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Monthly Archives: July 2015

Our Number 1 posting ever: The Wellness ROI Calculator

Our most widely read blog post offers a free Wellness ROI calculator.  It’s been getting hit after hit in the weeks we’ve had it up.  Further, no one has found any mistakes in it, which is unique in the ROI calculator field.  (The Brand X ROI calculator — we won’t mention any names but it rhymes with Wellsteps — is nothing but a mistake, since if you zero out inflation, their model always shows $1359/employee in savings by 2020.)

If you missed it (meaning ours), this is a good opportunity to download it and use it yourselves.

Here is the link directly to the calculator.  You still need to scroll down, though, to the June 30 posting.

 

Guest Post: Janet Bates Sums Up the Wellness Industry

Occasionally in a linkedin group, someone posts a comment that seems to merit more exposure, a “new voice” in the debate.  Janet Bates posted such a comment.  I asked her to expand and re-post it here, so that others could see it.


Follow the Money to Find the Truth

As long as there is money to be made, smoke and mirrors will abound. This is overwhelmingly evident in the current hysteria around corporate wellness. Insurance companies have their business customers whipped into a frenzy of “get those employees well (whatever that means) or else we’ll have no choice but to raise your premiums yet again.”

So in swoop the wellness “experts” to save the day with their “magic wellness dust”. The wellness people boldly claim that all it will take are education, incentives and contests for employees to improve their “numbers” (which somehow prove good health) or face penalties (or lose their incentives—same thing) if they don’t. Running these programs will keep insurance premiums in line, increase productivity, improve engagement, reduce absenteeism, make everyone love their jobs and probably save the world from insurgents all while delivering a jaw-dropping ROI.

What’s wrong with that? Nothing, except that it doesn’t work and it isn’t true. So what gives? Why do so many companies choose to believe this stuff?

They Can’t Handle the Truth

It’s pretty simple…few companies want to truly look at their own role in what may be impacting employee health. Hardly a company wants to honestly face the fact that the REAL causes of employee un-wellness include tangible items like:

  • Low wages
  • Limited or no paid sick time, family leave or vacation
  • Too many part-time jobs with non-guaranteed schedules and no health benefits
  • Hiring temps and contractors to avoid any type of commitment
  • Moving jobs off-shore

And then there are the intangibles, like:

  • Lack of flexibility and autonomy
  • Inept and bullying management
  • Required 24/7/365 connectivity and excessive hours for salaried employees with minimal, if any, salary increases
  • High deductible medical plans that employees can’t afford to use
  • A strong feeling of job insecurity leading to chronic stress
  • And other shoddy business practices and HR policies

So why don’t wellness vendors who claim to be experts help their customers face these real facts. Two reasons:

  1. There’s no fast money in it for the vendor. Helping customers address these facts won’t lead to the immediate sale of the vendor’s very profitable health risk assessments, screens, coaching, or contests.
  2. Employers don’t want to hear it. It’s much easier and cheaper to spend a few hundred bucks per employee for the “magic wellness dust” than it is to dig into the muck of the company and spend the money to fix what’s really wrong.

Following the money and facing the facts does lead to the truth. It might not be easy to hear and doing what’s right FOR employees won’t be free, but it will improve their well-being and ultimately that’s good for everyone. Unfortunately, the insurance companies will find other reasons to raise premiums. That, of course, is the real money trail to follow.

About the author:

Janet Bates is a semi-retired writer who spent close to 40 years in the “performance improvement” business.

We Caught a Wellness Vendor Doing Something Right: US Preventive Medicine

For a year now, we’ve been outing wellness vendors whose endless stream of rookie mistakes in outcomes calculations (that somehow always seem to overstate savings) has provided a correspondingly endless stream of mirth and merriment to our expanding cadre of visitors, whose numbers now exceed 50,000 in total.

During this period, like Diogenes, we’ve been searching for an honest, competent wellness vendor, one that we could highlight to show that we are not simply mean-spirited anti-wellnites who for some unknown reason were intent on denying employees the opportunity to become healthy.

Diogenes had it easy compared to us.

Quite literally we have sifted through hundreds of wellness vendors.  Some are just a few fries short of a Happy Meal. They get highlighted in our popular On the Even Lighter Side compilation. Some have very squirelly data.  They win Golden Squirrel Awards. Others, well, we’re not calling anybody scoundrels but let’s just say they could never be confused with Mother Theresa.  They get Smoking Guns, featuring questions that buyers can ask them based on their own claims that can’t be answered.

None of these vendors or any other wellness vendor, it is worth noting, have managed to receive validation from the Intel-GE Care Innovations Validation Institute, despite the obvious advantages of a respected third-party’s endorsement…and the offer by They Said What? to remove all unflattering references to them if they achieved such validation, as many non-wellness companies have,

Finally, however, our quest for an honest and competent wellness vendor is rewarded.  US Preventive Medicine has both achieved validation for its contractual language and has compiled an enviable record–across its entire book of business–of event reduction.  The full press release can be viewed here.

Further, they measure risk factors on the entire population, which is valid, not just the highs-to-lows.

We applaud their willingness to attempt validation but especially the results they’ve achieved and the contracts that codify those results, assuring that their customers will also receive validation should they choose to apply for it.

Hyperdiagnosis: The Wellness Industry’s Anti-Employee Jihad


Healthmine just released a survey bragging about how many employees were diagnosed through wellness programs. That reminded us of our popular 2013 posting on The Health Care Blog called Hyperdiagnosis.  We are re-posting and updating it below.   


By now we are all familiar with the concept of overdiagnosis, where “we” is defined as “everyone except the wellness industry.”

Wellness vendors haven’t gotten the memo that most employees should simply be left alone.  Instead, they want to screen the stuffing of employees, at considerable cost to the employer and risk to the employee.  The wellness vendors who overscreen employees the most win awards for it, like Health Fitness Corporation did with the Nebraska state employee program.

We call this new plateau of clinical unreality “hyperdiagnosis,” and it is the wellness industry’s bread-and-butter.  It differs from overdiagnosis four ways:

  1. It is pre-emptive;
  2. It is either negligently inaccurate or purposefully deceptive;
  3. It is powered by pay-or-play forfeitures;
  4. The final hallmark of hyperdiagnosis is braggadocio – wellness companies love to announce how many sick people they find in their screens.

1. Pre-Emptive

Overdiagnosis starts when a patient in need of testing visits a doctor. By contrast, in hyperdiagnosis, the testing comes in need of patients, via annual workplace screening of up to seventy different lab values–most of which, as They Said What? has shown, make no clinical sense.  Testing for large numbers of abnormalities on large numbers of employees guarantees large numbers of “findings,” clinically significant or not.  The more findings, the more money wellness vendors can add on for coaching and the more savings they can claim when they re-test.

2.Inaccurate or Deceptive

Most of these findings turn out to be clinically insignificant or simply wrong, no surprise given that the US Preventive Services Task Force recommends universal annual screening only for blood pressure, because for other screens the potential harms of annual screening outweigh the benefits.  The wellness industry knows this, and they also know that the book Seeking Sickness:  Medical Screening and the Misguided Hunt for Disease demolishes their highly profitable screening business model.   (We are not cherry-picking titles here—there is no book Here’s an Idea:  Let’s Hunt for Disease.)  And yet most wellness programs require employees to undergo annual screens in order to avoid a financial forfeiture.

Hyperdiagnosis also obsesses with annual preventive doctor visits.  Like screening, though, annual “preventive” visits on balance cause more harm than good.  The wellness industry knows this, because we posted this information on their LinkedIn groups, before we were banned from most of them.  They also presumably have internet access on their own.

3. Pay-or-play forfeitures

The worthlessness, the inconvenience, and the privacy invasion make screens very unpopular.  The wellness industry and their corporate customers “solve” that problem by tying large and increasing sums of money annually — now $694 on average – to participation in these schemes.  Yet participation rates are still low.

4. Braggadocio

While doctors are embarrassed by overdiagnosis, boasting is an essential ingredient of hyperdiagnosis.  We’ve already blogged on how Health Fitness Corporation bragged (and lied, as they later admitted) about the number of cancer cases they found in Nebraska.  They also bragged about the rate of cardiometabolic disease they found — 40% in the screened population — even though they admitted almost no employee did anything about those findings, and only 161 state employees reduced risk factors.  Hence, it was the worst of both worlds:  telling people they are sick without helping them get better.  Nothing like telling someone they’re sick to increase their productivity.

Compass Health is our favorite example of hyperdiagnosis braggadocio.  We realize this screenshot is a bit tough to read, but the hilarity is worth the effort.  We pulled this vignette from On The (even) Lighter Side, They Said What?‘s most popular feature.


The Definition of a “Healthy Employee” Is One Who Has Not Been Diagnosed by Compass Health

Feeling fine today?  Alas, you better get your affairs in order, bid your loved ones adieu, and watch the shows you’ve DVR-ed.  Why? Because, dodo-brain, feeling fine means you have:

compass health title I feel fine syndrome

You are “walking around without a clue that [you have] a debilitating or terminal condition.”  According to Compass Health (which at this point, having been “outed” by us, had the good sense to take this off their website…but not until we captured a screen shot), the major symptom of I Feel Fine Syndrome is:  not having symptoms.

We’ll let them take it from here, to display not only their epidemiological prowess but also, this being the wellness industry, their grammar and spelling prowess as well:

compass health screen shot2

We must confess we learned a lot from Compass.  We had not realized that employers’ concerns about employees feeling fine had their roots in ancient history.  But there it is, right in the opening words:  these concerns date back “millenia” [sic], when employers failed to get their employees tested for “percolating” conditions before throwing them to the lions.

So the bad news is that feeling fine may be hazardous to your health.  The good news is that your ICU bed may not need a DNR notice anytime soon because elsewhere Compass says it “has programs and solutions to help your employees overcome their I Feel Fine Syndrome.”  And it is “very likely” these programs and solutions can “completely cure the problem…forever in our bodies.”

And not a moment too soon, because we’re never felt better in our lives, which means the clock is ticking.  That’s the good news.  The bad news is, if we join Compass’s program it sounds like we need to start contributing more to our 401K’s.


 

Summary

We’d like to think that all our exposés have made a dent in the wellness industry’s business model, but the forces arrayed in the other direction have so far overwhelmed us.   The price of screening has plummeted almost to the $1-per-lab-value level for comprehensive screens, and as with anything, the lower the price, the greater the amount sold.

Couple those economics with the advent of genetic testing as part of wellness, big and profitable fines for non-participants, and the EEOC being defanged as a sop to the Business Roundtable, and it’s clear the wellness industry’s highly profitable hyperdiagnostic jihad against the American workforce has barely begun.

By contrast, Quizzify teaches employees that “just because it’s healthcare, doesn’t mean it’s good for you,” and to only get screened according to the USPSTF guidelines.  That’s a message that employees would love to hear, but that wellness vendors can’t afford to tell them.

Finally–a Free Wellness ROI Tool That Isn’t Made Up

We are pleased to present a free wellness ROI estimation model, as we promised about 3 months ago.  This is the only tool of its kind in the industry.  (Wellsteps has one, but let’s just say the good news is that NASA employees don’t have to worry about job security, because these people aren’t rocket scientists.  If you zero out inflation, no matter what other variables you enter, the Wellsteps model always shows savings of $1359.)

You can also use this to compare two wellness programs, to determine whether your vendor is lying (they are — and we are happy to help you get your money back from them), and to pressure-test Quizzify.

Quizzify Q in B and W

Quizzify, where facts are your friend, and they’re fun, too

You can download it here.

Eureka! An actual good idea for employee health and morale

I just read a provocative article by the IHPM’s Deborah Love, who points out the value of OTC drugs in self-care, citing multiple articles and sources.

I myself am a case study.  One day at work, out of the blue, I got this wicked case of indigestion.  I had to get in my car and drive all the way to CVS to buy a roll of Tums.  This would be considered a classic case of presenteeism followed by an hour of absenteeism.  The episode would definitely have reduced my productivity except for the fact that this particular job was a complete waste of a perfectly good cubicle, and the company was no doubt better off for my inattention to my half-soused boss’s half-witted directives.

If it is indeed the case that OTC drugs can alleviate, avoid or resolve some conditions that could cause absenteeism or presenteeism, perhaps they should be encouraged.  Many people have advocated that they be covered.  I have always thought that was unrealistic.  When you think about how much paper is consumed in health benefit administration today, coverage of OTC — requiring receipts and perhaps a doctor’s note — would be like adding more shrapnel to a hand grenade.

So perhaps the “answer” is that some OTC drugs should be made available — at cost — onsite.  Not all drugs.  Many OTC offerings are of dubious value or have long-term side effects, like taking a Prevacid every day, which can reduce bone density. But stocking those that are helpful in self-care could both encourage self-care and, — because they carry a lower price than the same drugs in a store — would be seen as a benefit by employees.  (If the price is low and employees are buying stuff for their friends, you can limit the number sold at one time.  Or sell them in a vending machine, where it is inconvenient to buy more than one at a time.  But if you are selling them at cost, it really doesn’t matter if your employees are buying more.)

Thoughts?  This seems pretty obvious and it always scares me when I think of things that should be obvious that I am missing something.

Otherwise, this should be a challenge to wellness vendors:  come up with an actual good idea, like this or like Quizzify.  If you do, we’ll be happy to tell people about it.

 

Validation Institute adds Linda Riddell as Validator

When I went on Jeopardy and my opponent (seen here) got the Daily Double right, I clapped.  It killed me because generally you don’t like your competitors to thrive, but, hey, it was national TV and you don’t want people — at least people who are not members of the Wellness Ignorati — to think you’re a jerk.

In the case of Linda Riddell becoming the second validator anointed by the Validation Institute and hence a “competitor” of mine, I am clapping but this time for real.  Linda is very smart, well-qualified educationally, and professionally she has whizzed through all the certifications needed to reach this level.

I welcome her “competition” and look forward to other consultants of her caliber following in our paths.

PS  I lost.  Bad draw.  My opponent, Bob Verini, went on to win the Tournament of Champions and then within the last year or so became the 80s decade TOC winner.  Lucky I didn’t give up my day job.

Al Lewis

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