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The wellness industry’s terrible, horrible, no-good, very bad year

OK, this time I’m not the one causing the kerfluffle in the wellness industry, though I will confess to being a force multiplier.

Not since 2014, when the very unstable morons at the Incidental Economist made fun of the very stable geniuses who give out the Koop Award and also unequivocally concluded wellness loses money — combined with continued fallout from the Penn State debacle and the Nebraska scandal — has the wellness industry had such a bad year. And it’s only February.

Let’s review what’s happened so far in 2018. First, a federal judge ruled that voluntary wellness programs need to be — get ready — voluntary. The EEOC’s responded with the legalese equivalent of:  “Fine, be that way.”

Next, WillisTowersWatson did something that might get them in hot water with the very stable wellness industry leaders: they were honest. They published a study revealing that employees hate wellness even more — way more — than they hate waiting for the cable guy to show up.

Finally, the very unstable National Bureau of Economic Research conducted a controlled study finding basically no impact whatsoever of a wellness program.  More importantly, they specifically invalidated the “pre-post” methodology.  Even more importantly, they specifically invalidated 78% of the studies used in Kate Baicker’s “Harvard Study” meta-analysis.

Here is an interesting piece of trivia. The lead researcher is an assistant professor at the Harris School of Public Policy. Why is this interesting trivia? Because Katherine Baicker — the Typhoid Mary of Wellness, whose THC-infused 3.27-to-1 ROI is the basis for essentially every subsequent genius wellness outcomes claim — is now the dean of that very same Harris School.  I’m just guessing here, but I’d say it’s gotta be a trifle embarrassing when your own subordinate publicly disproves your own study. I mean, it’s one thing for me, RAND, Bloomberg, and anyone else with five minutes, internet access and a calculator to do it, but…your very subordinate?

On the other hand, the researcher, Damon Jones, just demonstrated not just amazing competence, but amazing integrity as well. In other words, he has no future in wellness.


The Wellness Empire Strikes Back

How does the wellness industry respond to these smoking guns threatening their entire revenue stream? Apparently, there is little cause for concern on their planet.

Let’s start with America’s Health Insurance Plans (AHIP), the health insurance industry lobbying group. Here is AHIP’s oxymoronic Wellness Smartbrief (January 26), on the NBER research. Yes, it summarizes the same wellness-emasculating study as the one above, though you could never guess it from the headline:

Continuing, AHIP said:

Offering incentives for completing wellness activities might be more cost-effective than offering incentives for wellness screening, a recent study of a comprehensive program found. 

Perhaps AHIP has been infiltrated by Russian trolls, because here’s what the NBER article actually said about “completing wellness activities”:

We…do not find any effect of treatment on the number of visits to campus gym facilities or on the probability of participating in a popular annual community running event, two health behaviors that are relatively simple for a motivated employee to change over the course of one year.

AHIP continues:

Wellness programs might attract mostly employees who are already fitness-conscious, but the potential to attract healthy employees whose medical spending is already low could nonetheless be a boon to employers, the researchers found.

And on the subject of “the potential to attract healthy employees” being a “boon to employers,” the authors actually said:

We further find that selection into wellness programs is associated with both lower average spending and healthier behaviors prior to the beginning of the study. Thus, one motivation for a firm to adopt a wellness program is its potential to screen for workers with low medical spending. Considering only health care costs, reducing the share of non-participating (high-spending) employees by just 4.5 percentage points would suffice to cover the costs of our wellness program intervention.

In other words, you can apply some workplace eugenics to your company by using wellness to weed out obese employees, employees with chronic or congenital diseases, and so on. Good for you!

Soon, if AHIP and others have their way, there will be no need for guesswork in eugenics: employer wellness programs will be able to screen these employees out based on their actual DNA.


AHIP’s take on AARP v. EEOC

And now, AHIP’s take on this landmark case, their ace reporters scooping everyone with this February 2 headline on the December 20th court ruling:

Here are more typical headlines on that court ruling, headlines that came out the same month that the court ruling came out. Perhaps AHIP used the interim six weeks to focus-group various verbs until they settled on…tweak???


AHIP:  It’s not just the headlines

One prominent healthcare executive recently attended an AHIP conference and reports:

I just returned from one of the dumbest meetings I’ve ever attended in Washington. Report of a new “study” by AHIP. Turns out people don’t mind health costs all that much, they just want more benefits. And everything is hunky-dory with their health plans, people like them so much. They love wellness benefits and crave more. Prescription drug prices have been nicely controlled thanks to the competitive marketplace (no, I am not making this up or exaggerating for drama). For every $1 employers spend on benefits workers get $4 in value. Priorities for SHRM rep: Fitbits for all employees, solving the outrage that only 20% of her employees got an annual physical. 85 cents of every dollar spent on health care goes to chronic disease.

Over these same two hours, I’d estimate about a thousand employees were misinformed, harmed or harassed by wellness vendors, roughly equal numbers of  employees got useless annual checkups, employers spent about $200-million on healthcare and 40 people died in hospitals from preventable errors. But I’m being such a Debbie Downer! I’m going home to read Why Nobody Believes the Numbers to remove myself from this alternative universe.


Enter the Health Enhancement Research Organization (HERO)

HERO’s Prevaricator-in-Chief, Paul Terry, is demonstrating his usual leadership abilities in this crisis, of course. After all, HERO is the wellness industry trade association and these three items — the NBER invalidating their product, employees hating their product, and a federal judge forbidding them to force employees to use their product — represent existential threats to his “pry, poke and prod” members.

Here is quite literally his only blog post on any of these three items:

Teddy Roosevelt said, “complaining about a problem without posing a solution is called whining.” It’s a quote that also reminds me why I’ve not thought of angry bloggers who target health promotion [vendors] as bullies. Though they relish trolling for bad apples, their scolding is toothless, more the stuff of chronic whiners.

I suspect he is talking about me here as the “chronic whiner” who is  “scolding” them. Or perhaps he is referring to the “angry bloggers” at  the Los Angeles Times, the New York Times, Slate, or STATNews, since those “toothless” publications seem to be scolding wellness vendors more than I ever have.  For instance, I’ve never called wellness vendors’ offering a “scam” or a “sham.” I simply quote these very stable wellness geniuses verbatim, as above or below, or last week.

Being quoted verbatim, not angry bloggers, is their worst nightmare. (One thing I would concede, though, is that “Paul Terry and the Angry Bloggers” would be a great name for a rock band.)

Yep, looks like the implosion of his industry all my fault. Otherwise, I’m not quite sure who is the “angry blogger” he is referring to, other than to note that Mr. Terry himself seems to blog a tad angrily himself, both above, and here

Why I choose to ignore the blogger critics: We’re fortunate to work in a profession with a scant number of vociferous critics. My take is that there is one thing these few angry loners [Editor’s note: the complete “scant list” of the 220 “few angry loners” who have been “vociferous critics” can be found here] want more desperately than attention: that’s to be taken seriously. What they fail to comprehend is that as they’ve gotten ever more farfetched and vitriolic in search of the former, they’ve cinched their inability to attain the latter.

Baiting people with misinformation and offensive insults (but just a tad under highly offensive) is a pesky ploy that trolls hope will eventually land a bite that confers credibility where there is none. Even reading such drivel is a form of taking the bait; responding is swallowing it whole. Some say dishonesty should not go unchallenged and I respect their view; nevertheless, I’m convinced responding to bloggers who show disdain for our field is an utter waste of time. I’ve rarely been persuaded to respond to bloggers, and each time I did it affirmed my worry that, more than a waste, it’s counter-productive.

and especially here, a seemingly incongruous decision to “act out” by someone who claims to be “choosing to ignore the blogger critics.”

Having read years of my “drivel” alongside Mr. Terry’s posting explaining why you shouldn’t “swallow this bait,” perhaps readers might opine here: which of us, exactly, is the “chronic whiner”?

Coincidentally, when I run live health-and-wellness trivia contests, the first of our 3 rules is: No Whining. Seems to me that he would have just violated it. Indeed the only rule HERO hasn’t violated so far is #3 below. Not that I want to put ideas in their head.

 

 

 

Wellsteps stumbles over their own words

Often I don’t have time to write a full blog in my own words, but fortunately I usually don’t need to. It’s enough to quote the words of the very stable geniuses in the wellness industry verbatim. Being quoted verbatim, of course, is one of these geniuses’ worst nightmares.

Among the most stable of the wellness industry geniuses is Steve Aldana, CEO of Wellsteps, winner of the 2016 Koop Award as well as the 2016 Deplorables Award. How does he report the National Bureau of Economic Research’s complete evisceration of wellness industry research methods? Let’s take a looksee at the highlights of his posting.

First, it appears that two opposing studies, “one for and one against wellness,” came out “at the same time.”

One the one hand, someone — apparently he doesn’t know who — seems to say that there “wasn’t much improvement” at the University of Illinois.  And something must have been wrong with this result, because “these results contradict over 90% of publish [sic] studies.”

“At the same time,” a publication no one has heard of found the opposite: health behaviors improved for “over 2 full years” in — get ready — one of Wellsteps’ very own accounts.


This is a textbook example of a false equivalence, the wellness version of: “You also had some people that were very fine people on both sides.”

To begin with, the researchers in the first group weren’t just any old researchers. This was the National Bureau of Economic Research (NBER). And the NBER didn’t say “they didn’t see much improvement.” Their specific words were that the causal effects were — get ready — nearly indistinguishable from zero for nearly every outcome.

Further to say this conclusion “contradicts over 90% of published studies about wellness,” would be like saying Galileo’s findings “contradicted” over 90% of published studies about astronomy.

The study’s actual conclusion used a slightly different verb:

Our 95% confidence intervals rule out 78 percent of previous estimates [of the effect of wellness] on medical spending and absenteeism from the prior literature. [Let me translate that, in case the words are too long for the very stable geniuses at Wellsteps to understand: you and all your very stable friends have been geniusing about savings for decades now.]

The reason the NBER was able to be so conclusive is that, to quote one of our Alert Readers, Robert Dawkins: “They foolishly included a valid control group.” Kudos to Mr. Dawkins for that very unstable moronic observation. (In any event, far from contradicting other research, the study is quite consistent with most articles on wellness not written by someone feeding at the employer wellness trough.)

The other journal, which published an article “at the same time,” found an improvement in healthy behaviors. That journal is called Health Promotion Practice. And if you haven’t heard of it, you’ve got company. Their “impact factor” is the lowest in an industry whose journals are notable for low impact factors. I googled quite extensively, and it appears — get ready — that no article from this journal has ever been cited, excerpted or even had the fact of its very existence even grudgingly acknowledged in the lay or scholarly media.

By contrast, the NBER article has been picked up everywhere — except of course by the wellness industry. See if you can find any reference to this article — or AARP v. EEOC, which was also national news — on the Health Enhancement Research Organization website.

Turns out there’s a reason no one cites this journal. It’s because it’s so genius. Exhibit A is this very same article, a rehash of the Boise School District findings that somehow overlooked the key finding, which is that the employees got unhealthier during Wellsteps’ program. Instead, the author — displaying not the slightest intellectual curiosity as to how this could possibly be true — reports the most genius findings we’ve ever seen in a journal:

  • only 3% of Boise School District employees smoke, and…
  • …they smoke only 4 days a week.

Perhaps — just playing devil’s advocate here — the other 17% of Boise employees who smoke (Idaho has a 20% smoking rate) might have lied on their health risk assessment? The “tell” is that everybody knows smokers don’t smoke only 4 days a week. Obviously, they smoke 5 days a week, with time off for weekends, major holidays and Beethoven’s Birthday.

Very stable genius that he is, the author (both a friend of Wellsteps’ Mr. Aldana, according to the disclosure statement, and also a genius who has already been profiled on this site for his previous insights) also admits that with a high non-participation rate and a 20% dropout rate:

There exists the possibility of selection or dropout bias that could have influenced the results reported.

Ya think? Maybe just a tiny bit?


But wait…there’s more

We’ve highlighted Mr. Aldana’s phrase “at the same time” describing how these articles were simultaneously published. We repeated the phrase in three separate places above for emphasis because — get ready — these two results were not published at anything like the same time.

To begin with, Mr. Aldana has been very stably geniusing about his Boise results for more than two years now. (See my article from September 2015 accurately forecasting that, thanks to the number of obvious errors and self-immolating contradictions, this study would win a Koop Award. And of course the Boise employees got harmed.)

This article, using that same data set, was published last July, whereas the NBER article just came out a few weeks ago. Perhaps in some geologic sense July 2017 and January 2018 are “the same time,” but imagine if the rest of the world defined “at the same time” as “six months apart.” For instance, let’s join Sherman and Mr. Peabody in the Wayback Machine and set the dial for June 1944:

Eisenhower: “OK, we’ll storm Omaha and Utah Beaches, and you guys can storm Juno and Sword Beaches at the same time, and then we’ll hook up and say…”

Churchill: “…Merry Christmas, chaps.”



For a good time, try googling on Wellsteps.

And no need to google on their “ROI Calculator.”  I’ve done it for you.

National Bureau of Economic Research has bad news and good news for the wellness industry

Not to be confused with those immortal words often attributed to the great philosopher Yogi Berra, a big joke among economists is: “An economist is someone who upon learning how something works in practice, wonders how it will work in theory.”

That joke morphed into reality last month — though it was a controlled study testing a theory, rather than the theory itself. The “theory” would be that inactive unmotivated non-participants can be used as a control for active motivated participants. Ironically, this study design has never been proposed as legitimate, even in theory. Wellness “researchers” like it because it always show savings, even when nothing happens. For example, even when there was no program for the participants to participate in.

Obviously if this were a legitimate design, the FDA would approve it for clinical trials, saving a ton of time and money vs. having to do controlled trials.

To wit, the National Bureau of Economic Research (NBER) just published a study showing that the participants-vs-non-participants (“par-vs.-nonpar”) study design, used extensively by the very stable geniuses in the wellness industry to do their alt-research to fabricate their alt-findings, is completely invalid.

No surprise. This NBER study validates what we’ve all observed in practice — as the three examples in this article amply demonstrate.  The somewhat more amusing TSW version is here.


Highlights of NBER study for the wellness industry: bad news first

First the bad news. Fasten your seat belts and be shocked, shocked to learn that the researchers could identify:

  1. No noticeable change in health behaviors due to the wellness program
  2. No noticeable change in health outcomes due to the wellness program
  3. Clear self-selection bias among participants opting into the wellness program

Lest anyone think we are taking this out of context, here are their exact words:

We do not find any significant effects of treatment on total medical expenditures, employee productivity, health behaviors, or self-reported health measures in the first year following random assignment.  We further investigate the effect of our intervention on medical expenditures in greater detail, but fail to find significant effects on different quantiles of the spending distribution or on any major subcategory of medical expenditures (pharmaceutical, office, or hospital). We also do not find any effect of treatment on the number of visits to campus gym facilities or on the probability of participating in a popular annual community running event, two health behaviors that are relatively simple for a motivated employee to change over the course of one year.

This of course merely confirms what we observe in outcomes reports published by wellness vendors, including the two most recent proud recipients of the Deplorables Awards.  Actually, in the case of Wellsteps there was indeed a noticeable change in health outcomes among program participants — they got worse.

Also, the authors — no doubt anticipating the objection from the very stable geniuses at the Health Enhancement Research Organization — specifically note that nothing in Year One’s results presage any step-function improvement in Year Two. So the specious “Wait ’til next year” argument is off the table.

You might be thinking, “Another nail in the wellness industry coffin.” True, except that there almost isn’t room for any more nails. Soon the coffin will have enough nails to create its own gravitational field.


Next, the good news

Here are the two pieces of good news for the wellness industry. One finding was:

Our 95% confidence intervals rule out 78 percent of previous estimates on medical spending and absenteeism.

That means that it is possible that 22% of previous estimates may conceivably not be completely invalid. This is not to say that 22% are valid, just that they aren’t automatically invalid. That is great news for the wellness industry, where clearing the bar for not being automatically invalid is cause for celebration.  As Dave Chase says, the bar for wellness is so low a snake could jump over it.

However, the 78%-totally-invalid figure specifically invalidates Katherine Baicker,  author of the so-called “Harvard Study.” Depending on whether you are a wellness vendor or an oppressed employee, she is either the Johnny Appleseed or the Typhoid Mary of wellness.  Her famous 3.27-to-1 ROI was tallied entirely from par-vs.-nonpar studies, exactly the methodology that the NBER just invalidated, citing exactly the studies she cited. (The three examples in my study referenced above were also part of her meta-analysis.)

So perhaps she might now make a formal statement regarding par-vs-non-par as a study design?  Either a retraction or a defense. Just something that clarifies her previous statements, which seem to be neither retractions nor defenses but rather more like excuses:

  1. It’s too early to tell (um, after 30 years of workplace wellness?)
  2. She has no interest in wellness any more
  3. People aren’t reading her paper right (we’re only reading the headline, the data, the findings and the conclusion, apparently)
  4. “There are few studies with reliable data on the costs and the benefits” (um, then how were you able to reach a conclusion with two significant digits?)

The irony is that Kate Baicker has otherwise done outstanding research. Her study on Oregon Medicaid is a classic. In Oregon at the time, Medicaid eligibility was determined by lottery amongst applicants. That meant that — quite the opposite of wellness control groups  — the control group of people not picked in the lottery had equal motivation to seek insurance coverage as people who were picked.  After following both groups going forward, her finding was that obtaining insurance to access basic medical care did not change outcomes. (Having insurance did bring peace of mind, though.)

And yet somehow in “Workplace Wellness Can Generate Savings,” she was quite comfortable reaching a conclusion that was completely inconsistent with her Oregon finding, not to mention the Law of Diminishing Returns: throwing additional unrequested, generally unwanted, and largely misdirected medical interventions and advice at employees who already have insurance — and recall that most insured Americans are drowning in medical care — could dramatically improve their outcomes enough to calculate not just a massive ROI, but an ROI precise to two significant digits.

What she will hopefully learn through the NBER study is something that I learned 11 years ago: when the data proves you wrong, fess up.  Then people like me have to find someone else to blog about. Fortunately, in wellness, that is not a heavy lift.


The second piece of good news for the wellness industry

To quote the study:

 …wellness incentives may shift costs onto unhealthy or lower-income employees if these groups are less likely to participate in wellness programs. Furthermore, wellness programs may act as a screening device by encouraging employees who benefit most from these programs to join or remain at the firm

To be clear, this calculation does not imply that adoption of workplace wellness programs is socially beneficial. But, it does provide a profit-maximizing rationale for firms to adopt wellness programs, even in the absence of any direct effects on health, productivity, or medical spending. [emphasis theirs]

In other words, employers can use wellness programs to subtly discriminate against unhealthy — read, older and poorer — workers.  Many of the very stable geniuses in the wellness industry will be happy to hear this. The exceptionally stable genius who will be most thrilled to hear this is Michael O’Donnell.  Mr. O’Donnell is the former Prevaricator-in-Chief of the wellness industry trade publication and a current member of the Koop Award cabal.  These are excerpts from one of his editorials:

First, he says prospective new hires should be subjected to an intrusive physical exam [editor’s note: notwithstanding the fact that this is totally illegal], and hired only if they are in good shape.  OK, not every single prospective new hire needs to be in good shape — 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 Award Committee member, because those jobs require only excessive lying.

Second, he would fine people for not meeting “outcomes standards.” In an accompanying document, he defines those “outcomes standards.” He specifies fining people who have high BMIs, blood pressure, glucose, or cholesterol.

In other words, Mr. O’Donnell wants to charge for insurance by the pound, as that accompanying document says. Actually, by BMI, which of course is of dubious value as a measure of weight, let alone health.

Here is his actuarial formula:

Although having read his very stable arithmetic elsewhere in this same document, I’d worry about the accreditation status of any actuarial school, or for that matter any school of any kind within the 50 states, that would accept him:

Thirty-one states have no laws that prohibit employers from using smoking status as the reason for not hiring… In the remaining 29 states…smoking status cannot be used as the reason for not hiring.

I’m not waiting around for a retraction from this genius either.

Quiz: Which industry has the worst Net Promoter Score? (SPOILER ALERT: It’s wellness.)

We often talk about wellness vendors competing against one another in a race to the bottom, with the very stable geniuses at Wellsteps, Interactive Health, Total Wellness, and Star Wellness in the lead. Of course, the equally stable geniuses at Wellness Corporate Solutions, Healthywage and Bravo can’t be counted out. There could be other candidates too. Keep in mind that wellness is a crowded industry, with many very stable vendors constantly trying to outgenius one another. (There are, of course, some excellent vendors out there too. Simply put the name of your vendor in the “search” box and see what pops up.)

However, we never talk about the wellness industry as a whole competing against other industries in a race to the bottom. Why not? Because it turns out that the wellness industry has already won that race.  How do we know this?  Simple. By looking at Net Promoter Scores. Net Promoter Scores are the most widely used, and considered the most valid, measure of user satisfaction. Let’s see how wellness compares to  a benchmark of other industries.


The Benchmark: Where are other industries on the Net Promoter Score scale?

Here is a a screenshot of the Net Promoter Scores for the 20 largest US industries serving consumers. (Source: The Temkin Group, which sells comprehensive reports based upon the NPS.)

The worst performer of any industry is, not surprisingly, TV and internet services. The average for that industry is +2. Even so, we have Comcast and I love it. If you want to watch a show — say, Billions — you just literally say “Billions” and <presto> the show appears on your screen. Plus Comcast’s picture quality is now so sharp that every time Paul Giamatti realizes that Damian Lewis has outsmarted him again, you can almost see the steam coming out of his ears.

Nonetheless, the cable TV and internet services industry at least earns a positive score. It’s not that bad.


Where is the wellness industry on the Net Promoter Score scale?

On the other hand, the wellness industry is that bad, according to the data.

Wellness isn’t on the Temkin chart because, thankfully for America’s employees, it is not one of the 20 largest B-to-C industries. It is off the charts both literally, and also figuratively, because the wellness industry Net Promoter Score averages a minus-52 in the US. That’s 54 points lower than the next-lowest industry. (This does not include Quizzify, which is very highly regarded by employees. So much so that one of employees’ biggest complaints is, not enough quizzes.)

This isn’t us or one of the many other wellness skeptics doing the Net Promoter Score measurement. It’s the highly respected consulting firm WillisTowersWatson, whose comprehensive report covers all aspects of the industry.

This rating shouldn’t come as any surprise to people who read this blog, or for that matter people who read at all. Just last week we related a typical employee wellness story, and last year we reposted a few of the comments to the Slate article: “Workplace Wellness Programs Are a Sham,”  My favorite, of course, is “I’d like to punch them in the face.”

And also just last week, yet another person — who used their full name — commented on a previous blog, complaining about their “untethered from reality HRA and biometric screen.”

Speaking of untethered from reality, here’s what a wellness vendor — VirginPulse — believes to be the case on their planet:

And there is Bravo, saying punitive wellness programs are:

“very popular and well received by the vast majority of employers and employees alike…”

My question to VirginPulse and Bravo is, where is this “87%,” and/or this “vast majority of employees” who love wellness, and insist on being pried, poked and prodded?  We’ve looked in a number of places — here, here, here, here, here, here, here, here, and here — and can’t find anyone.

Oh, wait–yoo-hoo, over here — I found him! 


Why this matters

We have a saying: “Wellness will make employees happy whether they like it or not.”  In the real world, a minus-52 Net Promoter Score indicates that morale takes a big hit if you do wellness to employees instead of for them. (The Health Enhancement Research Organization concurs with us only on a few issues — the deleterious impact of wellness programs on morale is one of them. )

More importantly, employers, except for Quizzify’s customers and partners, are losing their “Safe Harbor” as of January for tying clinical wellness programs to large financial forfeitures.  Aggrieved employees will have much greater recourse in the federal courts than they have today.  As the Net Promoter Scores show, there is no shortage of aggrieved employees, and likely no shortage of attorneys willing to “assist” them in collecting a financial settlement.

There is also no shortage of expert witnesses here at They Said What? to support them. And we’ve never lost.

 

 

Will the Maryland state employee wellness program be the most epic fail ever?

It’s not just that Maryland is setting the record for most epic financial fail ever recorded in wellness. We are also bringing you an eyewitness account from the Belly of the Beast, an employee willing to give out her name in order to help spare other state employees and taxpayers the pain of this program.


The Most Epic Fail Ever?

Maryland is on track to miss its savings goals by 18 decimal places. To put that in perspective, the total economic output of the world sums to only 14 decimal places.

Here’s how the math works. The state is claiming that avoiding wellness-sensitive medical events will save $4 billion dollars  — a number with 10 decimals.  Thanks in part to Maryland’s lowest-in-country hospital rates of about $20,000/heart attack, the state would have to avoid 20,000 heart attacks a year to do this. No easy feat when the entire insured Maryland population — all private- and public-sector employees and their families combined — only suffer about 2700 heart attacks/year.

Plus, in the history of wellness, it appears that not a single heart attack, or for that matter, diabetes event, has ever been avoided. (More likely, a few have been avoided, but a few also have been caused by employees taking bad wellness vendor advice.)

Put yet another way, that’s $4000/family/year in savings. Achieving that outcome that would require wiping out all hospitalizations on all state employees and dependents, along with some of their closest friends.


Taxpayers, this is on you

Meanwhile, Maryland state taxpayers are paying Optum on the magnitude of $70,000,000 (8 decimal places) over this period, plus the cost of hundreds of thousands of useless and possibly counterproductive coerced checkups.

The best-case scenario? It’s a very safe bet–one I am willing to make to the tune of $3-million and give out 10-to-1 odds– that they will save nothing.  That’s 10 decimals in missed savings targets and 8 decimals in fees — a truly epic fail of 18 decimal places.

And yet even this is an optimistic assessment.  Like both other public sector employers — Connecticut and Boise — which have reported outcomes, Maryland’s program will likely drive up spending and possibly harm their employees. And if you guessed that Optum’s contract calls for them to receive bonuses based on invalid measurement of non-existent savings, then update your resume. You are too smart to be in this field.

Further, Optum (through its representation on the board of the wellness trade association), has already publicly admitted wellness loses money.  Their cabal tried to take that back by pretending they lied when they admitted it, but it turned out they lied when they said they lied. The data was real, meaning the admission was real.


It happens that I know two state employees. One bragged to me about how their entire quasi-public organization was able to dodge this program because everyone hated it so much. The other shared her “wellness” story, a typical one rather than the stories of great harms, or the experiences of employees who make constructive comments in the lay media, such as: “I’d like to punch them in the face.”

Instead, her story sounds like every other employee wellness story — with the notable exception that she is allowing me to use her name, since she no longer works for the state and is concerned about the stress and potential harms caused to employees, including her former colleagues.  (Plus, as a taxpayer, she’d like her $50 back, representing her share of the total program expense.)

Her name is Alice, and here is her experience. (Anyone who would like her last name and contact info may contact me and I will pass that along to her. She is willing to talk, though not for attribution.)


As a state employee and with my entire family being on the state plan, my husband and I have had the joy of recently completing our wellness assessments. Here is my rant:

First, it’s a giant pain in the butt. Second, the questionnaire could not have been more ridiculous and third, my doctor didn’t really do anything with it. She just gets to bill an unnecessary office visit to the state, in order to sign a form.

On the first topic, the questionnaire took 45 min for each of us, plus the inconvenience of having to schedule and go to an appointment we didn’t need. And in my case, having just gone through 9 months of prenatal care, labor and delivery care and postpartum care on top of all the newborn appointments, the last thing I needed was another doctor’s appointment.

On the second point, the questions they asked were terrible for assessing my actual health. There was an obvious right answer in every case, and it seemed to want to judge my mental health/level of happiness more than actual health. “Think of yourself on a ladder in terms of xxx (happiness, social status, personal accomplishments). What rung on the ladder would you place yourself, 1 being the lowest and 10 the highest?” How does that assess my health? It’s a personal fulfillment questionnaire that also asks if you exercise. At the end they ask for all these lab values which I don’t have and my doctor didn’t think she was supposed to request so they aren’t filled out at all.

And on the last point, my doctor never looked at the 30 page final assessment that I had to print and she just asked me if I think I’m healthy and I said yes. She was fine with that. The only thing she told me was that I could lose a few pounds to get my BMI in the right place – well OF COURSE! I just had a baby, which on a side note is not a part of the wellness assessment at all. There are all these questions about how much sleep I’m getting, am I stressed, etc… but no accounting for the natural things that happen in life like a newborn. 


Shame, shame, shame on Alice!

Like every other Maryland employee, Alice needs to pull her weight, if she ever expects to account for her $40,000 share of the $4 billion in savings. Unfortunately, according to the actual arithmetic, she is already way behind in her quest. She hasn’t saved a nickel but has cost the state:

  1. 1 doctor bill
  2. 1 vendor fee
  3. 30 pages of paper from needlessly destroyed trees
  4. 45 minutes of lost productivity completing her kumbaya assessment, plus the time spent at the doctor

Fortunately, the doctor didn’t realize she was supposed to run (and charge for) a bunch of lab tests, so she saved the state some money there.


Where should the state go from here?

A quick plausibility test should determine that they didn’t save anything to speak of. Then Optum should be forced to give their money back, and issue an apology to Alice and others for wasting their time. The Attorney General should announce to overjoyed state employees that they are no longer required to do this — and that he just saved the taxpayers $70 million. Then he should run for governor. Alice could be his running mate.

Where will the state go from here?  Like Connecticut and Boise, in exactly the opposite direction. The state HR people will claim they are heroes, using the classic combination of regression to the mean, ignoring dropouts, and participants-vs-non-participants study design, to pretend to show how much employees love the program and how much money it’s saving. When carefully read,  of course, the data will show the opposite.

They will also find one state employee willing to claim he or she started eating more broccoli.  As for the rest? For a more typical assessment of the Maryland program, I would recommend that the state, in the immortal words of those great philosophers Jefferson Airplane, go ask Alice.

The reward for showing wellness works is now $3 million!

2021 Update — we aren’t just “outing” the worst. Instead we are claiming to be the best: The reward now applies to any behavior-change vendor — diabetes, wellness etc. — vs. Quizzify. $3 million is yours if found by the 5 judges (and remember, we only appoint one!) to be more cost-effective than Quizzify.

Here are the specific rules to claim the reward.

Almost any behavior-change vendor (e.g., Virgin Pulse, Bravo, Accolade, Livongo) is eligible to claim the reward. A “behavior change” vendor would be one whose value depends on employees doing something voluntarily or with an incentive/penalty, paid via an admin fee. Eligible categories include wellness, diabetes, weight loss, mental health, sleep, coaching, EAPs, “challenges” programs, fitness, nutrition, navigation, patient-centered medical homes, and price-shopping companies.

We say “almost any” because behavior change vendors that we work with are ineligible because we help them dramatically increase engagement. For instance, Sera Prognostics enhances its guarantee if Quizzify is also used, and we enhance ours.

Also ineligible are those featured favorably in Cracking Health Costs and Why Nobody Believes the Numbers. And Virta, which legitimately reverses diabetes.

If indeed a vendor considers itself to be a behavior change company and Quizzify looks at it and says, no, this is not behavior change, the vendor may announce that Quizzify rejected their application. The vendor may then apply to the Validation Institute to arbitrate whether it is a behavior change company or not. If it wins, Quizzify agrees to pay for its validation.


Selection of Judges

There will be five judges, selected as follows:

  • Each side gets to appoint one, drawn from The Healthcare Hackers listserve with more 1000 people on it, from all walks of healthcare.
  • Two are appointed objectively. That will be whichever health services researchers/health economists are the most influential at the time the reward is claimed. “Most influential” will be measured by a formula: the highest ratio of Twitter followers/Twitter following, with a minimum of 15,000 followers.
  • Those four judges will agree on the fifth.

Using the criteria below, the judging will be based largely on value per dollar of the program spent on the program and incentives. In the event this is considered to be roughly a tie, the judges will consider the validity of their measurement and whether they are validated by the Validation Institute.


Written submissions

Each side submits up to 2,000 words and five graphs, supported by as many as 20 links; the material linked must pre-date this posting to discourage either side from creating linked material specifically for this contest.

Publicly available materials from the lay media or blogs may be used, as well as from any of the 10 academic journals with the highest “impact factors,” such as Health Affairs, published within the last ten years.

Each side must:

  1. list their average prices per employee per year
  2. speak to compliance with ACA, ADA, USPSTF, and Choosing Wisely;
  3. allow the other to test its materials (for example, taking the health risk assessment) and review them as part of the submission.

Each party may separately cite previous invalidating mistakes made by the other party that might speak to the credibility of the other party. (There is no limit on those.)


Oral arguments

The judges may rule just on the basis of the written submissions. If not, the parties will convene online for a 2.5-hour presentation (or, at the discretion of the judges, in-person at the World Health Care Congress), featuring:

  • 10-minute opening statements, in which as many as 10 slides are allowed;
  • 30-minute cross-examinations with follow-up questions and no limitations on subject matter;
  • 60 minutes in which judges control the agenda and may ask questions of either party based on either the oral or the written submissions;
  • Five-minute closing statements.

Entry process

The entry process is:

  1. Applicant puts $3000 into escrow, at which point an NDA is signed and Quizzify/Quizzify guarantors (“Quizzify”) demonstrate liquid assets exceeding $3 million. Applicant may either go forward at this point, or forfeit the $3000.
  2. Applicant adds $27,000, at which point earning assets exceeding $3,000,000 are placed in escrow, though the income from the escrow does not go to the applicant. Assuming the $3,000,000 is sufficiently secured, applicant may either go forward, or forfeit the $30,000. If not secured, Quizzify pays the applicant $100,000.
  3. Applicant adds $270,000 to the escrow within 30 days, at which point the entry process is completed. Both sides then have 30 days to submit materials and 7 days to rebut. Online argument then takes place, if needed.
  4. Judges are paid from the escrow, 50-50 from Quizzify’s and applicant’s shares.
  5. If the applicant pulls out after publicly announcing he or she is applying and before adding the $270,000, there is a $50,000 liquidated damages fee, tripled if it has to be procured through litigation. If Quizzify pull outs, there is a $150,000 liquidated damages fee in favor of the applicant, tripled if it is procured through litigation.
  6. The winner collects the escrow.

June 2021 Update: Virgin Pulse’s one-page outcomes report is eligible.  They can win just by defending one single slide with as much backup as they want.


March 2021 Update: Wellsteps can claim double the reward ($6 million) for half the entry fee ($150,000) simply by showing that their ROI calculator is more accurate than Quizzify’s


January 2021 Update: Omada is claiming outcomes on their home page that are textbook examples of both regression to the mean and participant bias. They are aware this is not valid. They can claim this reward by defending their specious claims.


December 2020 Update: This reward is now applicable to any actuary or other self-proclaimed expert who claims that their published analyses of the wellness/diabetes/disease management industries showing favorable outcomes and savings are better than mine showing losses and general cluelessness. 




Here is the original offer and how it is changed.

As almost everyone in the wellness industry knows, we have offered a $2 million reward to anyone who can show that conventional annual “pry, poke and prod” wellness saves money. I’m feeling very generous today, what with the holidays upon us, so let’s make the reward $3 million.

Even more importantly, let’s loosen the rules — a lot —  to encourage applicants. You’ll find the $3 million reward is not just more generous, but also far easier to claim than the previous $2 million reward.


Special Offer for HERO

Ah, yes, the Health Enhancement Research Organization (HERO). The belly of the beast.

Let me make them a special offer. Paul Terry, the current HERO Prevaricator-in-Chief, has accused me of the following  (if you link, you’ll see they had enough sense not to use my name, likely on advice of counsel, given that I already almost sued them after they circulated their poison pen letter to the media):

I’m convinced responding to bloggers who show disdain for our field is an utter waste of time. I’ve rarely been persuaded to respond to bloggers [Editors note, in HERO-speak, “rarely” means “never” — except for that intercepted Zimmerman Telegram-like missive], and each time I did it affirmed my worry that, more than a waste, it’s counter-productive. That’s because they’ll not only incessantly recycle their original misstatements, but worse, they’ll misrepresent your response and use it as fodder for more disinformation.*

Tell ya what, Paul. let’s debate disinformation, including your letter.

I have asked you on multiple occasions to clue me in as to what my alleged disinformation actually is, if any. That way I can publicly apologize and fix it, should I choose to do so.  Before applying for this award, you need to disclose this alleged disinformation. You can’t just go around saying my information is made up etc. without specifying what it is.

By definition, “disinformation” is deliberate misrepresentation. To my knowledge, as a member of the “integrity segment” of the wellness industry, I have never, and would never, spread disinformation.

On the other hand, if I did spread inadvertently incorrect information by mistake, it seems only fair to let me fix it — especially given that I have been totally transparent and generous with my time in explaining to you what yours is, and how to correct it. (I might have missed some. Keeping up with yours is a challenge of Whack a Mole-meets-White House press correspondent proportions.)

So perhaps it is time to man up, Mr. Terry.  You and your cronies claim to have been collecting my “disinformation” for years, without disclosing any of it. I’m offering you a public forum and $3-million to present it…with only one of 5 judges on “my” side.

Otherwise, perhaps you should, in the immortal word(s) of the great philosopher Moe Howard, shaddap.


*As a side note, Mr. Terry writes: “We’re fortunate to work in an industry with a scant number of vociferous critics.” This “scant” number appears to include the entire medialeft-wing, right-wing, centrist, and health policyApparently also most employees, according to Towers Watson. The good news about “pry, poke and prod” is that it truly bridges the partisan divide, in that everyone hates it.


 

Wellness Vendors Dream the Impossible Dream

Alice laughed: “There’s no use trying,” she said. “One can’t believe impossible things.”

“I daresay you haven’t had much practice,” said the Queen. “When I was younger, I always did it for half an hour a day. Why, sometimes I’ve believed as many as six impossible things before breakfast.”


Six impossible things before breakfast?  The wellness industry would just be getting warmed up by believing six impossible things before breakfast. They believe enough impossible things all day long to support an entire restaurant chain:

Consider the article in the current issue of BenefitsPro — forwarded to me by many members of the Welligentsia — entitled: “Can the Wellness Industry Live Up to Its Promises?”  BenefitsPro rounded up some of the leaders of the wellness industry alt-stupid segment. Specifically, they interviewed US Corporate Wellness, Fitbit, Staywell, and HERO. Each is a perennial candidate for the Deplorables Awards — except US Corporate Wellness, which already secured its place in the Deplorables Hall of Fame (and Why Nobody Believes the Numbers) several years ago with these three paeans to the gods of impossibility.

In case you can’t read the key statistic — the first bullet point — it says: “Wellness program participants are 230% less likely to utilize EIB (extended illness benefit) than non-participants.”  Here is some news for the Einsteins at US Corporate Wellness:  You can’t be 230% less likely to do anything than anybody. For instance, even you, despite your best efforts in these three examples, can’t be 230% less likely to have a triple-digit IQ than the rest of us.  Here’s a rule of math for you: a number can only be reduced by 100%. Rules of math tend to be strictly enforced, even in wellness.  So the good news is, even in the worst-case scenario, you’re only 100% less likely to have a triple-digit IQ than the rest of us.

And yet, if it were possible to be 230% dumber than the rest of us, you might be. For instance, US Corporate Wellness also brought us this estimate of the massive annual savings that can be obtained just by, Seinfeld-style, doing nothing:

So assume I spent about $3500/year in healthcare 12 years ago, which is probably accurate. My modifiable risk factors were zero then and they are still zero — no increase. So my healthcare spending should have fallen by $350/year for 12 years, or $4200 since then. But that would be impossible, since I could only reduce my spending by $3500. Do you see how that works now?

To his credit, US Corporate Wellness’s CEO, Brad Cooper, is quoted in this article as saying: “Unfortunately some in the industry have exaggerated the savings numbers.” You think?

I’m pretty sure this next one is impossible too. I say “pretty sure” because I’ve never been able to quite decipher it, English being right up there with math as two subjects which apparently frustrated many a wellness vendor’s fifth grade teacher:

400% of what?  Is US Corporate Wellness saying that, as compared to employees with a chronic disease like hypertension, employees who take their blood pressure pills are 400% more productive?  Meaning that if they controlled their blood pressure, waiters could serve 400% more tables, doctors could see 400% more patients, pilots could fly planes 400% faster? Teachers could teach 400% more kids? Customer service recordings could tell us our calls are 400% more important to them?

Or maybe wellness vendors could make 400% more impossible claims. That would explain this BenefitsPro article.


Fitbit

We have been completely unable to get Fitbit to speak, but BenefitsPro couldn’t get them to shut up. Here is Fitbit’s Amy McDonough: “Measurement of a wellness program is an important part of the planning process.”   Indeed it is! It’s vitally important to plan on how to fabricate impossible outcomes to measure, when in reality your product may even lead to weight gain.  Here is one thing we know is impossible: you can’t achieve a 58% reduction in healthcare expenses through behavior change — especially if (as in the 133 patients they tracked in one of their studies) behavior didn’t actually change.

You can read about that gem, and others, in our recent Fitbit series here:


Health Enhancement Research Organization (HERO) and Staywell

I’ll consider these two outfits together because people seem to bounce back and forth between them. Jessica Grossmeier is one such person. Jessica became the Neil Armstrong of impossible wellness outcomes way back in 2013.  Not just any old impossible wellness outcomes — those have been around for decades. She and Staywell pioneered the concept of claiming outcomes they already knew were impossible.   While at Staywell, she and her co-conspirators told British Petroleum they had saved about $17,000 per risk factor reduced.  So, yes, according to Staywell, anyone who temporarily lost a little weight saved BP $17,000 — enough to clean up about 1000 gallons of oil spilled from Deepwater Horizon.

See British Petroleum’s Wellness Program Is Spewing Invalidity for the details.

Leave aside both the obvious impossibility of this claim, and also the mathematical impossibility of this claim given that employers only actually spend about $6000/person on healthcare.  Jessica’s breakthrough was to also ignore the fact that this $17,000/risk factor savings figure exceeds by 100 times what her very own article claims in savings. Not by 100 percent. By 100 times.

Fast-forward to her new role at HERO. In this article she says:

The conversation has thus shifted from a focus on ROI alone to a broader value proposition that includes both the tangible and intangible benefits of improved worker health and well-being.

Her memory may have failed her here too because HERO — in addition to admitting that wellness loses money (which explains its “shift” from the “focus on ROI alone”) — also listed the “broader value proposition” elements of their pry-poke-and-prod wellness programs. The problem is the elements of the broader value proposition of screening the stuffing out of employees aren’t “benefits.”  They’re costs, and lots of them:

When she says: “The conversation has shifted from a focus on ROI alone,” she means: “We all got caught making up ROIs so we need to make up a new metric.”  RAND’s Soeren Mattke predicted this new spin three years ago, observing that every time the wellness industry makes claims and they get debunked, they simply make a new set of claims, and then they get debunked, and then the whole process repeats with new claims, whack-a-mole fashion, ad infinitum.  Here is his specific quote:

“The industry went in with promises of 3 to 1 and 6 to 1 based on health care savings alone – then research came out that said that’s not true. Then they said: “OK, we are cost neutral.” Now, research says maybe not even cost neutral. So now they say: “But is really about productivity, which we can’t really measure but it’s an enormous return.”


Interactive Health

While other vendors, such as Wellsteps, harm plenty of employees, Interactive Health holds the distinction of being the only wellness vendor to actually harm me.  I went to a screening of theirs. In order to increase my productivity, they stretched out my calves.  Indeed, I could feel my productivity soaring — until one of them went into spasm. I doubt anyone has missed this story but in case anyone has

They also hold the distinction of being the first vendor (actually their consultant) to try to bribe me to stop pointing out how impossible their outcomes were. They were upset because I profiled them in the Wall Street Journal . The article is behind a paywall, so you probably can’t see it. Here’s the spoiler: they allegedly saved a whopping $53,000 for every risk factor reduced. In your face, Staywell!

Here is the BenefitsPro article’s quote from Interactive Health’s Jared Smith:

“There are many wellness vendors out there that claim to show ROI,” he says. “However, many of their models and methodologies are complex, based upon assumptions that do not provide sufficient quantitative evidence to substantiate their claims.”

You think?

Finally, here is a news flash for Interactive Health: sitting is not the new smoking.  If anything is the “new smoking,” it’s opioid addiction, which has reached epidemic proportions in the workforce while being totally, utterly, completely, negligently, mind-blowingly, Sergeant Shultz-ily, ignored by Interactive Health and the rest of the wellness industry.

There is nothing funny about opioid addiction and the wellness industry’s failure to address it, a topic for a future blog post. The only impossibility is that it is impossible to believe that an entire industry charged with what Jessica Grossmeier calls “worker health and well-being” could have allowed this to happen. Alas, happen it did.

And, as you can see from the time-stamp on this post, except at establishments favored by the Wellness Ignorati, breakfast hasn’t even been served yet.

Response to my Posting on the Case Western Reserve Law-Medicine Journal Wellness Critique

The following was proposed as a comment to my posting on the article The Outcomes, Economics and Ethics of the Workplace Wellness Industry.  This response needs to be anonymous because the person who posted it actually works for a large employer and can’t represent the employer. I thought it was important enough to merit its own posting.  


Very good summary of all the items you have “uncovered” from these vendors.  I have worked 28 years in healthcare cost control and it’s unfortunate that most employers believe what someone else tells them (so you have the blind leading the blind).  These points tell about the industry from your article and other items I have learned from you and my experience:

1) We all want to feel like there is an answer to cost control/help our employees and management looks to HR for the answers:

On its surface, who can argue with the concept of workplace wellness? How could there be anything wrong with corporations helping their employees reduce their risk of disease while saving money in the process?

2) As a culture, we have convinced ourselves “more is better”.  So vendors have an easy sell—let’s do more testing, more HRAs, more surveys…because it will give better results.

(Al) See this article on the Arkansas state program. Wellness isn’t working so the state benefits director wants to do more of it. It’s not “robust enough” now, he says.

3) People don’t ask questions, they don’t take the time to understand or study the facts as outlined in your overview of ACA/Safeway, Harvard Study, HERO, etc.

4) For years no new studies show savings that can be independently verified.  You’ve pointed this out before and no vendor is willing to attempt to claim your $2-million reward.  You also noted…For the last seven years, no peer-reviewed article in a major journal has found that wellness programs lead to substantial risk reduction.

(Al) If the situation were reversed — and I dare them — I would (under the same rules as my reward) claim it in a heartbeat.

5) No vendor ROI savings/metric methodology standard.  Vendors don’t want to be held accountable and most employers don’t care/don’t understand or just want to put a program in place to feel good.  Similar to your experiences with vendors, I have felt others view me as an obstructionist or negative because I ask too many questions or point out their program doesn’t/didn’t provide savings.  Unfortunately, I don’t see the industry changing because wellness is an easy product to sell to employers that don’t ask hard questions.  Maybe we’ll see some type of regulations to help in this area.

6) I hope the good vendors mentioned at the end of your article/Validation Institute members begin publishing their results that demonstrate an independent verified ROI that the industry will want to follow (become the standard).  I would suggest you explore more discussion on these vendors so employers might look to them for help.

(Al) Will do, though my positive postings don’t get remotely as many hits as my exposes. Also one reason they get validated is they don’t fabricate ROIs.

Al, I appreciate your insight and oversight in this industry.  Thanks for sharing your time and expertise.

Case Western Reserve Takes on Wellness. Wellness Loses.

Workplace “pry, poke and prod” programs are like pennies, Communism, baseball and Microsoft Outlook, in the sense that if they didn’t already exist, nobody would invent them.

This observation does not apply to workplace screening according to actual clinical guidelines, and next-generation programs like the Wellness 401W Savings Plan, which are good ideas that should get traction.  It doesn’t apply to wellness done for employees instead of to them.  It doesn’t apply to the Sterlings, It Starts with Me’s, USPMs, ImpactHealths, Redbricks, and Limeades of the world, who are doing the right things.  (If you think I am leaving anyone out, let me know!) And of course it doesn’t apply to health literacy, a la Quizzify. There is no argument in favor of ignorance.

There is no better evidence for this observation than the current issue of the Case Western Reserve Law-Medicine Journal, which devotes almost its entire current issue to the problems with these first-generation wellness programs.


The lead article, “The Outcomes, Economics and Ethics of the Workplace Wellness Industry,”  shows how vendors cover up their losses and harms to employees with lies that would make a White House press secretary blush. When they get caught blatantly lying and harming employees (and kudos to Sharon Begley for her expose on Wellsteps), they simply give each other awards. To paraphrase the immortal words of the great philosopher Ryan O’Neal, being a Koop Award winner means never having to say you’re sorry.

Next up is The Incidental Economist (TIE) team, weighing in on the “Dubious Empirical and Legal Foundations of Wellness Programs.” Kudos to TIE for outing this scam (the LA Times’ word, not mine) years ago. I did too, but the difference is that they have “day jobs” dissecting all the other frauds in healthcare, whereas I have altogether too much free time on my hands.

Samuel Bagenstos then piles on with “growing…evidence that reliance on workplace wellness to reduce disease is bad and likely futile health policy,” before deconstructing the questionable legality of these programs, featuring a definition of “voluntary wellness programs” that would make George Orwell blush.

Next up is Leah Fowler, pointing out that one reason wellness programs fail is they assume you can basically “give [employees] the opportunity” to lose weight, and they will. Fowler and her co-author Jessica Roberts point out that social determinants of health rather than employee indifference are vastly disproportionately the cause of poor health. “Nudges” won’t help. The evidence overwhelmingly supports their thesis. (And kudos to our own Tom Emerick for being first out of the box with this insight.)

Finally, Penn State’s resident health policy experts, Professors Scanlon and Shea, review the debacle of Penn State’s own wellness program and the (many) lessons that can be learned from it. The combination of their policy expertise and having been in the belly of the beast makes for a compelling read.

The bottom line? Wellness in its current form is such a sham (Slate’s word, not mine) that I can offer a $2-million reward for showing it works, knowing my money is safe from the Wellness Ignorati, who for all their bluster apparently either know their programs fail, or don’t have any use for $2-million.  (They hate me so much you’d think that even if they didn’t need the money, they’d claim the reward just to keep me from having it instead.)

It’s up to us to create a next-generation offering that benefits employees, and that they like. I see some good things out there on the http://www.ethicalwellness.org website — Sterling Wellness, It Starts with Me, and many other vendors have endorsed it. (You know it’s a good start because none of the Wellness Ignorati want anything to do with it.)

Health Fitness Corp Meets Seinfeld: Saves Money by Doing Nothing

Employers are very fortunate that so many wellness vendors cover so many market niches, to satisfy an employer’s every need. Want to harm your employees?  Wellsteps has you covered.  If insurance fraud is your thing, there’s Healthfairs USA.  Suppose you really have it in for the US Preventive Services Task Force, maybe because you have a repressed childhood memory of being bitten by one of its members. As the leader in flouting USPSTF guidelines, Total Wellness can bite them back.

And, if you prefer a vendor that does nothing, Health Fitness Corporation (HFC) fits the bill:

Yes, when it comes to invalidating their results for doing nothing, HFC is truly a target-rich environment. HFC’s latest? They “saved” $586 per employee on a weight-loss program.

By now you’ve probably guessed that — by their own admission — in this successful weight loss program, these employees didn’t lose weight.

As befits a company that previously didn’t actually run a program but still saved money, and that didn’t actually treat cancer victims who didn’t have cancer but still claimed to save their lives — these employees actually gained 4 ounces.  According to HFC, though, they would have gained 13 ounces had it not been for HFC’s Herculean efforts.

The amount employees did not gain? 9 ounces.  Saving $586/employee for not gaining 9 ounces works out to $1041/pound of of savings for employee weight not gained. Extrapolating from that result, employees would have to not gain only about five or six pounds to completely wipe out healthcare spending.


This is where the magic happens…

To what does HFC attribute this incredible performance? I’ll let them put it in their own words. And these are definitely their own words. Trust me when I say no one is going to accuse them of plagiarizing these words:

More than half (58.5%) of participants that self-enrolled in the program never completed a coaching session, compared by 18.6% in the group enrolled by a health coach completing no coaching sessions.

English, of course, is one of the five things wellness vendors know the least about. (The other four are arithmetic, data, facts — and, of course, wellness.)  So let me translate that into English for you: the majority of self-enrolled “participants” didn’t actually participate.  To summarize, most self-enrolled employees didn’t actually participate in a program in which most participants didn’t actually lose weight.

Well, hey, at least they didn’t violate USPSTF guidelines, commit insurance fraud or harm these employees. That’s something, right?  And therein lies HFC’s market niche, a positioning inspired by the immortal words of the great philosopher George Costanza: “Everyone else is doing something. We’ll do nothing.”



Wrapping up some old business…

A couple of Saturdays ago, I raised some money for folks with MS — like our colleague, Jon Robison — by climbing to the top of the Hancock Building, the tallest building in New England.  This year I clocked in at 13:56, putting me in the top quartile and shaving almost 3 minutes off last year’s 17:15. You may have noticed that 13:56 is more than 3 minutes faster than 17:15, not “almost” 3 minutes faster. Before you attempt to claim your $1000 for spotting my first-ever material error, there was one fewer floor this year, which reduced average times by about 23 seconds.

Age-wise, I kicked some serious thigh.

13:56 earned me the runner-up spot in the 60-and-over cohort, among people from Massachusetts. (A small number of committed souls travel around the country doing these things. Two of them beat me as well.)  Second is huge for me — the closest I’ve ever come to winning any contest that didn’t involve knowing massive amounts of useless trivia. Helps that stair-climbing doesn’t require coordination, speed or athletic ability of any kind. Just, as luck would have it, wellness.

Speaking of “closest,” congratulations to Bill McPeck, who came the closest to guessing my time, at 16:45.

And special thanks to Barry Zajac, Fred Seelig and Mitch Collins, who along with an anonymous donor, helped me approach my fundraising goal. (Anyone care to put me over the top?)

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