Executive Summary:

We are getting very frustrated with the failure of wellness advocates to show even the slightest net savings using a legitimate methodology.  Therefore we are offering a million-dollar reward for the first person who does.  To win this reward, there are specific rules that must be followed regarding data sources and the selection of panelist judges, all listed below.

Recently a group calling themselves the Global Wellness Institute Roundtable put out a press release and report criticizing us for “mud-slinging on ROI.”  We are not familiar with this group.  Their headliner seems to be a Dr. Michael Roizen, head of the Cleveland Clinic’s much-vilified wellness program.  If that name sounds familiar, it’s because he used to work with Dr. Oz, though to Dr. Roizen’s credit, he avoided the Congressional investigation of Dr. Oz.

The report says we “impose a standard of evidence that doesn’t exist for any other workplace investment.”  Um, like it needs to break even?  Wouldn’t a company go bankrupt pretty quickly if it didn’t insist that its investments should break even?

Also, there are three very specific reasons why wellness needs a high “standard of evidence.” If Dr. Roizen doesn’t understand these reasons, he can get a smart person to explain them to him.

We get a little frustrated when we prove something, and then members of the wellness industry dress themselves up with words like “Global” and “Institute” and “Roundtable” and then say things like: “critics are misusing ROI science to castigate…workplace health efforts.”   Then they cite articles that inadvertently undermine their own arguments and support the critics.

They also say things like: “93% of the workplace wellness return in the first year is in productivity gains, not reduced cost.”  This is squirrelly even by the lax standards of wellness math.  No company can measure its productivity gains with that precision. Still — assuming you exclude time wasted in filling out forms, being screened, and getting unnecessary checkups — maybe they’re right. After all, nothing focuses the mind on work-related issues like being told you’re sick.

And yet casual observers assume there are two sides to this “debate.”  It doesn’t help that journalists need to print opposing quotes. However, pry, poke, and prod” wellness loses money, period–unless you count the money forfeited by employees who don’t participate, or don’t lose enough weight to earn their payment.  Those payments are not counted for the purposes of this reward since they are transfers, not savings.

Leaving out employee forfeitures, the country as a whole has not even remotely approached breaking even on wellness spending vs. claims costs.

But don’t take our word for this.  We are offering a million-dollar reward for anyone who can show that it is more likely than not that “pry, poke, and prod” wellness breaks even through healthcare claims savings.

Not” Show a 2-to-1 ROI” or “Defend the famous 3.27-to-1 ROI.”  Just: “Show a breakeven.”  Not “wellness is a success.”  Just “wellness is not a epic fail.”

The Rules

Specifically, you just need to show, using publicly available databases (not private “case studies” or vendor reports), that:

1. it is mathematically possible that the country’s employers can reduce their medical claims costs enough to cover the wellness industry’s $8 billion in annual billings by enough to offset internal costs and consulting fees (you can estimate those); and
2. during this millennium the wellness industry has reduced costs (by avoiding wellness-sensitive medical events, which is the methodology HERO and us agree on) by enough to break even according to the first calculation;
3. The so-called “best programs” in the country — Koop Award winners the last 3 years — are, if not exemplary, then at least good performers that earned the savings they claimed to save, by significantly reducing risk factors.

Here are the rules.  This is a binding legal contract.  We can’t offer something like this and then say we had our fingers crossed.

• You need to start out with a lie detector test, to be performed by the Boston police, as I will. The questions to be asked are: “Are you telling the truth?” and “Is the opposing party either deliberately lying, and/or has no clue how to measure outcomes?” Either side may submit either or both sides’ results, as they prefer.
• You must provide your view of the C. Everett Koop Award to Wellsteps and Boise (600 words, 6 hyperlink maximum), and rebut the other view (600 words, 6 hyperlink maximum). We will also both be asked: “Did the Wellsteps program reduce costs in Boise by roughly a third, as they claimed?” in the lie detector test.
• In order to facilitate your quest, you can use include the wellness industry’s own HERO Outcomes Guidelines, which represents the “consensus” (their word) of 39 “subject matter experts” who support wellness. (None who oppose wellness were invited to participate.) US Census Bureau information, Kaiser Family Foundation, and the AHRQ’s HCUP database can also be used.  Other databases will be allowed in at the discretion of the panelist judges if they deem their probative value to be very strong.
• You may cite/quote any peer-reviewed article in rebuttal of the opposing view; however articles in support of the position in question must be sourced from one of the ten medical journals with the highest reported “impact factors,” and have been published within the last five years;
  • Once an article is brought into the discussion, the opposing party may also cite it in cross-examination.
• We give you a lien on $1,000,000 as soon as you escrow $100,000 to cover the costs of the program (honoraria for panelists, venue etc). The loser pays this (meaning that if you win, you get it back).  If the costs are less than $100,000, the winner keeps the difference.
• We each pick four panelists from Peter Grant’s “A-List” of the leading 260 health economists and policy experts (this is an invitation-only email list in which health policy and health economics concerns are addressed and debated) that are unaffiliated with the wellness industry or with Quizzify . Each party can veto two of the other’s picks. Together, the remaining four pick a 5^th.
• Each side submits up to 2000 words and 5 graphs, supported by no more than 20 links;
  • The material linked must predate the claim for the award by 6 months, in order to discourage either side from creating linked material specifically for this contest.
• Each party may separately cite previous invalidating mistakes made by the other party that might speak to the credibility of the other party.
• Either side may cite an unlimited number of “declarations against interest,” made within the last 4 years–meaning comments made by the other party so prejudicial to their own position that the other party would only have said them if they were true. Example: if I said, “Wellness definitely saves money” (except when I said it as an April Fool’s gag), you could cite that. There is no word limit on these.
• Each party can then rebut the other party with up to 2000 words and 5 graphs, and 20 links.
• The parties will be convened, in Boston (or another agreed-upon city, if the other party is willing to pay my travel expenses), for a two-hour finalist presentation in which the panelists (whose travel expenses and professional charges are paid for out of the entry fee) can ask questions of either party, and both parties can cross-examine the other for up to 40 minutes, with followup questions and no limitations on subject matter. Each party can make a 10-minute opening and 10-minute closing statement. Up to 20 slides are allowed.
  • During their 40 minutes, each party that has not achieved Certification in Critical Outcomes Report Analysis by the Validation Institute must explain why they haven’t, and each party that has not signed the Employee Health and Wellness Code of Conduct must explain why they haven’t.

We invite the wellness industry leaders — the “Global Wellness Initiative Roundtable,” the Koop Award Committee, and the Business Roundtable (BRT) and of course the Health Enhancement Research Organization — to collect their million dollars. Or shut up.