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They say being on the cover of Sports Illustrated jinxes you. I wouldn’t know. There is no chance of that for me, unless they run a feature story about 60-year-olds playing Ultimate Frisbee on Christmas night, when they should be playing canasta with their aunts.
That jinx may be an urban legend, but here’s a real jinx: winning a C. Everett Koop Award. The 2016 vendor got humiliated in STATNews, of course — we’ve already covered that. The 2012 awardee was embarrassed in the media as well. The vendor ended up losing their gig.
Neither of their customers (Boise or Nebraska) are public companies, though, and that’s what this article is about, because it’s the customer’s performance we are most interested in, not the vendor’s. The latter do quite well for themselves, snookering unsuspecting employers.
The most recent public company to win an award was the 2015 winner, McKesson. McKesson got clobbered in the stock market in 2016, the 14th worst performance among the S&P 500, as investors learned that only the dumbest bunch of managers would pay a cabal of vendors (that themselves are among the industry’s most clueless, like Vitality) to harass their employees. Employee Benefit News took notice of the McKesson wellness program, and pilloried them, thus triggering the sell-off.
You might say: “Wait a minute. Yes, that was a failed, hilariously mismeasured, program whose award was due to the cronyism of having 5 of their vendors and consultants connected with the Awards Committee, but how could something as trivial as a wellness program be responsible for their stock price collapse?”
The answer, of course, is that it doesn’t. Based on the amount of money these programs lose, McKesson’s wellness program was probably only responsible for 1% or so of the 27% stock price decline. And that’s precisely the point. Ron Goetzel claimed that winning a Koop Award caused a dramatic increase in stock prices. I noted that, like most of Ron’s defenses of wellness, that analysis didn’t hold water, and any observer with a calculator and access to stock price histories could see that wellness causes a dramatic decrease in stock prices.
While I won that face-off (a year later, you would have been way ahead of the game shorting Koop Award stocks and hedging with index and sector funds), neither conclusion is really valid. Both analyses have a ridiculously low signal-to-noise ratio. Many things happen in the market that overwhelm wellness. For instance, I don’t think any of the analyses of Citibank’s 2008 crash would blame their Koop Award-winning wellness program.
Instead, the negative impact on stock valuations can be shown to be pretty trivial. Let’s start out with some favorable assumptions. Assume the typical program is more successful both than the allegedly successful one most recently measured in Health Affairs and also than the award-winning so-called best-in-the-country Wellsteps program for Boise, in that it neither loses money nor harms employees. Instead, it is only worthless. So even though Ron Goetzel and Michael O’Donnell say most programs fail, let’s assume yours neither causes health spending to increase or employees to get worse.
If you pay vendors to “manage” 10,000 employees @$150, that’s $1.5 million lost. With a typical pretax P/E of 10, you reduce your market value by $15,000,000. A company with 10,000 employees might have (for example) a market value of $1.5-billion. That makes the negative impact of wellness on stock price only 1%, hardly enough to cost a CEO his job.
So the good news is that McKesson’s collapse is the exception. Screening the stuffing out of employees, lying about outcomes, winning a Koop Award, and hiring a cabal of clueless vendors will not cause your stock price to plunge. In a year in which the media gave the wellness industry little reason to cheer, costing your shareholders only 1% of their investment in your company is great news. Worthy of a celebration. Or at least a couple rounds of canasta.
This completes our year-end series on the Goofuses and Gallants of the wellness industry. See:
- Announcing the 2016 Deplorables Awards
- Wellness Industry Stars of 2016
- So Many Candidates for the Deplorables Award Countdown, So Few Numbers between 1 and 10
- Wellness Stars of 2016, Part 2.
Are you smarter than an award-winning wellness vendor? Take this quiz and find out.
Q: How is the first unlike the second?
The first, Wellsteps CEO Steve Aldana, claims that it’s bananas that provide magical powers. And unlike Popeye and spinach, he doesn’t think we need to consume massive quantities. “Even one more bite of a banana” is all it takes to reduce overall costs by fully a third, despite their admission that costs for individual employees increase by about the same amount over the same period.
Yes, you read that right, and, yes, is it mathematically impossible for a number to go up and down at the same time. I noted in Wellsteps Stumbles Onward that Wellsteps had accidentally told the truth on the second display showing increasing costs, thus totally contradicting the first. The second display subsequently disappeared.
Perhaps Wellsteps deliberately made up the first slide to fool people (in this case, the Boise School District). The more charitable explanation, which shows Wellsteps in a better light, is that they didn’t deliberately lie when they said costs increased and decreased at the same time. Instead, they were simply confused by their own stupidity.
Lying is a Business Strategy
Wellsteps’ Linkedin group is called Wellness is a Business Strategy. I was banned from posting on it, accompanied by the following invocation of the First Amendment:
“It has come to our attention that an outspoken critic has entered false data into these calculators in order to make a point. We certainly support free speech; however, we wonder how valid the point can be when it is based on false data?” [Where “false data” is defined as “any data”]
Sounds like they support free speech…except when they don’t. Speaking of supporting free speech, they claimed in bright red letters — for no apparent reason other than they were probably suffering withdrawal symptoms from having gone a whole week without lying — that they had convinced Linkedin to ban us from posting. And yet many of you clicked through from linkedin. So here we are, posting.
Stupid is a Business Strategy
Wellsteps’ ROI model doesn’t generate an ROI. It doesn’t even generate a savings projection. What does it “generate”? One number: $1359. Yes, it always gives the same answer ($1359 savings per employee) if you zero out “annual cost increases” in their model to control for inflation. So anyone can see this model simply makes no sense, notwithstanding Wellsteps’ insistence that it is “based on every ROI study ever published.”
How stupid is Wellsteps’ model? Even Ron Goetzel refused to defend it. And when Ron Goetzel won’t defend stupid data fabricated by his friends, you know it’s bad.
Harming Employees is a Business Strategy
To win the Deplorables Award, outlying and outstupiding other vendors is a dicey strategy due to all the competition trying to do the same thing. So Wellsteps decided to boldly go where no vendor has gone before: they acknowledged, even bragged about, harming employees. Sure, plenty of vendors harm employees–by enticing them into crash-dieting contests, flouting clinical guidelines or giving them worthless nutritional supplements and billing their insurers. But no one had ever documented the before-after harms of wellness as conscientiously as Wellsteps did, which I helpfully displayed in detail.
Insults are a Business Strategy
What the judges here at TSW especially liked about Wellsteps’ candidacy for the Deplorables Award was their track record of not just harms and deceit, but also insults. Very clever ones too.
For instance, Wellsteps’ rebutted my observation that all their data is fabricated by saying I’m full of “hot air.” Touche!
One would think that that this guy (Mr. Aldana’s crony) could have come up with a better counterargument, given that he claims to have spent “11 years in college.” If you’re keeping score at home, that’s four more years than Bluto Blutarski.
Here are a few more targets of their ripostes:
- Everyone who is overweight: “It’s fun to get fat. It’s fun to be lazy.” They skewered 2/3 of the population in 10 words. Bada-bing!
- Sharon Begley, arguably the best health/science journalist of our generation. Mr. Aldana called her a “lier.” Her crime? Quoting him verbatim.
- WELCOA‘s exemplary leader, Ryan Piccarello. For not wanting to harm employees, Ryan is apparently part of a “gang of bullies.”
Such brilliant repartee, in an earlier generation, would have landed them a seat at the Algonquin Roundtable.
Bananas are a Business Strategy
So, congratulations to Wellsteps for winning their first Deplorables Award. Darwin will take it from here, and maybe get them a new gig more appropriate to their capabilities.
Recently we described how to cheat one of those worthless, hazardous corporate crash-dieting contests, like the ones run by Wellness Corporate Solutions or HealthyWages or Virgin Pulse (nee ShapeUp). But we didn’t interview any employees who actually did.
Journalist and wellness expert Pat Barone, writing in LifeZette (Laura Ingraham’s popular online magazine) managed to do just that. She found some employees who “confessed” (bragged about) the ways they snooker these vendors — and of course their own employers –every year, starting again in most cases next month.
These employers, like Schlumberger, think they are creating a culture of wellness when in reality they are creating a culture of deceit, diet pills and dyspepsia. Why would any employer sponsor one of these contests? Simple: in wellness, stupid is the new black.
I don’t want to spoil your fun reading the article by giving away all the punchlines, but the keywords are carbs, sodium, and rocks. All the things that employees should eat, as part of a healthy diet. OK, maybe not too many vitamins but certainly lots of minerals.
A shocking statistic just appeared on Linkedin:
Does this concern you? “A small share of doctors, 11 percent, accounted for about 25 percent of the complications. Hundreds of surgeons across the country had rates double and triple the national average. Every day, surgeons with the highest complication rates in our analysis are performing operations in hospitals nationwide.
Darn right it concerns me. It concerns me that someone who claims to be an expert (and I won’t mention a name, because it’s the holiday season, and because he is quite good at other things, and because he ordered my book so I don’t want to embarrass him) thinks this paragraph makes any sense whatsoever. Sure, it sounds dramatic to a lay reader, but a true expert would have parsed it just a bit…
First, it is possible that those 11% of surgeons also accounted for about 25% of surgeries–and that’s why they accounted for about 25% of complications.
Second, “11% accounting for 25%” actually proves the opposite point than the one this guy is trying to make. If there were truly “bad apples” there would be an 80-20 rule. 11% accounting for 25% is about as far from an 80-20 rule as you can get. In sharp contrast, in healthcare spending generally, 5% of the population accounted for 50% of spending last year. And a tiny percentage of doctors account for half of all oxycontin. Truly bad apples. 11% of doctors probably account for 90% of oxy prescriptions, I would guess.
Third, he said “hundreds of surgeons…had complication rates double and triple the national average.” Newsflash: it’s called an “average” because many people will be above it and many below it.
Indeed, with maybe 135,000 surgeons in the country, it would almost be mathematically impossible for only “hundreds to be double or triple the national average,” given that many surgeons, particularly those with low volumes of patients, would be at zero complications.
This whole thread is a perfect example of why people should read Why Nobody Believes the Numbers: Separating Fact from Fiction in Population Health Management. It teaches how to read this type of statistic using a critical eye, rather than accept stuff at face value that makes no sense whatsoever.
Note: none of this is to say there aren’t bad surgeons out there. Certainly, there are. But there are better ways to make the point than using mathematical fallacies about averages and 80-20 rules. And sometimes surgeons are really competent in the OR because they perform high volumes of surgeries…but maybe many of those surgeries shouldn’t have been performed in the first place and that’s why the surgeon is performing so many. As Peter Drucker says: “Nothing is more wasteful than doing something efficiently that need not have been done at all.”
That, of course, is what Quizzify teaches…how to avoid medical interventions that should not be done at all.
Two postscripts. First, he ends with:
Every day, surgeons with the highest complication rates in our analysis are performing operations in hospitals nationwide.
Well, where the heck else would they be performing operations besides hospitals (and surgicenters)?
Second, although he is a very capable guy in other ways, biostatistics are not his long suit. For instance, he once wrote:
“For millenia [sic], employers had no way of knowing that their employees were walking around without a clue that they had a debilitating or terminal condition…percolating in their bodies.”
I must confess I learned a lot from this exposition. I had not realized that employers’ concerns about employee chronic disease had their roots in ancient history. But there it is, right in the opening words: these concerns date back “millenia,” when employers failed to get their employees tested for “percolating” conditions before throwing them to the lions.
Last week I highlighted the first cavalcade of Wellness Stars of 2016, deftly juxtaposed with the popular Wellness Deplorables Award annual countdown. (The actual countdown has to be done in three parts, with #1 still to come. So many candidates, so few numbers between 1 and 10.)
Today we again switch back from the Deplorables to the Stars, in nonprofits, government, and the private sector. We’ll end with shout-outs to some individuals.
Nonprofit Advocacy and Government Groups
A number of organizations have distinguished themselves in 2016. AARP is right out in front, advocating for employee rights. AARP is right out in front, advocating for employee rights. They see involuntary wellness poking and prodding as highly disproportionately discriminatory against older employees (which we would observe is just one of wellness’s many charming features). Since older people are more likely to weight more, have higher blood pressure, diabetes, and more trouble losing weight, etc., they are more likely to want to withhold health information from their employers for fear of discrimination, but instead will be penalized by these programs into surrendering it, with wellness promoters advocating even more penalties.
Next is NIOSH, the National Institute of Occupational Safety and Health. Withstanding the pressure from their CDC overlords who have gotten completely drunk on wellness Kool-Aid, NIOSH wrote an amazingly thoughtful vision for the next 10 years of “Total Worker Health“…without even mentioning the word wellness. Why? For the simple reason that hiring a vendor to pry, poke and prod employees in excess of US Preventive Services Task Force (USPSTF) guidelines has virtually nothing to do with real occupational health and safety — except, as in the case of crash-dieting contests and/or Wellsteps, to damage it.
And speaking of USPSTF, hats off to them. They have withstood the pressure from various specialty societies and the National Business Group on Health (NBGH is now the leading wellness vendor shill in Washington) demanding more screenings, and threatening to oppose their funding if they don’t deliver. The actual science always favors USPSTF in these debates, but the whiners have plenty of money to support their very specific agenda: overscreening today, overscreening tomorrow, overscreening forever. (Those with long memories recall when USPSTF revised its mammogram recommendations to be consistent with the evidence…and almost lost their funding as a result.)
Also on the nonprofit scene would be the former National Business Coalition on Health, now renamed the National Alliance of Healthcare Purchaser Coalitions, in order not to be confused with NBGH, and hence not be accidentally sullied by the latter’s reputation. The regional coalitions that comprise the national group also take their roles defending employers seriously.
In particular, the Midwest, Philadelphia, Northeast, Pittsburgh and South Carolina coalitions deserve extra plaudits. I’ve participated in each of those regional events and consistently have found them to be among the best of the employee health conference genre. The speakers are well-vetted, and it’s not a vendorfest. And the food is consistently good too. One was even covered by the local media.
And if there were an advocacy organization hall of fame, Leapfrog Group would be the first inductee. For years they’ve been getting hollered at by hospitals for ranking them objectively, and lobbying for more transparency in medical error reporting. Since “pry, poke and prod” overscreening is one humongous medical error, needless to say Leapfrog has been visibly opposed to it, and highly supportive of our efforts…and also can be as funny as we are on that subject.
The Private Sector
First is Medencentive. Whereas most employee health vendors generate tons of comments demanding the program’s removal (Penn State received about 2000 employee signatures demanding the removal of their Goetzel-inspired debacle before they finally caved), Medencentive generated over 3,000 users signatures in support of their program…out of only 21,000 eligible people, over a brief 45-day period. You might say: “Oh, well, their program must be tied to some huge incentive.” Actually, it’s only $15 per office visit.
A list of other companies worth of mention would include, as always, Quantum Health. When Cooperstown builds the Employee Health Program Hall of Fame, Quantum will be the first inductee. While what they do is most important, what they don’t do is also notable: they don’t chase down healthy employees to pry, poke and prod them. They focus only on employees who can benefit from their assistance. That shouldn’t be rocket science, and yet focusing only on employees in need who want help is the opposite of the typical wellness vendor “hyperdiagnosis” model.
I would also like to give a shout-out to Welltok, which received validation from the Validation Institute, for creating some of the best analysis I’ve ever seen to show noticeable and completely valid impact of their program.
Wellable, right here in Boston, publishes a newsletter that is a must-read, due to its sensible and literate takes on the wellness scene and speaking of sensible and literate, that brings us to…
…the industry’s drop-everything-and-read blog, when he actually gets around to writing it, is Bob Merberg’s In tEWn. To say Bob’s smackdown of Ron Goetzel’s Graco fiction was Al-worthy is an insult to Bob. He even found obvious lies missed by even the guy Mr. Goetzel calls “sharp-eyed Al Lewis.” (That explains it. All this time I thought Ron’s analysis was wrong all the time because he was dishonest. Turns out it’s only because he didn’t get LASIK and I did.)
To be sure, Mr. Goetzel’s reports in general — and Graco in particular — are a target-rich environment but even so, Bob’s was an impressive piece of peer review. Though to call this “peer review” is also an insult to Bob.
I am also a big fan of postings by Fred Goldstein, Bill McPeck and Dean Witherspoon even if I don’t always agree with them, and am pleased to add them to the Stars list despite the occasional disagreement. I am not interested in conformity but rather just in basing a debate on facts.
The up-and-comer on the scene among individuals? That would have to be Dave Chase. Dave is putting together The Big Heist, a documentary series on ripoffs in healthcare, naturally featuring wellness. You can look at his master list to find other “Good Guys.” Big Bang Health is such a Good Guy, also an up-and-comer. Phia Group, also a charter Good Guy, enjoys a well-deserved top-flight reputation in designing benefits plans incorporating state of the art cost and risk reduction techniques — and is also certain to be featured in Dave Chase’s magnum opus.
And three cheers for the industry’s #1 podcasters, James Kelley and Michael Prager. No one has ever found a material inaccuracy in this blog and I don’t want to start now so just for the record, Michael’s is on video. Speaking of which, Michael hasn’t found “inaccuracies” but he has made observations that helped me tighten or tweak my language, on two occasions, so thank you for that. Rachel Druckenmiller and Michelle Spehr have also contributed very insightful comments and postings and I look forward to highlighting them separately.
Meanwhile, more astute commenters on TSW worthy of mention: Dell Dorn and Doug Dame (I don’t think those are the same person, but then again, has anyone ever seen them in a room together?), and a big shout-out to Robert Dawkins for finding a fallacy in McKesson’s stillborn overvendored, underperforming, program that, as with Bob’s Graco analysis, even sharp-eyed Al Lewis missed. While McKesson’s program basically accomplished nothing, I did give them credit for a 1% reduction in tobacco use. Mr. Dawkins pointed out that over that same period, US tobacco use in general fell by that very same 1%. Frank Pennachio also has our backs and pushes out much of our material to the workers comp community.
Now that you are all done puking, rest assured that for my last post of the year, next week, I will step back into character and name the Winner of the 2016 Wellness Deplorables Award.
Until then, in the spirit of the season, we graciously offer all the Wellness Ignorati, Ron “the Pretzel” Goetzel, and all the Deplorables a very
Having covered the also-rans last week, here are the first runners-up, as we inch ever closer to the coveted top spot. (To read the original postings, click on the numbered headers.)
Today we are highlighting more people and organizations who’ve made the wellness industry what it is. Wednesday we will complete the listing of the Stars of Wellness, the people and organizations who are making the industry what it should be.
Interactive Health conducted what may be the head-scratchingest screen in wellness industry, a difficult feat given all the competition. For starters, they tested me for calf tightness. It turns out my calves are tight–and right on-site they loosened them. I could feel my productivity soaring…until the left one went into spasm that night and I couldn’t get back to sleep. Still, I can see their point — loose calves are a useful trait for many common jobs.
Next, Interactive Health shattered the record, previously shared by Total Wellness and Star Wellness, for most USPSTF non-recommended blood tests. I don’t know what half these things are, which means neither does Interactive Health.
Where would a Deplorables Greatest Hits List be without the Koop Award Committee?
Every year, like clockwork, the industry’s biggest liars select the industry’s biggest lies. 2016 started with last year’s winning program, McKesson’s, being exposed as a joke in Employee Benefit News, and ended with this year’s winner, Wellsteps, being exposed as a joke in STATNews.
When bestowing this year’s award to their fellow Committee member, Wellsteps, they didn’t even pretend not to lie. And what lies they were! Not just regular-sized lies. Not even supersized lies. We’re talking lies that would make a thesaurus-writer blush.
To put their lies in perspective, I may not even know you, but if a Koop Committee member told me the sky was blue, and you told me the sky was green, I’d at least go look out the window.
PS Not everyone on the Committee is a liar. One person is quite honest and can’t believe what goes on every year. I don’t want to name my source because in Koop-land, honesty is grounds for termination. As is getting validation. Or adopting the Code of Conduct. Basically ethical behavior is off-limits. An executive of one group, Altarum, published a blog critical of wellness and <poof> the Committee disappeared them.
Michael O’Donnell seems to crave my attention. When he managed to go three whole months without being featured in a TSW posting, he came up with these irresistible nuggets:
- “Wellness is indeed the best thing since sliced bread, up there with vaccines, sanitation and antibiotics.”
- “[Wellness] can prevent 80% of all diseases.”
- “The ROI from wellness is very strong.”
- “Workplace health promotion may play a critical role in preserving civilization as we know it.”
If nothing else, Mr. O’Donnell presents the best argument for requiring educational standards, or at least a GED, in this field — by demonstrating his total lack of understanding not just of wellness, but also of vaccines, sanitation, antibiotics, percentages, diseases, ROIs, and preserving civilization as we know it.
Oh, yes, and multiplication as well. His article on how to increase productivity with wellness used an example demonstrating a productivity decrease. In 2016, he also went on an anti-employee jihad that should be read in its entirety. (Translation: some of my best work…) Highlights:
- Prospective new hires should be subjected to an intrusive physical exam, and hired only if they are in good shape. OK, not every single prospective new hire — only those applying for “blue collar jobs or jobs that require excessive walking, standing, or even sitting.” Hence he would waive the physical exam requirement for mattress-tester, prostitute, or Koop Committee member–because those jobs require only excessive lying.
- He would “set the standard for BMI at the level where medical costs are lowest.” Since people with very low BMIs incur higher costs than people with middling BMIs, Mr. O’Donnell would fine not only people who weigh more than his ideal, but also employees with anorexia.
If employees didn’t already have an eating disorder, what better way of giving them one — and hence extracting more penalties from them — than to levy fines based on their weight? Employees above his ideal weight would pay per pound, sort of like if they were ordering lobster or mailing packages.
These three characters — naturally also on the Koop Committee — managed to pile more lies, sardine-like, into a single page than anyone else in this industry, in the “poison pen” about me they circulated to the media.
A good starting question would be, why on earth would anyone think that they can send a “confidential” letter to the media? The media are in the business of disseminating information. You see, that’s why they call them “the media.” Am I going too fast for you, Mr. Goetzel?
The funny thing about these Einsteins? Their defense to my observation that their very own numbers show wellness loses money was that their very own numbers were made up. Imagine being so dishonest that the way you defend yourselves is by claiming you fabricated your own report.
That’s not even the punchline. It turns out that this allegedly fabricated report is in truth an actual non-fabricated report. So, in the immortal words of the great philosopher LL Cool J, they lied about the lies that they lied about.
How did I learn this? That will be the subject of a post early year.
Watch this space…soon we will be naming the industry’s #1 Deplorable of 2016.
On Monday, we announced the 2016 Deplorables Awards, highlighting the bad hombres and nasty women who’ve made the wellness industry what it is. In this post we recognize instead those good hombres and gracious women who’ve been trying to make the industry what it should be.
They too deserve recognition for the great work they did in 2016. I apologize if I’ve left anyone off. If you feel like you should be recognized, or know someone who should be recognized, just ping me for inclusion in next week’s Part 2.
Being in first place is not news if you’re the New England Patriots, and have led your division for something like 12 of the last 14 years. Worst-to-first is what generates news, though…and that’s exactly why we are highlighting WELCOA. (Their “worsts” were well-chronicled on this site during the David Hunnicutt era.)
WELCOA’s new executive director, Ryan Picarella, is leading the way both on adoption of the Code of Conduct (and standing firm against Wellsteps calling him part of our “gang of bullies” for supporting it) and in general leadership. Quizzify has signed up for WELCOA and even though our year doesn’t start until January, we are already very impressed with their professionalism, timeliness etc. Quizzify would support them on principle, but joining their Premier Provider Network could easily be justified on merit alone. Current PPN vendors report getting many inquiries.
Speaking of which, next up would be Quizzify. Quizzify, in addition to having earned the privilege to carry the Harvard Medical School shield, was first vendor of any kind to adopt the Code of Conduct, and among the early companies to earn validation from the Validation Institute.
Rather than do a sales pitch here (Quizzify has its own website for that), I would simply ask employers a question: If employees spend an average of about $10,000/year of your money on healthcare, why not invest $1 PEPM to help teach them how to spend it wisely? To decide whether they will learn anything, play the game yourself to see if you do.
Speaking of the Code of Conduct, this list wouldn’t be complete with mentioning Salveo Partners. Rosie Ward of Salveo Partners penned the actual Code of Conduct (with input from her partner Jon Robison, myself and of course Ryan Piccarella, the four of us comprising the aforementioned “gang of bullies”). I found myself dog-earing many pages of their book How to Build a Thriving Culture at Work.
The Code of Conduct has attracted other adherents besides its authors, Quizzify, the 149 people who have “liked” it, and the 29 very positive commenters. Some of the most respected vendors also jumped on board…and it didn’t take long for them to do so. Any honest vendor committed to improving employee health should have no issue with it. Indeed, the most pushback our “Gang of Bullies” gets from honest vendors is: “Shouldn’t we be going farther than just respecting employee dignity, doing no harm, and not lying about outcomes?”
On the other hand, It Starts with Me and Medencentive have both endorsed the Code and been validated by the Validation Institute — a twofer matched only by Quizzify. Sterling Wellness lives up to its name — these folks have endorsed the Code and while they don’t yet have validation, I can tell you firsthand that their excellent program could certainly meet the standard needed for validation, should they choose to pursue it.
Speaking of validation, a big shout-out to the Validation Institute. 2 years later, no one has ever been able to find a mistake in their any of their validation language for any of their validated entities. This is despite the fact that, as we’ve noticed with the Health Enhancement Research Organization (HERO), finding whoppers in industry association materials is not exactly a heavy lift.
Another industry association makes the list: The Corporate Health and Wellness Association. They are everything HERO isn’t: honest, competent, and committed to advancing the evolution of employee health programs. And popular too: About five times as many people attended their fall conference as attended HERO’s, which shows that most people prefer not to pay money in order to be lied to.
The media had a tough year in 2016, but if there is one topic they aced, it’s wellness. Here at TheySaidWhat, we ♥ media, whether it be trade or lay, lamestream or right-wing. We keep a complete list of all articles on wellness. Special shout-outs to:
- Sharon Begley, who exposed Wellsteps’ program for Boise as a total failure, and basically allowed the rest of the Wellness Ignorati to self-immolate. Um, Mr. Goetzel, a program that harms employees shouldn’t be described as “not perfect.” The correct adjective would be: “fraudulent.” Still, it was nice of you to give your friends that Koop award anyway. I mean, none of the participants actually died, right? In wellness, that should count for something.
- Laura Anderson, whose Slate expose of the “sham” wellness industry attracted mind-boggling numbers of comments and stories from aggrieved employees;
- Pat Barone, of Laura Ingraham’s Lifezette, writing that “corporate wellness needs a checkup.”
- Among the trades, Employee Benefit News stands out for its willingness to air all sides, even though the other side does most of the advertising;
- And among blogs, what’s there not to love about Insurance Thought Leadership, The Doctor Weighs In (describing how old-line wellness vendors became liars), and The Health Care Blog?
- ConscienHealth and Dances With Fat have helped to shine a light on the hazards and uselessness of corporate crash-dieting programs. As B-to-C websites, they introduce our work to many people who would not otherwise be aware that they are not alone in the universe.
And, course, the New York Times‘ economics bloggers, The Incidental Economists, earns plaudits for the single best wellness smackdown ever.
I’d also like to thank people who consistently reblog, retweet, repost — or even comment using their real names. There are a lot, so I’ll be saving some for Part Two (and if you think I’ll miss one, ping me now). Tom Emerick, Krisna Hanks, Mitch Collins, Bill Fabrey, Nicole Ausmus come to mind.
But most of all, to paraphrase the immortal words of the great philosopher Yogi Berra, I’d like to thank everyone who made this blog necessary. That would be the liars, idiots, cheaters, and misanthropes who have provided seemingly endless material for TheySaidWhat. If not for them, there wouldn’t be an opportunity to highlight people doing things right.
For this year’s Deplorables Awards, I think we’re gonna need a bigger basket. As a result, this will be a two-part series.
Why? Because we need to accommodate all the bad hombres and nasty women who have subverted the perfect elegant philosophy of wellness into nothing more than a profit machine, with no regard for integrity, customers, or employees.
Yes, 2016 was a year in which a record number self-anointed industry leaders gave lying and cheating a bad name. In that sense it was no different from any other year, though 2016 offered even more good news and bad news:
- The bad news: not content with merely lying and cheating, this cabal branched out into harming employees, fat-shaming, and pure misanthropy;
- The good news: wellness did succeed in one way, as a “natural experiment” showing what happens in healthcare if being a provider requires no credentials beyond a GED, a driver’s license, and a pulse.
Indeed, whatever mathematician first postulated that everyone can’t be worse than average had apparently never experienced the wellness industry. (Exceptions of course, being the few that, like Quizzify, are validated by the Validation Institute or have accepted the Employee Health Program Code of Conduct.)
#10 Optum and Wellsteps (Runners-Up);
What do you do when you need to defend your blatant disregard of the US Preventive Services Task Force guidelines? Simple — you blame your customers. Optum’s Seth Serxner said: “Customers make us” do this. Optum’s PR hack said I was making Optum “look bad.”
I said: “Sure, I’ll apologize. Just name one account that will admit to insisting on paying a higher price than you wanted to charge, in order to screen the stuffing out of their employees.” Never heard from them again.
#9 The Johnson & Johnson Fat Tax gives misanthropy a bad name. (Honorable mentions to Vitality and Ron Goetzel.)
Misanthropy, greed, and weight-shaming provided the wellness industry with its key “talking points” in 2016. And nothing combined the three like the Johnson & Johnson Fat Tax fiasco. The point of the (apparently stillborn) Fat Tax was to stigmatize overweight employees, by “pressuring” (their word) companies into disclosing to shareholders how many fat employees they had. That in turn would somehow pressure these employers into spending more money on wellness vendors.
It’s not altogether clear what that disclosure would do for the actual overweight/obese employees, but somehow this disclosure was supposed to allegedly benefit shareholders. Indeed, the Fat Tax cabal is right about that in one respect: this disclosure would benefit shareholders — it would indicate to shareholders that they ought to unload their shares in a hurry, because management just disclosed it is stupid.
Vitality was a co-conspirator in hatching this scheme, which is ironic because they admitted they couldn’t even get their own employees to lose weight. And where you hear the word “stupid,” can the name “Goetzel” be far behind? This whole thing was his idea, based on the notion that “playing doctor” with employees makes stock prices increase. However, his claim that companies with Koop Award-winning wellness programs outperformed the market can easily be invalidated by anyone with a calculator and a triple-digit IQ.
#8 IBISWorld: How is wellness different from King Midas and Gold?
Here are links to the postings on the most hilarious report we’ve ever read about the wellness industry:
- New wellness industry report costs $5400 (but that includes shipping)
- New report raises the bar for cluelessness in wellness
- How is wellness different from King Midas and gold?
The answer to the question in the header? Everyone who touches wellness turns to stupid. Not just garden-variety stupid. More like fifty shades of stupid.
Mind you, most wellness industry leaders don’t need to touch anything first before reaching that endpoint, but occasionally a company like IBIS, with no prior experience in wellness, ventures into this field — and that’s where the fun starts. These IBISWorld Young Turks (literally–the writer is named “Turk”) are so excited about this industry, they practically speak in tongues:
Wellness firms may offer employers stress management courses and sessions that offer music therapy, aromatherapy, Tai Chi, and post disaster stress reduction through coaching.
Government-funded initiatives that promote wellness to cut costs related to chronic ailments (e.g., obesity and diabetes) has further exacerbated many businesses movement toward purchasing corporate wellness services.
And my own personal favorite:
The industry provides wellness programs to businesses across the United States, including small, medium and large businesses in the private sector and businesses in the public sector.
“Businesses in the public sector”? I knew that many of our legislators are for sale but I didn’t realize they had incorporated.
Healthfairs USA doubled down in 2016 on lying and cheating with an elegant new strategy: insurance fraud. They not only harm employees, but bill insurance companies directly for the privilege of paying for those harms. They offer cancer tests that are “99% accurate” (hence their multiple Nobel Prizes), and over-the-counter nutritional supplements…all of which are covered by most insurance companies because they get a doctor to sign a claim form.
Disclosure: we aren’t entirely sure that billing insurance companies for USPSTF D-rated screens and worthless, possibly harmful, pills constitutes insurance fraud. Our opinion is probably no more accurate than their cancer tests.
In 2014, Aetna decided to “play doctor” with obese members of self-insured customers by telemarketing their employees to pitch very controversial high-priced drugs whose sales are “flailing” because almost no patients seem to want to take them. Among other things, Aetna said these drugs increase productivity even though right on the label, the drugs warn that they could reduce productivity (attention span and language facility).
Not content with the warm welcome that scheme brought them, in 2015 they introduced a DNA-based wellness program and claimed a whopping $1464/participant in savings. What put the whop in that whopper were these two tidbits. These savings were achieved:
- in the first year alone;
- on participants who were not actually sick to begin with. (You couldn’t qualify for this study if you were already sick.)
The reason Aetna needed to fabricate such a high savings figure is that the wellness field requires ROIs greater than 2-to-1, and this DNA test sells for $500/employee. So you need to show savings between $1000 and $1500.
Also, in 2015, we were able to show the program was completely ineffective, a convincing enough demonstration that one of the board members of the journal that published the study with the $1464 claim publicly apologized.
What do you do when it turns out your science is all wrong (news flash: being told you have a gene for obesity doesn’t motivate you to lose weight) and your math is all wrong? Of course, you apologize and retract the study, and offer to return the money to the lucky few companies that signed up for your program.
Haha, good one, Al. Obviously, like all the other Deplorable Award-winners on this list, you sell your snake oil harder than ever, and that’s what gets them on the 2016 list. Whereas in 2015, they could use the dumb-and-dumber defense, this year they know the numbers don’t add up and yet they are still flogging it.
Don’t miss the slam-bang conclusion as we count down to #1. Will Ron Goetzel retain his crown, or will he be unseated as the wellness industry’s #1 Deplorable?
Yes, we realize he has already appeared on this list at #9, but many lists feature the same entities making multiple entries. For instance, the Beatles once held positions #1 through #5 in Billboard’s Top 40, so it can be done.
Not that I want to put any ideas in his head.
There are three ways to win a debate:
- Cite facts that support your position.
- Be smart enough to win a debate even though the facts go the other way.
- Break your opponent’s microphone.
Let’s consider each possibility in turn:
- Not a chance–Wellsteps won a Koop Award. When was the last time you saw a bona fide fact in a Koop Award application? Certainly STATNews doesn’t seem to have found any. And if Wellsteps had an actual fact in their favor — meaning if we were wrong about one single solitary thing — don’t you suppose they would have stumbled onto it by now? Don’t you suppose that just one of their insults would be grounded in reality? In the immortal words of the great philosopher Rick Perry, even a broken clock is right once a day, so the score is: Broken Clocks 1, Wellsteps 0.
- Smart? Hello! We’re talking Steve Aldana and Wellsteps here, not to mention Troy Adams, the originator of the Wellsteps tag line: “It’s fun to get fat. It’s fun to be lazy.“
- Bingo. That’s what Wellsteps just tried to do. When all else fails, cheat. They tried to get Linkedin to shut us down for “bullying” them by adding up their own numbers. Here is their exact “update,” which they were kind enough to put in red so you can’t miss it. To paraphrase the immortal words of the great philosopher Michelle Obama, when they go low, we go paste:
And yet you may have just clicked through to this post from Linkedin, meaning that reports of our death (me and Jon Robison of Salveo Partners) are greatly exaggerated.
The irony is, Wellsteps doesn’t understand irony
The irony is, what greater form of bullying is there than to try to muzzle someone whose only crime was to agree with Wellsteps’ own data?
The other irony is, Wellsteps’ CEO recently wrote: “We certainly support free speech:”
It has come to our attention that an outspoken critic has entered false data into these calculators in order to make a point. We certainly support free speech; however, we wonder how valid the point can be when it is based on false data?”
I guess, to paraphrase the immortal words of the great philosopher John Kerry, Mr. Aldana was for free speech before he was against it. (Is “entering false data” like “bearing false witness”? If so, we yield to Wellsteps’ expertise. And we did enter every combination of data imaginable into their “calculator.” It always gave the same answer. Try it. It’s like wellness savings measurement-meets-Fisher-Price. Just make sure to zero out inflation.)
Being in the “integrity segment” of this industry, we aren’t exactly big fans of Ron Goetzel, and the longer he lets his cronies at Wellsteps keep their Koop Award, despite it now being well-established that they harmed employees in multiple ways, the more his own sullied reputation suffers. However, we will acknowledge one thing that Ron Goetzel excels at, and that’s ignorance. He is great at ignoring facts, ignoring data…and, most strategically, ignoring us. Indeed, as the leader of the Koop and HERO cabals, he inspired the collective noun “the Wellness Ignorati.” He knows better than to debate us, because the Wellness Ignorati always lose debates, even when they break our microphone.
Here’s a similar apology, for Professor Baicker’s infamous “Workplace Wellness Can Generate Savings” meta-analysis claiming the 3.27-to-1 ROI from wellness that RAND also eviscerated:
I had been quite adamant in the previous post that this meta-analysis was likely just a gold-plated package of garbage case studies. I compared it to packaging subprime home loans into AAA-rated collateralized mortgage obligations (CMO).
That was before I looked at the individual studies comprising this meta-analysis. I realize now that comparing the Harvard Study to the CMO scam was unfair. So I owe an apology to Bear Stearns, Lehman Brothers, and Countrywide.
Next, I apologize for pointing out that Ron Goetzel, as recently as last week, is still quoting this very same thoroughly discredited 7-year-old study, as well as many other outdated analyses. For example, he insists on continuing to quote the New York Times economists’ September 2014 analysis that wellness programs “generally” don’t work, even though they subsequently made their conclusion much clearer: “We’ve said it before, many times and in many ways: workplace wellness programs don’t save money.” They then specifically criticized Mr. Goetzel’s own methodology (“industry studies based on study designs that cannot produce valid causal estimates”).
I apologize for thinking that this deliberately selective misinterpretation of these economists’ previous conclusions makes him sound deceitful. And I apologize for being sure that the people who forwarded me this slide would agree with that assessment. And I apologize for once again making phony apologies.
The real apology
Now that I’ve checked off the usual Wellsteps-and-Goetzel-integrity boxes, it’s time to step out of character and seriously apologize. Here’s what I did that I really do need to apologize for: not cutting wellness professionals enough slack on giving them enough time to learn what took me several years to learn about wellness losing money.
I was once guilty myself of believing this 3-to-1 ROI nonsense, specifically about disease management (DM). Why DM in particular? I had some ego wrapped up in it because I am actually credited with inventing DM. Really. Just google on “invented disease management.” Whether or not I did (and plenty of others could share the credit), I was not just drinking the DM Kool-Aid. I was mixing it up and selling it to others.
Then, 10-12 years ago, a few people told me none of the DM savings numbers added up. I didn’t believe them. I thought it was sour grapes because they missed the boat.
True, I had enrolled a few of my own extended family members and friends into DM programs. Vendors were more than happy to offer me their best nurses, VIP treatment, you name it. Yet no one I referred thought these free programs were even worth a second free phone call.
Nonetheless, I was sure that somewhere there existed a whole lot of employees who did benefit from DM. Yes, in my fantasy world tons of people really appreciated these unsolicited calls from their health plan offering to help. After all, who among us doesn’t trust an unsolicited caller from their health plan offering to help?
In my worldview, the lucky recipients of these calls would respond: “You’re right. I should be taking my pills. Hey, thanks. I never would have thought of that on my own. And I was just about to have a heart attack, so you saved a ton of money.”
Yes, I realize this made no sense. Yet I never questioned my own findings. Basically, I ignored the warning signs about DM’s sketchy economics for years. When I finally had the epiphany, it got quite the headline:
Once I questioned my own figures, the rest because immediately obvious to me — one after another after another, sets of numbers in this field simply did not add up. Wellness was a far worse offender than DM, which does appear to roughly break even or better. No surprise about wellness. Screening costs about 10 times as much as DM and whereas people who qualify for DM are already well down the slope to infirmity, screens are performed mostly on healthy employees, who can’t generate any savings. (We of course support screenings according to guidelines, for the health of employees rather than an ROI. But most vendors ignore guidelines and screen the stuffing out of employees.)
Still, it had taken me years to have the initial epiphany…and yet now I was quite curt and dismissive with other people who didn’t immediately get it, and were defensive in support of their lifelong assumption. I was basically saying to others in the field: “You know all those savings claims? Total malarkey. Prying, poking and prodding doesn’t save any money.” I’d expect everyone else to get this right away. When they didn’t, I was not gracious with them in many cases.
Over time, a large number of folks have come around. They did it at their own speed, same as I did. Take WELCOA, for example. They were among the worst (and God bless ’em, funniest) offenders…and yet now you won’t find an organization more committed to getting wellness right, helping employees, and being honest than WELCOA. (In their case, a night-and-day change of leadership helped.) I’m not just saying this–I’m walking the walk. Quizzify is joining WELCOA’s Premier Provider Network for 2017, joining vendors I have a lot of respect for, like It Starts with Me, Populytics, and SelfHelpWorks. The first two, also like Quizzify, are validated by the Validation Institute.
Making good on the apology
A good apology comes with an offer to make it up. So if you feel like I dissed you prematurely, while you were learning wellness economics on your own, you can have one of:
- a free pdf of any of my books — Surviving Workplace Wellness, Cracking Health Costs, or Why Nobody Believes the Numbers
- half-price on a hardcopy of those books (order direct, not through Amazon, of course)
- a free analysis of any outcomes report
- a free month of Quizzify with no commitment (there is a minor asterisk on this one, please inquire)