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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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Koop Award Committee-meets-Sergeant Schultz
Ever wonder why no one notices that wellness results are completely made up?
Wonder no longer. it all starts with The Health Project, which gives out the C. Everett Koop Award. This month is award season, meaning some of the award’s sponsors or committee members gets to ingratiate themselves with customers. In honor of this month, let’s review previous years’ awards, and see the self-invalidating, but somehow unnoticed, details that call to mind the immortal words of the great philosopher Sergeant Wolfgang Schultz: “I know nothing. I see nothing. I hear nothing.”
To that iconic phrase, the Koop Committee adds: “I notice nothing.”
2014: British Petroleum (BP America)
Last year, the award went to British Petroleum. BP’s candidacy wasn’t exactly a longshot, since both its vendor (Staywell) and its consultant (Mercer) are on the Committee AND are “sponsors” of this volunteer committee. By the way, if you’re looking for any disclosure on the award announcement of those connections when you click through on the first sentence above, you’ll need x-ray vision, since there is none. No one seems to have noticed this omission.
Besides not understanding ethics, apparently Mercer and Staywell don’t understand arithmetic: their “rigorous analysis” claimed almost $20,000/person in savings for active participants who reduced a risk factor. Besides being mathematically impossible, clinically laughable, unchecked for plausibility in violation of their own HERO guidelines, and not adjusted for dropouts and non-participants, this figure, as the screen shot below shows, is over 100 times more than Staywell itself says is possible. Once again, no one seems to have noticed this glaring contradiction.
2013–GRACO (honorable mention)
Ron Goetzel has written at length about Graco, as have we and others. By starting the measurement in 2009, the year after the program started (as opposed to starting the measurement two years before the program started — see the 2011 award winner, Eastman Chemical), and “forgetting” to count revenues added by an acquisition. Mr. Goetzel was able to tie the growth in Graco’s revenues to the “bottom line performance” of its wellness program. Of course, when you actually start measuring the year the program actually started (2008) — which coincidentally was also the year before the recession knocked 29% out of Graco’s revenues — and then adjust for the 2012 acquisition’s added revenues, Graco organically grew at about the same rate as everyone else. Wellness had nothing to do with it. Graco’s salespeople did not exceed their quotas because they ate more broccoli.
Here’s what else didn’t happen due to its wellness program: savings. As our post showed, Mr. Goetzel didn’t notice that the cost trend for children (none of whom were in the wellness program) outperformed the cost trend for wellness participants. This means, of course, that the favorable trend among participants couldn’t be attributed to wellness, since the trend for a cohort without access to wellness was even more favorable. It’s all right here.
Oh, yes, and it also turns out that Graco’s insistence on making its employees go to the doctor was more likely to harm them than benefit them. That’s not us–that’s the New England Journal of Medicine.
2012: The State of Nebraska
We’ve already chronicled this one at length. There were quite a number of glaringly obvious rookie mistakes that escaped the notice of the award committee, either due to incompetence or perhaps the fact that the state’s vendor, Health Fitness Corporation (HFC), was also a sponsor of the award. See if you can find that sponsorship disclosure in their press release “congratulating” the State and LL Bean (the other winner, also a customer of HFC). You’ll need an electron microscope to go with your x-ray vision.
HFC actually admitted lying about saving the lives of cancer victims who as it turned out didn’t have cancer, but still got the award because, according to Ron Goetzel at the 2014 Datapalooza conference, apparently this particular lie didn’t count because it wasn’t on their application, just everywhere else. It was impossible to miss, but Ron said he didn’t notice. Is this a great country or what?
2011: Eastman Chemical
Another HFC customer. (HFC is really getting its money’s worth out of its sponsorship.) This was the one where — unlike 2013’s Graco, which started measuring outcomes the year after the program started in order to maximize the results — HFC started measuring outcomes two years before the program started in order to maximize the results. They separated participants and non-participants in 2004 but didn’t start the program until 2006. By 2005 the would-be “participants” were already 9% ahead…and by the time the program got underway in 2006, they were almost 20% lower-cost than the non-participants.
Once again, all this information was perfectly obvious at the time of the award submission, as well as highlighted in all of my books. It was also re-printed and re-presented multiple times, but somehow no one on the Koop Committee noticed until late 2014, when it was in Health Affairs. At that point, the light being shined on him being too glaring to hide from, Mr. Goetzel had to respond. Employing the passive voice to great advantage, Ron said the slide was “unfortunately mislabeled.”
Read that carefully. If it’s hard to read, here is the source. It’s towards the bottom. He says this slide and other data “convinced” the Koop Committee to give them an award. That’s his story and he’s sticking to it.
Recently, for the second time, he went back into the Koop Award submissions and rewrote history. Compare the original Koop submission screen shot with the photoshopped version. Note the missing X-axis:
The original was:
His explanation didn’t indicate who mislabeled this slide, why he didn’t notice until now, why he snuck into the old files to relabel it, what the labels should have read — or why HFC never apologized, as others outside the wellness industry do when mistakes are made.
I can explain the last — just look at the wellness industry motto, on YouTube: “A Koop Award means never having to say you’re sorry.”
2010: Pfizer
None of Pfizer’s outcomes figures stand up to even the slightest scrutiny, and Mercer did the analysis — making Pfizer a shoo-in for this award. By their own admission only 4% of people moved out of high-risk status. (Naturally this tally excludes non-participants and dropouts, who likely increased risk factors at a faster rate than participants reduced them.) In other words out of 30,000 employees, 1200 reduced a risk factor. And yet somehow Pfizer saved $9.4 million, almost $9000 per risk factor. So if everyone at Pfizer reduced a risk factor, they’d easily wipe out all their healthcare spending.
They did some secure messaging, but only about a quarter of the at-risk population even opened their messages…and only about a quarter of them clicked through to the messaging.
Smokers self-reported at 6% before the program and 3% after it. No one hazarded a guess that perhaps some employees were, oh, I dunno, lying?
However, no one can accuse Pfizer of lying about their weight loss results. In particular check out this comparison, which was offered with a straight face, of employees who read their weight-loss messages vs. employees who didn’t.
Over the course of the study, people who didn’t read their messages gained 1.6 ounces while employees who did lost 2.9 ounces. You could practically attribute that differential performance to the calories required to open the emails.
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Greatest Hits Collection: Staywell
Collaborating with Staywell may not be enhancing the American Heart Association’s reputation.
Occasionally we have to attend to our Day Jobs and can’t post regularly. Fortunately, we have access to a bolus of posts from mid-2014, the posts that went up on this site initially. There were too many stories to highlight, so we decided to inventory them, in order to fill in gaps when we didn’t have time for new posts.
High on that list would be Staywell. First was their collaboration with Mercer, in which they agreed to tell British Petroleum that they found $17,000/person savings. They knew those savings were mathematically impossible since the average person only spends $6000/year. They also forgot that they themselves had said it was only possible to save $100/person.
Following on the heels of that was a collaboration with the American Heart Association to create screening guidelines that (surprise) call for much more screening than the United States Preventive Services Task Force recommends.
In both cases, we welcomed — and in the latter case offered $1000 honorarium for — responses to our questions, but our good-faith offer was met with silence.
Also, in both articles Staywell continued to cite Katherine Baicker’s study that she herself no longer defends, with the added wrinkle of referring to it as “recent” in the hopes that no one looks at the endnotes and sees that it was submitted for publication in 2009 and covered studies from a decade before that. With any luck they’ll have enough integrity to stop citing that study now that RAND has invalidated it. A good rule of thumb is that anyone who cites Baicker’s study without noting that no one (including Professor Baicker) believes that 3.27-to-1 ROI any more is prima facie deliberately misleading people. It is no longer credible to say one doesn’t know that her study has been shown to be hooey and that she is no longer defending it (and actually says she has no more interest in wellness).
Our health benefit education will never break your heart
We recommend click-throughs to both studies. Each raises questions that Staywell refused to answer, after initial conversations which confirmed they knew about these issues. You’ll also see how the American Heart Association was shocked, shocked, that anyone would question their integrity (perhaps they haven’t read The Big Fat Surprise) but then let it go, rather than create a news cycle.
Staywell also helped give British Petroleum a Koop Award. Nice to be on the award committee AND be an award sponsor–makes it easy to give your customers awards. With one or two exceptions, we can’t remember the last time the Koop Award went to a company with no connection to a sponsor or committee member. Perhaps someone could let us know?
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Is Mercer Cooking Staywell’s Books At British Petroleum?
Staywell, Mercer
Short Summary of Intervention:
Comprehensive wellness program offered to all American employees of British Petroleum. Staywell was the vendor. Mercer was hired by British Petroleum to validate the savings claimed by Staywell.
Materials Being Reviewed
- Staywell and Mercer Analysis of British Petroleum Program
- The Health Care Blog Review of British Petroleum Wellness Program
Summary of key figures and outcomes:
No visuals were provided. A review of the articles is recommended.
Questions for Staywell and Mercer
You claimed that spending would have increased by 10.5% instead of 7% across the entire company, absent the wellness program. Since only 1139 people reduced their risk factors (not including non-participants and dropouts whose risk factors might have increased), are you saying that by reducing a risk factor, those 1139 people were responsible for the entire difference in trend for the 62,000 employees and dependents versus the original trend you projected?
ANS: Refused to answer
The savings you are claiming works out to about $17,000 for each person whose risk factors declined, almost the equivalent of avoiding one heart attack for each person who reduced a risk factor. Are you suggesting that most of those 1139 would have had heart attacks otherwise, even though fewer than 200 American BP employees had a heart attack the previous year?
Note to Staywell’s and Mercer’s actuaries: if costs decline $17,000 every time someone reduces a risk factor and your spending is about a third of that level, you can wipe out your healthcare bill by getting a third of your employees to reduce a risk factor.
ANS: Refused to answer
How does $17,000 in savings for BP employee reducing a risk factor reconcile with Staywell’s own website claiming only $100 in savings for each person reducing a risk factor in a multi-employer study?
ANS: Refused to answer
How does this unprecedented savings reconcile with the PepsiCo findings, published in a leading journal (Health Affairs) by leading researchers (RAND), that concluded applying approximately the same interventions to PepsiCo’s workforce using the same consulting firm (Mercer) actually lost money?
ANS: Refused to answer
Did Mercer notice the discrepancy between Staywell’s alleged results and PepsiCo’s (and also Staywell’s own website) and inform British Petroleum of it, since Mercer’s job was to validate this program on behalf of British Petroleum and ensure that the savings were accurate?
ANS: Refused to answer
Since a wellness program can only reduce wellness-sensitive medical events, how come you elected not to disclose the rate of wellness-sensitive medical events across the entire population before and after the program?
ANS: Refused to answer
Did you inform British Petroleum that there was an article on The Health Care Blog about their program that reached the opposite conclusion you reached?
ANS: Refused to answer
Staywell employees Jessica Grossmeier (who authored the journal article) and Paul Terry (Chief Science Officer) were asked privately and by many of the people who posted comments to rebut The Health Care Blog and declined. Wouldn’t it have been a useful discussion to explain to readers how British Petroleum could have saved more than 100 times what you yourself said was possible?
ANS: Refused to answer
They Said What? 