers awards. With one or two exceptions, we can’t remember the last time the Koop Award went to a company with no connection to a sponsor or committee member. Perhaps someone could let us know?
Share this:
Newtopia Wants Your DNA
We’re sure nothing could go wrong when Aetna and a wellness vendor want your DNA
We often say on this site that “lying is part of wellness vendor DNA.” However, we didn’t mean that literally–until Newtopia came along. You see, Newtopia, like most vendors, lies — but they also actually collect employee DNA.
We think your DNA belongs to you
In all fairness to Newtopia, many of what could be termed “lies” could charitably be characterized as “very misleading but technically accurate statements,” So ironically it would be us who would be lying if we said these were all lies. Hence we will call them “gaffes,” a category which includes lies but also includes situations in which the truth shocks the conscience as much or more than a lie would.
Gaffe #1: Engagement:
To Newtopia’s credit (not unlike HERO, which did the same thing in its report), they put the invalidating information about their engagement right on their website. This again proves our mantra from Surviving Workplace Wellness that: “In wellness, you don’t have the challenge the data to invalidate it. You merely have to read the data. It will invalidate itself.”
Specifically, for some reason Newtopia provided a link to an Associated Press story, which they called a “profile,” but obviously we wouldn’t be linking to a puff piece “profiling” them. They Said What? only links to real reporting, which is invariably unflattering to wellness vendors and which would never be considered “profiles.” Puff piece or real reporting? You make the call — We can’t both be right.
Among other things (and there are plenty of other things, which we will get to) the AP reported that of 130 employees of the profiled customer organization, Jackson Laboratory, invited into the program, only 15% remain one year later,
However, the website itself proclaims:
Maybe “unheard of engagement” technically isn’t a lie. Maybe they meant: “unheard of” in that an engagement rate as low as 15% would be unheard-of. We doubt that because elsewhere they cite their use of “engagement science,” whatever that is. (Funny thing, Quizzify, the only company to literally financially guarantee increased engagement, doesn’t use “engagement science.” Instead Quizzify simply offers employees a tool they will want to use.)
Gaffe #2: Success
On its website, Newtopia’s case study for this customer, Jackson Labs, states:
However, the AP’s Tom Murphy borrowed a trick from Reuters’ Sharon Begley—and actually did reporting. They asked Jackson Labs itself for some statistics. They learned that of the 28 employees who submitted to Newtopia, only 19 remain. So even if every single one of those 19 lost weight, only 68% — not 92% — would report weight loss. (Newtopia might respond that their website’s 92% statistic was after six months whereas the 68% was after a year, thus begging the question of why they decided not to update the statistic on their website. It’s also a window on the truism that the longer the measurement period, the more people regain the weight.)
Whether 68% or 92%, Newtopia credits its results to “science.” Indeed their website loudly proclaims:
Gaffe #3: Made-Up Facts
One of the darnedest things about science is, it is a fact-based discipline. You can’t “drive” your own facts. For instance, their website proclaims:
Productivity is defined as “output per man-hour.” Therefore in a company that is “3x more productive,” each employee gets 3x more work done.
If Newtopia’s statement is accurate, and if Walmart promoted health, their cashiers could ring up 3x more customers. Doctors could see 3x more patients. Pilots could fly planes three times faster. Teachers could teach three times more classes. The recorded messages on hold would tell us that customer service thinks our calls are three times more important to them…
Another made-up fact:
Quite the opposite of “failing to control the incidence,” current approaches have in fact dramatically reduced the rate of heart attacks and strokes. Don’t take our word for it. Here are the federal government’s statistics for heart attacks:
During most recent available period, in which the population over 50 grew close to 20%, the number of heart attacks fell 19%. Not bad for “failing to control the incidence.” The wellness industry, of course, had nothing to do with that decline, which encompassed all age categories and payers.
Strokes also declined quite a bit. Curiously, strokes increased significantly in the age categories in which wellness programs were supposed to prevent them, paralleling the dramatic growth of the wellness industry from 2001 to 2012. They declined dramatically in the >65 population, which doesn’t have access to workplace wellness and which grew close to 20% over this period. So it looks like the only industry that “failed to control the incidence” was: the wellness industry.
Gaffe #4: Unsupported Statements
Another thing about science? Credible scientists don’t make statements that aren’t “driven” by evidence. Note this statement:
Besides being uncited and disputed by its largest customer (Aetna, which “collaborated” on the HERO report admitting wellness loses money), note the wording. It makes it sound like the more you spend on wellness, the more your costs fall. The implication is that spending an extra $500 on Newtopia’s genetic testing (over and above the cost of a regular wellness program) will then save even more.
Gaffe #5: Newtopia’s Privacy Policy
If only this were a lie!
One should be able to assume that if your employer forces you (under threat of fine) to give up your DNA, that the company using it will destroy it after use. The fine print is breathtaking. Whereas Quizzify’s privacy policy requires 13 words and is prominently displayed on our home page (“We can’t misuse or lose personal health information because we don’t request any”), Newtopia’s is buried in a linked footer and stretches on for 900 words. Apparently they will be using your DNA for their own purposes–eventually profiting on it, without giving you any royalties. It will allegedly be de-identified, but privacy guru Anna Slomovic notes that de-identified data can and has been re-identified.
Newtopia also admits they could make a mistake with it. OK, they don’t exactly admit it. They imply it. They say your DNA could be used in “error management,” and by definition there is no need for error management unless you make errors. And with the full list of people who have access to it — eight categories of occupation including “naturopathic doctors” plus unspecified “other persons” — errors are inevitable.
People sometimes complain that all we do is criticize wellness vendors. Newtopia is Exhibit A in why that’s often not such a bad idea. Even Newtopia doesn’t seem to mind–we gave them the opportunity to fact-check, rebut or comment on this, and they didn’t.
Share this:
Does HERO’s Model HRA Teach Employees to Lie?
When you’re hot, you’re hot; when you’re not, you’re a wellness vendor
This is the seventh in the series on the HERO Report, covering page 26 to 38. Six previous installments can be found here. A future installment will include a wellness savings calculator that you yourself can apply to determine whether the HERO report accurately captures your own economics or not. To make sure not to miss it, “follow” us on WordPress.
Employers learn a lot about their own companies when employees complete health risk assessments (HRAs). For instance, HRAs ask employees how many ounces of alcohol they consume. Wellness vendors then produce reports showing the statistical difference between the number of ounces of alcohol employees say they consume vs. the number of ounces of alcohol that employees with similar demographics actually consume, to show the extent of that company’s workforce dishonesty.
Haha, good one, Al. Obviously no wellness vendor does such an analysis. Doing that would require actual competence, one of two critical success factors — integrity being the other — conspicuously lacking in the wellness industry. (Exhibit A: this HERO report.) Instead, they summarize the self-reported drinking estimates with no qualification or comparison to national norms, as though these self-reported figures actually mean anything.
Not being wellness vendors and hence priding ourselves on our triple-digit IQs, we have done this analysis on multiple occasions. Here is a typical result:
According to self-reported estimates from this company, literally no one has a drinking problem and very few people drink at all. Time after time, we get the same result. Hence, self-reported estimates of alcohol consumption on HRAs are useless at best. At worst, asking this question simply encourages employees to lie. Somehow wellness vendors have never figured this out, despite their extensive experience in the lying department.
This chapter contains three other head-scratchers as well.
First, why this obsession with body mass index (BMI)? It is probably more important to be “fit and fat” than to attempt to diet and not exercise. You can’t get people to change multiple behaviors. HRA advice should be focused on fitness, rather than weight.
At Quizzify, we know the difference between fruit and juice
Second, speaking of weight, why hasn’t HERO gotten the memo that most fruit juice is junk food? Why are they urging the consumption of more sugars? Why do they equate fruit juice with healthy vegetables? Where is the up-to-date nutritional guidance? This isn’t rocket science. Quizzify incorporated this revised dietary guidance into its health education tool when it was first released, in March.
Third, why do HRAs obsess with seat belts? Seat belt use in the U.S. is at all-tme highs, but distracted driving is a serious problem that no HRA we’ve seen even mentions. If you are routinely hiring employees who don’t buckle their seat belts, but are texting and talking while driving, then you have bigger programs, and a computer print-out telling them to buckle their seat belts isn’t going to save anyone.
The Good News
Still, credit where credit is due. For the first time ever, we see the advice that HRAs recommend the shingles vaccine for employees 60 and older. Of course, we’ve never seen that recommendation in an actual HRA itself, though Quizzify covers it. Once again, covering shingles would require competence on the part of wellness vendors. Were a wellness vendor actually to recommend this vaccine, it would be an example of exactly why people should take HRAs: to learn something that they didn’t already know, that is easily implemented and that could prevent a debilitating illness. (By the way, there is some controversy as to the vaccine’s effectiveness. However, that’s not why HRAs don’t recommend it. They disregard it because vendors don’t know about it.)
And, aside from the fruit juice, there is no demonstrably bad advice in this model HRA. HRAs, of course, are notorious for bad advice, like telling males to get prostate tests, telling females without genetic predispositions to get mammograms before the recommended age of 50. And, don’t forget WebMD’s infamous testicle checks, one of the late-night TV staples from the Highmark-Goetzel Penn State debacle. Men who didn’t say whether they check their testicles every month – a D-rated idea, according to the US Preventive Services Task Force – faced a $1200 fine.
And while we realize that offering “no demonstrably bad advice” isn’t exactly a ringing endorsement, this chapter is the first in the HERO Report that isn’t mostly wrong.
Share this:
Wellness Innovations Reduces Blood Pressure by 90.9%
Who says you need blood pressure?
Believe it or not, we do actually have day jobs, but our “presenteeism” spikes when we are asked to provide color commentary in the ongoing competition among wellness vendors trying to out-stupid one another. We try to highlight every competitor, but they multiply faster than the brooms in Fantasia. For those of us in the Welligentsia who like to flaunt our mastery of fifth grade math, wellness is truly, as one pundit noted, a target-rich environment.
The current winner of the Cluelessness Olympics, Wellness Innovations, has been nominated multiple times following their article in Corporate Wellness. Corporate Wellness is the Corporate Health and Wellness Association’s “official” magazine. One shudders to imagine the fact-checking standards of the bootleg versions.
While the whole article is a must-read to learn how to achieve a 17-to-1 “estimated 2-year return in 19 months,” the highlight would be Wellness Innovations’ randomly generated outcomes calculations:
Wellness Innovations didn’t name the company that instituted the program — and a good thing, because their employees’ next-of-kins might be insisting on survivor benefits since the average participant, according to the fourth bullet point, no longer has a pulse. (The good news is that, according to their website, one of their other customers is a chain of funeral homes.)
However, they did say this company was a “respectable” one with 43 employees. Yes, this entire 2000-word article was written about 43 employees, giving it the highest word count per employee of any wellness article ever.
Employees who Quizzify maintain a healthy blood pressure and pulse
Oh, and did we mention Wellness Innovations made up their numbers? According to the article, they spent 5.5% of their healthcare budget on wellness, and achieved a 17-to-1 ROI. The problem, as any fifth grader can tell you, is saving that much money arithmetically wipes out almost all your healthcare spending–leaving only enough to spend on the employee who has a disease that “went unnoticed by the PCP for 12 years” but who is now being managed by “a team of physicians and professionals.”
Thank goodness Wellness Innovations caught this dread disease and got a team of physicians on the case, or it might have gone unnoticed for another 12 years.
Share this:
The Greatest Danger for Your Employees? Hospitals
Employers obsess with reducing the 1-in-800 chance that an employee gets a heart attack…while usually ignoring the 1-in-25 chance that they leave the hospital with an infection. As a further irony, employers can actually do something about the odds of the latter…but overlook the opportunity. As an even further irony, some of what gets done for “wellness” ends up putting employees in harm’s way in these very same hospitals–more stents, more emergency room visits if hypertension is “discovered” etc.
The Leapfrog Safety Scores are out now. We’d encourage everyone to take a looksee and ask two questions:
(1) Are the hospitals my employees are most likely to use on the “C” or “F” lists?
(2) Are my state’s hospitals safe? Don’t just assume that because you live in a “good” state, that hospitals are safe.
Finally, see how much your company is paying for unsafe hospitals by using Leapfrog’s GE-Intel validated Hidden Surcharge Calculator. You might think you are getting a “deal” on a hospital, but poor quality will overwhelm any cost savings.
We are often asked what employers should focus on if, as most experts now agree, wellness loses money and damages morale. Here’s your answer: keeping your employees safe.
Or in the immortal words of the great philosopher Peter Falk in The In-Laws: “The CIA has a terrific benefits plan. Staying alive. That’s the key to the CIA benefits plan.”
Share this:
Dan Ariely on how the Wellness Industry Crowdsources Reality
We recommend that everyone listen to Dan Ariely’s interview on NPR and TED talk “Why We Lie.” It explains exactly why the Wellness Ignorati could decide to collectively self-publish an entire guidebook full of misinformation and disinformation designed specifically to increase the revenues of wellness vendors.
Here are our take-aways from Professor Ariely’s TED Talk.
Like Walter White in Breaking Bad, the Ignorati started out honest. They genuinely believed that wellness saved money and that they were doing good. It was very counter-intuitive to believe otherwise. If you look at page 201 of Why Nobody Believes the Numbers, you’ll see I even mildly supported biometric screens. I hadn’t done the math. I just assumed early detection was a good thing and that Ron Goetzel and others was telling the truth, for which on page 83 I professed my admiration. As another example, ShapeUp’s CEO Rajiv Kumar would never have attacked us (largely for refusing to believe Kate Baicker, who even RAND now dismisses and who herself no longer appears to believe her own claim) if he had realized his own outcomes claims were false.
Like Walter White, it was easy to justify the first transgressions. Since the Wellness Ignorati genuinely believed in what they were doing, when the numbers didn’t add up, they either justified to themselves that it was OK to fudge them (like ShapeUp’s now-retracted claims about Highmark) or ignored glaring invalidating mistakes. The best example of the latter: Ron Goetzel finally recanting Health Fitness Corporation’s infamous participants-vs-non-participants self-immolation after years of ignoring it.
Or wellness vendors create a parallel universe where numbers don’t have to add up (like Keas), or completely misquote industry experts saying the opposite (like Vitality).
Like Walter White, they don’t actually believe they are bad people. Ariely calls this a “personal fudge factor.” With the possible exception of Wellsteps’ Steve Aldana (who may be honest but simply unable to recognize that no matter what numbers you enter into his model you get the same answer), they really think what they are doing is OK—even though the math clearly dictates otherwise.
Also like Walter White, they kept getting drawn deeper in. The more they lied, the more they have to keep lying. They needed to continue to defend what was looking increasingly indefensible. After giving Nebraska’s program a much-publicized and ironically named C. Everett Koop Award, it’s hard for Ron Goetzel and his committee to say “We goofed—we need to take it back because they made up the data and defrauded the state” even after the vendor, Health Fitness Corporation, admitted it.
Quizzify…truth serum for wellness.
Like Walter White, the Wellness Ignorati “suspend reality” (to use Ariely’s term) and “buy into a new reality.” Essentially the Ignorati crowdsource reality. They peer-review one another’s work, give themselves awards, and decide (to use Michael O’Donnell’s term) that anyone who challenges them lacks the “credentials” to do so. Or, as Ariely says: “If you were getting well-paid by Enron, wouldn’t you want to see reality as they present it?”
Avoiding the media is an excellent strategy. Once again, like Walter White, the Wellness Ignorati want to keep a low profile. Exposure is bad if the facts all go the other way. That explains Ron Goetzel’s refusal to debate, ever, and the Ignorati’s characterization of us as name-calling bullies when all we do is ask questions.
Yep, you can read this site up, down and sideways. The fact is no names are called other than the “Wellness Ignorati.” We’ve offered them the opportunity to propose a different name for their practice of denying facts, which they’ve declined. We do use the term “pretzel” to describe the very impressive twists and turns that Mr. Goetzel uses to wriggle out when he’s been caught calling failed or fraudulent programs “best practies” because they are run by friends, sponsors or clients. The alternative word for what one would be called when all your claims are made up is less flattering, and we’ve never used it with respect to Ron.
This explains why the Ignorati steadfastly refused to answer questions for a $1000 honorarium. Once again, like Walter White, they have so much as stake that $1000 is chicken feed. At Enron, if you questioned Ken Lay at an analyst conference, he would accuse you or not understanding their business, and cut you off from future meetings, rather than answer the question. We of course were not invited to participate in or even listen to the “discussion” about the HERO report.
Like Walter White, at some point the Wellness Ignorati needed to commit to their chosen path. The Wellness Ignorati have gone too far in their insistence that wellness saves money. There is no turning back. The existence of this site makes turning back even harder because retracting their lies means acknowledging them. And as soon as they do that, we do what we do best other than invalidate the Ignorati’s misstatements, which is: gloat.
Like Walter White, they are now doubling down. Examples: Ron Goetzel calling Nebraska a best practice after they admitted lying about saving the lives of cancer victims, in order to justify his original award to them. Steve Aldana can’t create a real ROI model now without admitting that his original model was not “based on every ROI study ever published” as he has maintained, but rather always yields a savings of $1359/employee no matter what inflation-adjusted figures you enter.
As the house of cards collapses, people on the fringes who were sucked in (in this case HR and some brokers and consultants) wake up and ask: “How could I have believed what these people were saying?” Many major and mid-level figures connected with Enron did exactly this. We see this every week in wellness, as people come to us and say: “I get it. I can’t believe I fell for this.”
So thank you to Dan Ariely. In one 8-minute TED talk, he explained the entire alternative crowdsourced reality of the Wellness Ignorati – without once even mentioning them by name. But I’m sure the Ignorati nonetheless think he bullied them.
As a hot-off-the-presses example of what Professor Ariely is talking about, Wellsteps just updated their model so that now instead of saving $1359 per person in 2019, they save $1359 per person in 2020. As with previous iterations of their model, the success of the wellness program is irrelevant to the outcome of the model. Just enter a 0% inflation rate and “1” for covered people (“1” so you can see the $1359 reveal itself without having to do division) — and then whatever figures you want to enter for spending, obesity and smoking.
Here you started out with astronomical healthcare costs and got a 99% reduction in smoking and obesity…and saved $1359
Here you save $1359 without changing smoking or obesity at all:
And here you saved $1359 even though there was nothing to save. The costs are as low as the model will allow you to enter (until they got caught, you could enter figures low enough that they model would calculate negative costs), and there was no smoking or obesity to reduce:
Naturally, Wellsteps is prominent both on the Koop Award Committee and the HERO Report Committee. Wellsteps’ “back story” is here.
They Said What? 