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In wellness, life imitates Dilbert

Today’s Dilbert:

 

The Penn State wellness program:

 

At the same time this program was being announced, the campus bakery announced an expanded selected of pastries and desserts for the upcoming academic year.  

 

5 Ways Diabetes Vendors Snooker Employers

Hate to knock Interactive Health off the front page, but this just in

The bullet points are that diabetes vendors claims credit for savings based on:

  1. Squirrelly “predictive modeling” of cost reductions that have not yet occurred
  2. Assuming employees pre-diabetes would almost immediately turn into high-cost diabetics absent their intervention
  3. Comparing participants to non-participants (why are vendors still pretending this is a thing?)
  4. Claiming that people are going to keep their weight off
  5. Lying

This doesn’t cover their other sleight-of-hand, which is charging via claims instead of admin fees, and positioning that opacity as a feature rather than a bug.

Here is the link to the whole ball of wax.

Image result for the music man Robert Preston

 

 

 

 

The very stable geniuses at Interactive Health once again put their very good brains on public display

Interactive Health is well on its way to disproving the law of averages.

I’ve never, ever, seen them get the facts straight. This is a very hard feat to accomplish. Just randomly — or by hiring someone who might know a friend smart enough to do searches on the internet — you’d think they could stumble into an accurate statement every so often. In the immortal words of the great philosopher Rick Perry, even a stopped clock is right once a day. But we’re talking about an outfit that can’t tell the difference between a chair and a cigarette, and, speaking of cigarettes, ran a “smoking recession program.”

They also recently wrote that employers should run batteries of medical tests on their youngest and healthiest employees. Due to the likely harms of overdiagnosis and overtreatment, this “protocol” is directly contrary to what the US Preventive Services Task Force, Society of General Internal Medicine, Choosing Wisely and most recently Consumer Reports advise.  But what do all those organizations know? Have they ever diagnosed an 80-pound adult as having weight in a “healthy range”? No, but someone at Interactive Health was able to figure that out without even needing to consult any outside experts.


Can Interactive Health spell EEOC?

On Tuesday (12/11), I conducted a very successful and extremely well-attended webinar for the Pittsburgh Business Group on Health, on the upcoming EEOC wellness rule change, and how to make lemonade out of that lemon, which turns out to be spectacularly easy.

An attendee wrote to me to note that a vendor had said exactly the opposite of what I said about the EEOC rule change — that it was no big deal and that employers need only be “compliant with existing regulations.” I replied that, with everything that has been published by me and others explaining the decision in lay terms, no vendor could possibly be that stupid. But after the person disclosed that the vendor in question was Interactive Health, I immediately apologized and asked for the link, which he sent:


Here is a line-by-line deconstruction of their misinformation:

“The EEOC could…reissue the same regulations but provide more appropriate justification for why a 30% incentive is reasonable and voluntary…”

The judge said the opposite: “AARP vs. EEOC’s decision means that the Equal Employment Opportunity Commission must rewrite its definition of “voluntary” to achieve consistency with the dictionary definition.” He was quite clear that forcing employees to choose between (1) suffering a 30% financial forfeiture and (2) having the stuffing screened inappropriately screened out of them by an unlicensed wellness vendor isn’t the slightest bit “reasonable or voluntary.”

Further, if anyone at Interactive Health could find someone smart enough to actually read the EEOC’s January motion, that person could explain to Interactive Health that the EEOC eventually acknowledged that the judge was right. (“The ADA regulation will still require that participation in wellness programs to be voluntary.”)

Even if they hadn’t agreed, it wouldn’t matter. If the judge says you can’t write rules allowing 30% penalties, it’s not OK to then write rules allowing 30% penalties. That’s why we have a judicial system. To determine what is OK and what’s not OK. A simple concept, covered in eighth-grade civics. Surely someone at Interactive Health has a friend somewhere who is smart enough to find someone who can explain that concept to them.

Interactive’s very stable genius is most on display with this advice:

Generally, employees must be offered choices for earning financial incentives. This includes the opportunity to pursue a reasonable alternative if the individual can establish with their personal physician or an allied health professional that the choices offered by the program are not reasonable for the employee due to a health condition.

They say in the stock market, no one is as valuable as the person who is always right except the person who is always wrong, and indeed Interactive Health has inadvertently created a teachable moment.

Here goes. The “reasonable alternative standard” is an Affordable Care Act construct. It has nothing whatsoever to do with the decision in AARP v. EEOC, which defined “voluntary” as written in the Americans with Disabilities Act (and the Genetic Information Non-Discrimination Act). If you did exactly what Interactive Health is suggesting to “comply” with this ruling, you shouldn’t even bother showing up at the trial if you get sued. Just send a check to the plaintiff.

The reason? The decision in AARP v. EEOC — and the ADA and GINA themselves– address specifically involuntary clinical wellness programs. According to those statutes, any “clinical exam or inquiry” must be voluntary. Large fines (or withheld incentives) are anything but voluntary. In their language above, Interactive Health is proposing replacing one involuntary clinical exam (by them) with another involuntary clinical exam (by a doctor) to determine that the first involuntary clinical exam would not be appropriate, and therefore the employee needs to be presented with yet another type of involuntary clinical exam as an alternative. Wrong, wrong, wrong and wrong.


To summarize, someone at Interactive Health needs to find someone smart enough to explain to the company’s employees that replacing one inappropriate test with another will not suffice to comply with a court order that says you can’t perform inappropriate tests.

Someone needs to step up. The good news is, we know there’s at least one adult in the room — that big, strapping 80-pounder.

 

 

Dec. 11 is last chance to see webinar on EEOC January rule changes

There is a ton of misinformation circulating, as you can see from the quotes in this article from NPR and Kaiser Health News.

Just this one sentence is wrong in two ways:

The advice they are receiving from benefit consultants ranges widely, from “drop all incentives and penalties” to “stay the course.”

No, you don’t have to drop all or any incentives and penalties. You can still be protected if you offer a Quizzify-type alternative alongside your wellness program.

And whoever is recommending “stay the course” should lose their license to read. There is no scenario in which any in-house corporate counsel of any company offering $500 or more in incentives or penalties could know about this rule change and recommend doing nothing.

The article also notes:

Some employers say they will stick with their existing programs — even if they hit the 30 percent level — because the EEOC is unlikely to challenge companies that stick with the rescinded percentage while they await the new rules.

But here’s the thing. Nobody ever said they were going to “challenge” companies that max the penalties/incentives. They have bigger fish to fry and these days are much more employer-friendly than they once were. (They are also woefully understaffed at the top.) But employees can sue. That’s the issue. The EEOC challenge thing is a total red herring.


Fortunately, there is an elegant solution which will allow you to turn this lemon into lemonade, offered Tuesday 12-11 at noon EST. You can sign up right here. Make sure you have your credit card handy because the free webinars are done. It’s $25 (such a deal) unless you are a member of the Pittsburgh Business Group on Health.

 

Move on. Nothing to see here. Except…

…a cover story in one of the most respected magazines in the US which spells the end of Interactive Health, Wellsteps, Total Wellness, Star Wellness, Wellness Corporate Solutions and every other vendor whose business model is to screen the stuffing out of employees.

Meanwhile, I know of one company where the staff is popping champagne corks. Wonder what that company could be?

 

Guest Post from “Anonymous Fan”

This came in over the transom today from a wellness executive.  I am shocked, shocked, to find that conflicts of interest are going on in here!


Hi, Al! I’ve been a big fan of yours for some time. As I am a senior executive in the “Corporate Wellness” market, I unfortunately cannot reveal myself publicly for fear of ostracism, but have agreed almost completely with the arguments you’ve made about our industry shenanigans for years.

Unfortunately the shenanigans have gotten worse. Don’t know if you noticed this, but the Art & Science of Health Promotion Conference recently appointed Dr. David Katz as their new program chair, replacing Michael O’Donnell. The community had been voicing concerns to Michael for years about ASHPC’s not-so-veiled bias for certain vendors and consultants without disclosure of their financial relationships. Now, seems the conference is willing to blatantly flaunt its conflict-of-interest as Katz has announced Dr. Rajeev Kumar of Virgin Pulse would be the keynote speaker at the next conference. Unsurprisingly, Katz is on the “scientific advisory board” of Virgin Pulse. Links: https://www.virginpulse.com/blog-post/saboard-members/david-l-katz, https://www.healthpromotionconference.com/keynote/how-do-we-adapt-to-the-emerging-growth-and-evolution-of-health-promotion.

I see the same conflict-of-interest at HERO and other conferences. It’s truly sad that our profession has allowed these snake oil salesmen and their proxies to run these events under the guise of “impartiality”.

 

To screen or not to screen: the most coherent answer ever

I am a mere supplicant at the feet of the true experts in the field of screening.

Linked here is the single most coherent article on the subject I’ve ever seen, just came out today. Basically, it says: “Screen according to guidelines.” That simple sentence is the source of a great battle pitting Quizzify and the Welligentsia against the Wellness Ignorati and most of the screening industry (excluding It Starts with Me, Limeade, and US Preventive Medicine, all of which offer screening programs more or less aligned with guidelines), whose livelihood depends on employers not screening employees according to guidelines, and finding some of the wackiest tests in the world to foist onto unsuspecting employees.

Highlights of the article:

  1. Many people are overscreened and massive numbers of people get tests they don’t need
  2. Many people are underscreened
  3. Do not purchase B-to-C screenings like Star Wellness, the subject of a recent profile here, offers.

Specifically as to the third point, they called out AngioScreen as an example of companies trying to circumvent doctors by offering inappropriate screenings. AngioScreen is unique in that right on their website they acknowledge that their entire business model is built on an a screen the US Preventive Services Task Force calls inappropriate.

They also list an outfit called Matrix Medical Network as an example of a company offering inappropriate screens. Matrix Medical Network…hmmm…where have I heard that name before…oh, that’s right! I founded Matrix Medical Network. (Actually, co-founded and was an original board member and investor. And, yes, unlike wellness vendors, irony is not lost on me. See “Ironically, the wellness industry does not understand irony.“)

One way or the other, this article is worth a read because it truly draws a thoughtful line between appropriate and inappropriate screenings.

 

 

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