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Is your wellness vendor snookering you? Take this quiz to find out.
Is your wellness vendor snookering you? There are certain facts that vendors are not exactly forthcoming about. This is because facts represent an existential threat to the “pry, poke and prod” industry. See how many facts you know — and how many they’ve suppressed — by taking this quiz.
You’ll earn more points, the closer you are. You don’t have to be exact — and honestly I’d worry about you if you got the exact answers to every question. I’d love you for it, but I’d still worry about you.
- Wellness vendors claim they can save significant money by reducing hospital admissions for diabetes and heart attacks, because those admissions are very common. How many admissions per 1000 covered lives does the average employer incur in a typical year?
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The Health Enhancement Research Organization claims a certain savings figure for wellness PEPM. But that’s before taking into account vendor fees, extra doctor visits, tests, and prescriptions, compliance issues, employee time needed, overhead and basically anything else. In other words, what is the PEPM savings figure that at Bain & Company we used to refer to as “profit before cost”? Answer to the nearest one dollar. Hint: the answer is somewhere in this quiz.
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To eventually save money someday, you first need to improve/reduce the risk profile of your population. According to eternal optimist and wellness promoter-in-chief Ron Goetzel, what is the maximum percent improvement in a risk profile that a company can expect after 2 to 3 years of wellness programming @$150 PEPY?
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Speaking of Ron Goetzel, he said “thousands of wellness programs” fail to get good outcomes. What round number did he claim have succeeded?
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And speaking of Ron Goetzel again, he finally admitted it was “hard” to force employees to change behavior. How many “very’s” did he put in front of the word “hard” in that admission?
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The Wishful Thinking Factor, totally coincidentally abbreviated as WTF, is defined as: Total claimed cost reduction/total number of risk factors reduced. What is the average WTF for the last six Koop Award-winning programs, on average? (Hint: the real ratio of savings to risk reduction is about 0.05x, since even if savings does not lag risk reduction, a maximum of 5% of spending is wellness-sensitive.)
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Speaking of risk reduction, employees in the most recent Koop Award-winning program, Wellsteps/Boise, originally tallied 5293 risk factors. Approximately how many risk factors did those same employees tally after participating, excluding dropouts?
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In a participants-vs-non-participants study design, what percent of the perceived savings is due to the invalidity introduced by the study design itself in which unmotivated employees are used as the control for motivated employees, rather than health improvements attributable to the actual program itself, according to all four studies conducted on this topic, including three by wellness promoters?
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If you use Interactive Health as a vendor hyperdiagnosing the stuffing out of your workforce, what is the annual percentage of employees that will likely be told they have “newly discovered conditions” that “require” a doctor’s intervention?
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Of 1000+ wellness vendors, how many are validated by the Validation Institute?
Answers:
- 2. Yes, only 2. All this wellness fuss is about 2 admissions per 1000 employees. Derivation: the roughly 150,000,000 employees and dependents covered by commercial insurance (mostly from employers) generate roughly 150,000 heart attacks and 120,000 diabetes events. See the HCUP database and enter “410” for heart attacks and 250 for diabetes admissions for the ICD9 for the most recent full year (2014). Scoring: Give yourself 1 point for guessing 4 to 10 and 2 points for guessing fewer than 4.
- One dollar. $0.99 PEPY. As is well-known, they tried to walk this figure back once they realized they had told the truth. Scoring: Give yourself 1 points for guessing $1.00, since the answer in the hint was on that very same line.
- 2%. That’s a few dollars PEPY in savings. (Looks like the HERO report was pretty close, its own protestations notwithstanding.) And you paid $450/employee over 3 years to achieve it. Actually it was 1% to 2%, but we asked for the maximum. Scoring: Give yourself 2 points for 2% or less, 1 point for 4% or less.
- Only 100. Besides Johnson & Johnson, Mr. Goetzel has never disclosed any of the other 99 without others making the observation that they self-invalidate according to their own data. Scoring: 2 points for 200 or fewer, 1 point for 400 or fewer.
- 4. In The Healthy Workplace Nudge, Rex Miller gets Ron Goetzel to admit that “changing behavior is very very very very hard.” Gosh, Ron, do you suppose this might explain why an employer population’s risk factors never noticeably decline? Scoring: 2 points for 4, 1 point for 3 or 5.
- Infinity. That’s because of the next question. The 21% risk factor increase for Wellsteps more than offset the trivial risk reductions achieved by the previous years’ winners. The actual WTFs for the previous years will be the subject of a future posting. Scoring: give yourself a point if you guessed that the WTF was 5 or higher. That would be 100 times the actual figure and still way below the wellness fantasy-league figure.
- 6397. Risk factors rose 21%. And yet somehow, even though the risk profile was deteriorating sharply, the risk profile of the population was also improving enough for Wellsteps to claim that healthcare costs declined 30%. 30% is enough to wipe out wellness-sensitive medical events for the entire Boise teacher population and about 30,000 of their closest friends. (Wellsteps originally admitted that costs increased, but took that slide down when it occurred to them that telling the truth would be inconsistent with their marketing strategy.) Scoring: 1 points for 5500 to 6000 or 6600 to 7000, 2 points for 6001 to 6599.
- 100%. It turns out that the participant-vs-non-participant study design is responsible for all the perceived savings that wellness vendors claim for programs. The New York Times just explained how, in the landmark University of Illinois study, both the “gold standard” RCT methodology and the invalid par-vs-non-par methodology were used and had completely different results. This also happened three other times (summarized here) — with Newtopia, Health Fitness Corporation, and a study done by the chairperson of the Koop Committee showing how feeding diabetics more carbs would reduce their costs by improving their health. Literally, 4 studies — all of which were run by people trying to show savings — showed exactly the same thing. Scoring: all or nothing — 1 points for 100%.
- 45%. This is because running 40 inappropriate tests on every employee makes it inevitable that at least 1 or 2 of those tests reveal a false positive. Scoring: Give yourself 2 points for guessing between 40% and 50%, 1 point for 30% to 39% or 51% to 60%.
- Four. All four are honest and make modest claims they can defend or valid contractual representations. AND, they actually screen according to guidelines! (In the wellness industry, doing something appropriate merits an exclamation point.) They are: It Starts With Me, Splashlight, Sustainable Health Index, and US Preventive Medicine. That’s <1% of all wellness vendors. Scoring: give yourself 1 points for 8 or fewer.
Scoring:
0-2 points. Has your wellness vendor sold you a bridge too?
3-5 points: Your wellness vendor is blocking your internet connection
6-9 points: Nice work!
>9 points: Send your fifth-grade math teacher a thank-you note for doing a better job than the wellness vendors’ teachers did.
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What if they gave a Koop Award and nobody came?
You have to read this all the way through because, in breaking with long-established precedent (which needless to say is recounted in loving detail), in 2017 the Koop Award Committee — wait for it — did the right thing.
In 2017, 3 companies applied for a Koop Award. This is down from a peak of 21, and represents the belated recognition on the part of wellness vendors that it simply isn’t mathematically possible to satisfy the requirement of saving money. Thankfully, one of the best attributes of math is that it’s true whether you believe it or not.
Many an employer has won an award, only to learn later — via the media — that their vendor had fabricated the savings. This litany might explain the slight reticence of vendors to shine a light on their own programs:
- Wellsteps: “Top Wellness Award Goes to Workplace Where Many Health Measures Got Worse,” STATNews
- McKesson: “Wellness ROI Comes under Fire,” Employee Benefit News
- Health Fitness Corporation:”Nebraska’s Acclaimed Wellness Program Under Fire,” Omaha World-Herald
An example of what transpires when employers find out they’ve been snookered would be McKesson. If the name “McKesson” sounds familiar, it’s probably because you saw 60 Minutes the other night explaining how drug distributors including McKesson facilitated the opioid crisis.
The good news is, illegally trafficking in opioids doesn’t disqualify a company from winning a wellness award. Is this a great country or what?
Once McKesson got wind that Employee Benefit News was going to publish an expose on how they got snookered, they called in a consultant, not to investigate how they got snookered but rather to mount a coverup. The consultant “clarified” to Employee Benefit News — in lay terms that any fifth-grader could understand — how, among other things, employees’ weight could go down and up at the same time:
“Health indicators in 2013 and 2014 were adjusted in the analysis, while several sensitivity analyses of the ‘inter-individual’ impact that used a matching approach confirmed the results.”
Silly me! Of course weight can go up and down at the same time!
McKesson was not exactly copacetic about this coverage. Here is the reaction of McKesson’s wellness program champion to my analysis, as reported to me:
“I wish you could have been in the room when I questioned the architect of that whole program. I’ve never unintentionally pissed anyone off that much. Red faced and table pounding, it was a moment! He retired 3 days later. Coincidence?”
Next, consider last year’s award, bestowed upon their Wellsteps buddies. Wellsteps (motto: “It’s fun to get fat; it’s fun to be lazy”) is the kind of company that gives cronyism a bad name…but they were overdue for the award, never having won one despite their years of service on the Awards Committee.
Sure, Wellsteps harmed employees, but harming employees has never been a deal-killer for a wellness award. Ron Goetzel observed that employees en masse becoming sicker — both objectively and according to their own self-assessment — only meant that the program did not “[go] exactly right.” By that logic, the Vietnam War did not go exactly right either.
The 2017 Awards
No one won in 2017. The Committee deserves great credit for getting it right this year, finally albeit belatedly acknowledging that it is indeed impossible to get a positive ROI by screening the stuffing out of your employees. So kudos to them!
Instead, they gave “honorable mentions” to the three applicants: Delta Airlines, IDEXX Labs, and Pepsico. I’m sure all three deserved their —
Whoa! In the immortal words of the great philosopher Meat Loaf, stop right there! Come again? Pepsico? That Pepsico?
If one excludes the total debacles at Penn State, Nebraska and Boise — Pepsico runs the single most-pilloried wellness program in history. It was the subject of a Health Affairs article showing massive losses on its wellness program. These losses, massive as they appeared, were likely understated. I was the peer reviewer, and I passed it rather than make the author do more work, because I thought it was more important to get the word out there promptly than to make him recount every single stupid thing they did.
Pepsi’s Latest Innovation
In all fairness to Pepsico, maybe they do deserve at least a “most improved” award, because now you can buy Pepsi made with real sugar. This is a good thing, according to their announcement, even if the people who run their wellness program disagree. One can only imagine what a beleaguered Pepsico employee’s Outlook calendar looks like:
Perhaps McKesson’s consultant could explain this to us.
Delta and IDEXX
I can’t really comment on the other two because none of the four flight attendants I talked to at Delta had any familiarity with their program beyond the basics (“Yeah, I think if you fill out a form and go to the doctor, you get a discount on insurance or something like that”), while IDEXX doesn’t use vendors connected with the Awards Committee and doesn’t make up savings. To bestow an outright win in that situation would go against all precedent, so IDEXX should be happy with their honorable mention.
Theirs is a fitness-based program that deserves a closer look, as a model for what a wellness program should look like. I hope to do that someday.
And perhaps IDEXX is a harbinger of things to come, where wellness is done for employees and not to them, wellness vendors don’t lie about savings, and they endorse and agree to adhere to the Employee Health and Wellness Code of Conduct.
Otherwise, for the wellness industry, there might be trouble on the horizon.
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So many candidates for the Deplorables Award countdown, so few numbers between 1 and 10
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.
#2: Ron Goetzel, Seth Serxner, and Paul Terry (Health Enhancement Research Organization)
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.
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Announcing the Wellness Industry 2016 Deplorables Awards
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.
Wellsteps got caught by ace reporter Sharon Begley of STATNews, and their CEO was forced to admit Wellsteps was violating USPSTF guidelines.
#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.
#7 Healthfairs USA Raises the Bar for Misbehavior
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.
#6 Aetna’s DNA wellness program combines junk science, junk math, and junk integrity
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.
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Oops, they did it again. Wellsteps stumbles on integrity one more time.
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.
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Wellsteps Arithmetic for Dummies
Those of you with lives may not have noticed all the commotion yesterday. Wellsteps moved their post about our bullying from their own blog to Linkedin.
But then, sort of like Dukakis in his tank, once they did that, they realized that wasn’t such a good idea and took it all down, but it was too late. The problem was that on Linkedin, their rant attracted many comments from the triple-digit IQ crowd. So now, in order to find this post, you have to go to the Wellsteps blog. It is posted under: “Great Ideas from the Experts.” Among other highlights, they said we were extorting them. Here is the source for that: we offer $1000 and public apologies if we made a mistake in our writeups, and a $2-million reward for proving wellness breaks even, or that Boise saved money.
To them, and to all members of the Koop Committee that decided this Boise School District outcome was award-worthy, I say, “Find a mistake in my critique and collect the $1000. Or show I’m wrong about my ‘twisted facts’ and claim the reward. Instead of just criticizing me for ‘twisted facts,’ take my money. Sue me. Have me arrested for blackmail and extortion (their words). Anything. Don’t make me beg.”
This isn’t about that — postings on that topic, along with Sharon Begley’s brilliant smackdown in STATNews are easily findable elsewhere. Instead, all we want to do today is simply add up a column of Wellsteps’ own numbers. That is how Wellsteps defines “bullying” — adding up their own numbers. In this case, it is the improvements and deteriorations, year over year, in the Boise School District’s biometrics.
I’ve already done this once, as a service to Wellsteps, but apparently they had a really bad fifth-grade math teacher. So I’m doing it again — and this time color-coding it, so even the dumbest Wellsteps executives can find someone to explain it to them.
Here is the actual screenshot of the year-over-year biometrics, from their Koop Award application. Once again, these are their figures. They often ask why we don’t publish our own studies. We don’t have to — their numbers make our case better than we could make our own, with no “he said-she said” about whose numbers are right. So, we’ll admit it! Their numbers below are facts — they are right! (I guess graciously conceding that one’s adversary is correct is another form of bullying.)
We then twisted their columns of facts into totals, below. I can send the Excel sheet on request.
As you can see, the population deteriorated quite a bit–6397 readings got worse while 5293 improved. Oh, and one other thing: more than 40% of the “improved” values are glucose levels declining, in employees whose glucose was already normal. Attention, Wellsteps: there is no concept of “improving” normal glucose levels. That would be like “improving” on a 98.6 body temperature.
And who amongst us hasn’t felt draggy during a workday as our glucose falls, and eaten a snack to get our energy and productivity back? Excluding the 2134 glucose “improvements” in people who already had normal glucose, deteriorating biometrics outnumbered improving biometrics by 6397 to 3159. That’s more than 2 to 1!
We’re taking those out to be consistent with the word “normal.” Or, since we are very polite bullies, we could leave them in and stick with 6397 vs. 5293, if Wellsteps chooses. We are happy to do the latter because we understand that in Wellsteps’ lexicon, words and phrases mean the opposite. In addition to “normal” and “bullying,” that lexicon would include “extortion,” “blackmail,” “twisted facts,” and “great ideas from the experts.”
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The Wellsteps Empire strikes back! CEO defends its harms to Boise employees
Steve Aldana, CEO of Wellsteps, finally defended his program for the Boise School District. It took him a while presumably because he had to retain a team of biostatistical consultants to discern the flaws in critics’ arguments against it. After analyzing all the data, these biostatisticians were finally able to compile a list of the mathematical and clinical flaws in our apparently erroneous conclusion that Wellsteps harmed Boise employees and fabricated savings and raised lying to an art form.
I apologize in advance to those lay readers without a strong background in biostatistics. You may have trouble understanding the mathematical subtleties in Mr. Aldana’s arguments. But I’ll repeat them verbatim nonetheless. According to Mr. Aldana, wellness critics are:
- “Great at writing click bait”
- “Great at creating BS out of thin air”
- “liers”
Leave aside his creative spelling and his mixing of cliches. Focus instead on his novel interpretation of Lavoisier’s law of conservation of mass, which states that nothing can be created out of thin air. Notwithstanding Mr. Aldana’s claim to the contrary, this law would seem to particularly apply to bovine excrement, the end result of a complex biochemical and physiological process, one which he would seem to have great familiarity with, as we’ve noted multiple times in this website. However, we encourage Mr. Aldana to try to undertake this endeavor, because at least his efforts won’t harm anyone, which is more than can be said for his wellness program.
Kudos to Dave Chase for posting the STATNews expose of the Wellsteps program, so that Mr. Aldana could respond. Mr. Chase, who is producing a documentary called The Big Heist on wellness and other healthcare ripoffs, is obviously goading Mr. Aldana into writing some material for him, and Mr. Aldana obliged. Rather than create a news cycle, where the Wellness Ignorati inevitably lose, he should have followed the lead of Ron Goetzel and simply ignored me. Indeed, if there is one thing that Ron Goetzel excels at, other than doctoring data and lying about outcomes, it’s ignoring me.
In addition to calling me a lier, he also called the author of the STATNews expose, Sharon Begley, a lier. I won’t question the wisdom of alienating the media, but I would question whether someone of Ms. Begley’s impeccable credentials (listed here on her Wikipedia page) could possibly have received all the accolades and awards she has amassed for health/science reporting if indeed she couldn’t find all the obvious flaws in a Koop Award application.
The linkedin thread is pasted below and I’d encourage reading it. Don’t make me beg.
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Wellsteps Presents a Confederacy of Wellness Vendors
When a true genius appears, you can know him by this sign: that all the dunces are in a confederacy against him.
–Jonathan Swift
Wellsteps’ Steve Aldana has “endorsed” a confederacy of 25 wellness vendors, including his own company, Wellsteps. Alas, in the world of the Welligentsia, in which an increasing number of employers reside, an endorsement from Mr. Aldana earns about as many points in a vendor selection process as neat handwriting.
There are usually not enough hours in a week to both do my Day Job running a fast-growing company (Quizzify, which plenty of thought leaders have endorsed, so they don’t have to endorse themselves), and also play wellness-meets-whack-a-mole with the Ignorati. Fortunately, this week does have enough hours, thanks to the time change. (The wellness industry is lucky that “falling back” is not a regular occurrence.)
I haven’t heard of many members of this confederacy, but I’ve heard more than enough about the ones below. Each link takes you to our own “endorsements.”
Keas Meets Lake Wobegon: All Employees Are Above Average (in Stress). This is the best argument for requiring that wellness vendors attain a GED.
Provant: “In the Belly of the Beast” A nine-part series that one line can’t do justice to. We would simply note that you do not have to drink eight glasses of water a day. Indeed, you probably shouldn’t if you expect to get anything else done.
Staywell’s Wellness Program for British Petroleum is Spewing Invalidity. It wasn’t just that their savings claim was mathematically impossible. That’s just the threshold for wellness savings claims. Staywell also somehow saved BP 100x as much as Staywell’s own website says is possible. And because they have a “special relationship” with Mercer (meaning they pay them), Mercer “validated” this fiction for BP, at BP’s expense…
Staywell, Mercer, and British Petroleum Meet Groundhog Day. They won a Koop Award. Since Staywell and Mercer are both on the Koop Committee and their results are completely invalid and they are obviously lying, they satisfy all the award criteria.
Total Wellness’s Total Package of Totally Inappropriate Tests. They could lose their license for subjecting employees to this panoply of US Preventive Services Task Force D-rated quackery, except that in wellness the only license you need is a license to steal from unsuspecting HR directors. This leads to…
…Total Wellness: The Best Argument for Regulating the Wellness Industry. Total Wellness isn’t about to lose this Race to the Bottom without a fight. Watch as they try to out-stupid Star Wellness in their quest for that prize.
US Corporate Wellness Saves Money on People Who Don’t Cost Money. We call this Seinfeld-meets-wellness, because it’s about nothing: even if you have absolutely no risk factors, these Einsteins will still save you a fortune. And someone should also tell them you can’t reduce a number by more than 100% no matter how hard you try.
Virgin Pulse. This outfit acquired ShapeUp, which gives harmful crash-dieting programs a bad name. Don’t take our word for it. It’s in the Pittsburgh Post-Gazette.
Vitality’s Glass House: Their Own Program Fails Their Own Employees. These people might have more luck selling you a crash-dieting program if they could get their own employees to lose weight.
Wellness Corporate Solutions Gives Us a Dose of Much-Needed Criticism. We don’t want to spoil the punchline.
And that brings us to Wellsteps itself, which earns its “endorsement” from its own CEO by making so many appearances on this list that there is barely enough room for the rest of the confederacy. If you only have time for the Executive Summary, this is the one to read. But squeezing it all into one place requires sacrificing the laugh lines, and if there is one thing Wellsteps excels at, it’s providing laugh lines.
Wellsteps ROI Calculator Doesn’t Calculate an ROI…and That’s the Good News. Watch what happens when Wellsteps meets Fischer-Price. No matter what variables you enter in this model, you get the same result.
Wellsteps Stumbles Onward: Costs Go Up and Down at the Same Time. This isn’t possible even using wellness arithmetic. Eventually Wellsteps solved this problem by simply deleting one of the slides. But because we long ago learned that doctoring/suppressing data is one of the wellness industry’s signature moves, we took a screenshot before we did our expose.
Prediction: Wellsteps Wins Koop Award. In 2015, I went out on a limb to make this prediction, noting Wellsteps’ perfect Koop Award storm of invalidity, incompetence, and cronyism.
Wellsteps: “It’s Fun to Get Fat. It’s Fun to Be Lazy.” This one was penned by Dr. Aldana’s waterboy, Troy Adams, who apparently during his self-proclaimed “11 years of college” never learned that “fat” and “lazy” aren’t synonyms. Paraphrasing the immortal words of the great philosopher Bluto Blutarski, 11 years of college down the drain.
Does Wellsteps Understand Wellness? They are demonizing even the slightest consumption of alcohol, among many other misunderstandings. Shame on me for enjoying a glass of wine on a Saturday night!
The Back Story of the Scathing STATNews Smackdown of Wellsteps and the Koop Committee. This one leads to several other links.
The Koop Committee Raises Lying to an Art Form. It turns out Steve Aldana is not stupid: he apparently has heard of regression to the mean, but just pretended he hadn’t so he could take credit for it with the Boise Schools, who were not familiar with the concept.
if Wellsteps Isn’t Lying, I’ll Pay Them $1 Million but let’s just say I’m not taking out a second mortgage just yet.
An Honorable Mention goes to another vendor on this list, in the form of the Don Draper Award, for this advertising gem, aimed at ensuring that even the stupidest member of the Ignorati, and/or HERO Board members, can catch their name:
To quote the immortal words of the great philosopher Rick Perry, even a stopped clock is right once a day.* And, yes, on that Wellsteps list there is one standout vendor, US Preventive Medicine. It has validation from the Validation Institute. As you read their validation, note that while they show an enviable reduction in wellness-sensitive medical events, they don’t claim an ROI. This is testament to the integrity of both USPM and the Validation Institute.
*If you are a regular reader and didn’t find this quote amusing, read it again. If you are a wellness vendor, find a smart person to explain it to you.
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Rocky, Bullwinkle, Wellness, and the American Journal of Managed Care
Some of you might remember the closing credits of Rocky and Bullwinkle. Due to copyright restrictions, we can display only a “fair use” snippet. (“Fair use” means you could use one question from Quizzify as an example without special permission as long as you cite the source, but if you tried to copy the whole thing, we’d get elected president, hire a special prosecutor, and throw you in jail.)
Rocky asks: “You got the credits, Bullwinkle?”
Bullwinkle replies: “All on this itty-bitty card…oops” and then it folds out:
(Source: Jay Ward Productions.)
So what does this have to do with wellness, besides nothing?
Simple –I just consolidated all the lies and harms of the Wellsteps/Koop Award into one itty-bitty posting for the American Journal of Managed Care blog. And it also folds out — with links to all the other “smoking guns” in this scandal. If you just want to forward one article around, that’s the one.
Kudos to American Journal of Managed Care for going where Health Affairs fears to tread, by posting the entire, unbowdlerized expose in all its sordid glory. Indeed one would think the latter publication would show some contrition for having started this “pry, poke and prod” mess, by publishing the original Baicker propaganda — with no disclosure of the authors’ conflicts of interest or funding sources…and apparently also no peer review. This thing has been cited 250 times. And that was after it was shown to have been made up. It has 549 citations in total.
Sadly, in addition to not being subject to any other regulations, wellness is not subject to Pottery Barn Rules. Health Affairs created this mess, but they don’t need to pay for it. Quite the contrary, the Health Affairs “impact factor” has probably been boosted more by this article’s 549 citations than almost any other article they’ve ever published. And guess who has to clean up after them?
(Source–you guessed it–Jay Ward productions. These are the closing credits to Mr. Peabody.)
Kudos also, by the way, to the perpetrators of the Wellsteps fraud — Steve Aldana, Ron Goetzel, Seth Serxner. They have the good sense not to take my bait by actually attempting to rebut. The one time they did, in Sharon Begley’s article, their “rebuttal” took the form of basically admitting they had made the whole thing up.
Abe Lincoln seems to be in the news a lot this week, and he put it best: “Better to be thought a fool and say nothing than to speak out and remove all doubt.” Words the Wellness Ignorati should live by. You’d think they would have learned that by now.
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If Wellsteps and the Koop Committee can show they aren’t lying, they can collect the $1-million reward
Those of you with long memories may recall our standing offer of a $1-million reward to anyone who can show that the wellness industry has broken even during this century. You need a long memory because no one ever claimed the reward. For all the bluster of Ron Goetzel and his cronies, apparently none of them actually believe what they say…or they would be $1-million richer.
Oh, wait, in the case of both Ron Goetzel and his cronies, maybe they haven’t claimed the reward because they do believe what they say.
The offer is legally binding. There are clear rules. There is an entry fee, but it is refundable to the claimant if they win.
We would now extend that offer specifically to Wellsteps and/or the Koop Award Committee, and we’ll throw in HERO too, since it’s all the same inbred crowd. All they have to show is what they have already claimed: that Wellsteps made Boise School District employees so much healthier — perhaps by reciting their mantra that “it’s fun to get fat and it’s fun to be lazy” — that the School District could, as a direct result of this enhanced employee health, reduce their healthcare benefit spending by roughly one-third after three years.
To make it extra easy for the these people, I’ll relax the requirements:
- They can submit the existing “This Is How You Win a Koop Award” self-congratulatory paean. That means both that they don’t have to do any extra work (besides adding to up 20 links at their option, as the rules allow), and that the word limit on the reward application is waived to accommodate the size of that posting.
- Any or all Koop Committee members can participate with you in the oral arguments, but I myself am not allowed to bring a second. This means they can gang up on me, by crowdsourcing their IQs.
And of course they already know what arguments I am going to make because I posted them. That’s like having the debate questions in advance.
They would have to file the entry fee, or formally request a month’s extension, by November 1. The only reason for the deadline is that when they ignore this offer, as they inevitably will, I can start saying they are admitting they’re lying as early as November 2.
As with the regular award, I am perfectly happy to offer it the other way around, where I pay the entry fee, and I have to prove they’re lying, as opposed to them proving they are telling the truth. That way they can’t say the game is rigged, since I’m willing to play either hand.
Since the Koop Committee members are all such civic-minded citizens, they need not personally collect the windfall if they win. I am perfectly willing to — indeed, would prefer to — donate a million dollars to the Boise School District, either as an unrestricted gift or to set up a fund to update, enhance, and increase employee (and student) access to their fitness facilities and equipment.
Surely, Mr. Aldana and Mr. Goetzel, if you truly care about the health and well-being of those employees, you will make the small effort required to secure this million-dollar contribution on their behalf.
And, Mr. Aldana, please don’t pretend you aren’t applying for the award because you are unaware of my work. For instance, you view my Linkedin profile with a regularity roughly halfway between obsessive and man-crush.*
*As recently as…
They Said What? 