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1984


A word means whatever I want it to mean, neither more nor less.”

–Humpty-Dumpty


Like George Orwell and Humpty Dumpty, the wellness industry (thanks largely to the Business Roundtable pressuring the EEOC) has now managed to redefine wellness programs as their opposite: “voluntary” now means “required,” in the sense that if you don’t volunteer to submit to “wellness or else” you could be fined up to about $3600 (if you spouse is on your insurance), which is a little less than 10% of the median annual wage, and exceeds the amount in many people’s savings.

But the wellness program is still voluntary, according to the EEOC. Or as Surviving Workplace Wellness says: “wellness programs will make employees happy whether they like it or not.”

These wellness people have experience at redefining words as their opposites. Health Fitness Corporation’s Dennis Richling redefined “514 Nebraska state employees didn’t have cancer at all” to “we made life-saving catches of 514 employees with cancer.” He referred to this subtle difference as “semantics.”

Jon Robison and I just posted a “Pulse” on the wellness industry’s creative use of the English language, which rivals their creative use of fifth-grade math.

We hope you hate it, where “hate” means “love.”

Nebraska’s Award-Winning Wellness Program Meets an Ignominious Demise

No program epitomized conventional “pry, poke and prod” wellness more than Nebraska’s state employee wellness program.  And by that of course I mean no wellness vendor has ever lied about outcomes more blatantly or won more awards than Nebraska’s state employee wellness program vendor, Health Fitness Corporation.  (Blatantly lying about outcomes and winning Koop Awards, in the immortal words of the great philosopher Frank Sinatra, go together like a horse and carriage.)   Their big mistake was admitting it.  (See the timeline link.)

Not to mention the cover-up of the lies, that Ron Goetzel and his Koop Committee friends botched so badly that the state’s HR team and procurement department could no longer do the Sergeant Schultz thing.  I guess now, finally, Mr. Goetzel will stop referring to this program as a “best practice.”

The complete timeline, including all the screenshots, “best practice” references, and the cover-up, is here.

Now, the program is officially dead.  It was close.  On October 1, we thought we had lost:

nebraska award to hfc

But then last week, following a number of behind-the-scenes conversations and finally a bit of googling by the state:

Nebraska rejection

In other words:

victoryismine

Cancergate: Did a Koop Award Committee Member Commit a Crime?

As part of the cover-up of Health Fitness Corporation falsely claiming to save the lives of 514 Nebraskans with cancer, someone doctored their Koop Award application to remove the evidence of that claim and replace it with a literally and figuratively much more benign statement. For reasons described below, this may not even be legal. We are offering our assistance to Ron Goetzel to help him find the perp.


What would Dr. Koop say?

After Health Fitness Corporation (HFC) admitted lying about saving the lives of 514 alleged Nebraskan cancer victims who turned out never to have had cancer in the first place as part of their Koop Award-winning wellness program, someone tampered with their original award application to try to erase that lie. The “514 early-stage cancers” they claim to have cured morphed into “514 polyps.”

At the 2015 Great Debate, Ron Goetzel (who runs the Koop Award Committee) insisted that the Koop Committee knew nothing of the original lie about finding 514 cases of cancer, even though that line appeared twice in the original Koop Award application.  The Koop Award Committee also saw nothing suspicious in HFC’s marketing materials, which, incredibly, still resided on the HFC website for years after HFC was outed.  HFC finally took it down, an obvious admission of guilt on their part (to go with the actual admission in the newspaper), given how much they had ballyhooed it in the past. Naturally we have copies of the entire “case study” if anyone would like one.

Admittedly, that original lie was a little hard to spot in that case study. You needed to actually open your eyes:

nebraska life saving catches

nebraska cancer cases

And a lot of people did open their eyes.  The claim made its way into Google…and all the way to CalPERS:

nebraskacancergooglesearch

The Koop Committee missed this, though. Claiming to know nothing and see nothing — the Sergeant Schultz defense — is a Koop Committee favorite. However, the initial oversight doesn’t explain why Ron has called Nebraska a “best practice” three times even after he was shocked, shocked to learn that lying was going on in here.

Rewriting History

I want to be very clear: we are not accusing Ron Goetzel of sneaking back in and rewriting the original applications (including forging a section of a letter from the governor of Nebraska) to cover up the lies told by Health Fitness Corporation, which sponsors his award.  He could lose his job at Johns Hopkins if he did, so he wouldn’t.  Quite the opposite, both of us would want to get to the bottom of this!

Clearly, though, someone with the same coverup agenda and with the same access to the same Koop Award site rewrote the original HFC/Nebraska award application. Specifically, someone replaced “514 new cases of early-stage cancers” with these employees having only “benign polyps” in order to make it consistent with the denial that the Committee knew anything about HFC’s lie:

nebraska polyps

Owing to the previous doctoring of original evidence in the Koop Award (for which Ron Goetzel did admit responsibility), we now know to keep screenshots of originals.  Note the difference in the last sentences. The original is claiming “514 new cases…of cancer” below. This is the original that Mr. Goetzel insists did not appear in the application. And yet, here it is.

nebraska cancer koop award

This bungled evidence-tampering shows our book, Surviving Workplace Wellness, is right: “In wellness you don’t have to challenge the data to invalidate it.  You merely have to read the data.  It will invalidate itself.”

The doctored paragraph has now replaced the original paragraph in both places where it appears.  Ours is the only extant copy of the original screenshot.  We learned long ago that you need to capture screenshots because these people always cover their tracks when they get caught lying.  And since most of wellness is a lie, they have a veritable Pennsylvania Station of tracks to cover.

Cancergate?

The perpetrator is in a lot of trouble:  In the application, this altered phrase appears in a letter from then- Governor Heineman’s office in support of the Koop Award.  Obviously that’s not legal. The reason we assume Ron Goetzel didn’t do it is because he would have had to get permission from Johns Hopkins, and they would not have let him forge official state documents while using their affiliation in his title.

Goetzel’s History of Rewriting History

We don’t know who the perpetrator is, but one reason to doubt that Ron Goetzel is the guilty party is that he was already caught doctoring original Koop applications, and it wasn’t fun for him. Hence, one could assume he would be unlikely to do the same thing again.

So Mr. Goetzel is a victim here too because of the Koop Award’s shattered credibility. He should be as horrified as we are, and we should work together on this, and offer our help.  We urge, demand, insist that as the leader of this committee, Ron Goetzel get to the bottom of this!  He needs to find out who tampered with this letter from the Governor, turn him in to Nebraska authorities if indeed that is illegal, apologize, and rescind that Koop Award.

We can’t investigate this ourselves without his cooperation. Even if we knew who it was, we can’t convene the wellness industry ethics committee because in wellness, there is no ethics committee.  That’s because in wellness, as this website has repeatedly shown, there are no ethics.

First, Do Harm: The Ten Most Dangerous Wellness Vendors

If corporate wellness didn’t already exist, no one would invent it.  In that sense, it’s a little like communism, baseball, pennies, or Outlook.

After all, why would any company want to purchase programs that damage morale, reduce productivity, drive costs up…and don’t work 90%-95% of the time?  And that’s according to the proponents.  What the critics say can’t be repeated in a family publication such as ours.

Still, those are the employers’ problems. However, the employers’ problems become the employees’ problems when employees are “voluntarily” forced to submit to programs that are likely to harm them. (As the New York Times recently pointed out, there is nothing voluntary about most of these programs.)

Recently, the head of United Healthcare’s (UHC) wellness operations (Optum), Seth Serxner, admitted that Optum’s programs consciously ignore US Preventive Services Task Force (USPSTF) screening guidelines.  Lest anyone was expecting a wellness vendor to actually apologize for bad behavior, Mr. Serxner went on to blame employers for insisting on overscreening and overdiagnosing their own employees…and (by implication) overpaying for the privilege of doing so.   “Our clients make us do it,” were his exact words.

Funny thing, we first asked our own clients who use Optum about why they turned down Optum’s generous offer to do more appropriate screenings at a lower price.  None of them remember receiving this offer. Go figure.  Then a UHC executive wrote and said we were making them look bad. I softened some of the language (like the paragraph below), and said I would happily retract the whole thing if indeed they could introduce me to just one customer — one out of their thousands — who recalls insisting on overscreening and overpaying.  Never heard back…

United Healthcare isn’t alone in harming employees. They are just the first company to admit it, and far from the worst offender, as the harms of overscreening for the usual suspects (glucose, cholesterol etc.) don’t hold a candle to some of the more creative ideas listed below.  Here, in order, are the ten vendors most likely to harm employees in the name of wellness.


 

#10 Healthmine

Healthmine’s CEO, Bryce Williams, isn’t blaming the victim like United did.  He has publicly announced that Healthmine flouts clinical guidelines.  He says he is right and everyone else — specifically including the “US Preventative [sic] Services Task Force” — is wrong.  A real doctor acting on this pronouncement might be risking his or her license.  Fortunately for Mr. Williams, being a wellness vendor doesn’t require a license, so regardless of the harms a wellness vendor inflicts on employees, no one can confiscate it because there is nothing to confiscate..

In addition to not misspelling the name of the group he is attacking, we might also recommend that he not misquote the sources on which his faulty argument is based. We’re just sayin’…

For starters Mr. Williams declares: “One out of every two people in America has at least one chronic condition according to the CDC…”

Here’s what the CDC really said: “One out of every two adults has at least one chronic condition.”  And if you dig deeper, you’ll see that this list of chronic conditions cited by the CDC includes arthritis, mental illness, eye disorders and asthma, none of which Healthmine’s hyperscreening is going to reveal.

He also claims that “chronic diseases account for $3 out of every $4 spent on healthcare.” Here’s what the CDC really said: $3 out of every $4 “is spent on people with chronic conditions.”  That is a much broader statement. It would include someone with borderline hypertension giving birth.  In any event, we long ago eviscerated Mr. Williams’ cherished myth and just this week showed that essentially none of the top 25 hospital admissions has anything to do with screening, broccoli, or Fitbits.


#9 Cerner

The employee who recorded this blood pressure is essentially dead. Cerner’s diagnosis?  Blood pressure “higher than what is ideal.” Cerner’s recommendation? “Talk to your healthcare provider.”   A real doctor’s recommendation?  “Call an ambulance. The guy barely has a pulse.”

cerner pulse

This is not a random mistake.  This is the front cover of their brochure.


#8 Nebraska/Health Fitness Corporation

USPSTF Screening age recommendations aren’t minimums.  They are optimums, the ages at which screening benefits might start to exceed harms, even if they still fall far short of costs.  Otherwise you are taking way too much risk.  This is especially true for colonoscopies, one of this program’s favorite screens — complications from the test itself can be very serious.

Your preventive coverage is not supposed to be “greater than health care reform guidelines.” That’s like “rounding up twice the number of usual suspects.”  And you aren’t supposed to waive “age restrictions.” That’s like a state waiving minimum “age restrictions” to get a driver’s license.

nebraska screening guidelines

Yet despite or perhaps because of this and other examples of total cluelessness and pure dishonesty, this program won a C. Everett Koop Award for excellence in wellness, not to mention the unwavering support and admiration of leading wellness apologist Ron Goetzel.


#7-#6 (tie) ShapeUp and Wellness Corporate Solutions

Both these outfits pitch exactly the opposite of what you are supposed to do in weight control:  unhealthy crash dieting.  Attaching money to this idea and setting a start date makes it even worse: along with crash-dieting during these eight weeks, you’re incentivizing employees to binge before the initial weigh-in.

Here is ShapeUp:

Lose ten pounds in eight weeks

Here is Wellness Corporate Solutions:

wcs-weight loss challenge

Both also made up outcomes. In ShapeUp’s case they had to rescind their “findings” after their customer, Highmark, skewered them in the press.  And neither seems to care that corporate weight control programs are proven not to work.


#5 Aetna

In addition to its dystopian wellness program that collects employee DNA (partnered, ironically, with a company called Newtopia) and then makes up savings, Aetna owns the distinction of launching the only wellness program whose core drugs are specifically editorialized against in the Journal of the American Medical Association.  This would literally be the most harmful wellness program ever, except that the only employees being harmed are (1) obese employees who (2) answer the phone when their employer’s health plan calls them to pitch these two drugs; (3) have a doctor who would willingly prescribe drugs that almost no other doctors will prescribe due to their side effect profile; and (4) not google them.  Presumably in combination this is a very low percentage of all employees.

The good news is that these drugs, Belviq and Qsymia, should be off the market in a couple of years because almost no one wants to take them, so the harms of this Aetna program should be self-limited.

#4 Star Wellness

Star Wellness offers a full range of USPSTF D-rated screens. “D” is the lowest USPSTF rating, and means harms exceed benefits.  Star gets extra credit for being the first wellness vendor to sell franchises. All you need is a background in sales or “municipal administration” plus $67,000 and 5 days of training and you too can poke employees with needles and lie about your outcomes.  Is this a great country or what?

Also, their vaccination clinic features Vitamin B12 shots. We don’t know which is more appalling–routinely giving employees Vitamin B12 shots, or thinking Vitamin B12 is a vaccine.

star vaccines


#3 Angioscreen

Angioscreen doesn’t have the most USPSTF D-rated screens. In fact, it offers only one screen in total, for carotid artery stenosis.  That screen gets a D grade from USPSTF, giving Angioscreen the unique distinction of being the only vendor 100% guaranteed to harm your workforce.

Carotid stenosis D

Angioscreen’s other distinction is that they admit right on their website that this screen is a bad idea.  This is probably literally the only non-tobacco company in America to admit you are better off not using their product.


#2 Total Wellness

Total Wellness loses the wellness industry’s race to the bottom only because the winner, HealthFair, has out-stupided them.  However, in addition to the usual assortment of D-rated tests, they offer screens that the USPSTF hasn’t even rated, because it never, ever occurred to them that anyone would ever use these tests for mass screening of patients or employees. Criticizing the USPSTF for not rating these “screens” (CBCs and Chem-20s) would be like criticizing Sanofi-Aventis for not warning against taking Ambien after parking your car on a railroad crossing.


#1 HealthFair

Let’s leave aside for a fact that the majority of their other screens are harmful too, and focus on their screening for H.pylori, the strain of bacteria associated with ulcers. To say it is a stupid idea would be an understatement. As Clarice Starling replied when asked if Hannibal Lecter was a sociopath: “They don’t have a word for what he is.”

Likewise, this idea is too stupid for words, certainly for the small number of words we can allot to this overview blog. Visit our full treatment here.  In a nutshell, the majority of us harbor H.pylori–without symptoms. It may even be beneficial. The screening test is expensive and notoriously unreliable, and the only way to get rid of it is with some very powerful antibiotics, a treatment rarely even used on patients with symptoms due to its inconvenience, ineffectiveness and potential long-term side-effects.

A Modest Proposal

So how should we as a country protect employees from these harms?  Our policy recommendation is always the same, and very non-intrusive. We aren’t saying wellness vendors shouldn’t be allowed to harm employees.  That would be too radical to ever pass Congress.  If it did, the Business Roundtable would pressure the White House again, to preserve their hard-earned right to medicalize the workplace, and literally and figuratively, show employees who’s boss.

Instead, we recommend merely a disclosure requirement.  The harms of screens or (in United Healthcare’s case) screening intervals that don’t earn at least a “B” from USPSTF should be disclosed to employees, and employees should get a chance to “opt out” into something that isn’t harmful (like Quizzify, perhaps?) without suffering financial consequences.  Call us cockeyed optimists, but we don’t think employers should be able to force employees to choose between harming themselves and paying fines.

They Said What? makes list of three top healthcare websites

OK, so maybe this news got pushed off the front page by the other prizes announced this week, but They Said What? made the list of Tom Emerick’s three favorite websites.

TSW occupies a unique niche, Rachel Carson-meets-wellness-meets-Dave Barry.  As an added bonus, all of our wellness statements are true, which makes us unique in the field (and explains why we have been blacklisted by many conference organizations).

Most importantly, we are in august company with the other two selected sites.  Not Running a Hospital and The Doctor Weighs In are both take-no-prisoners websites as well, and we recommend both.


Disclosure:  I co-authored Cracking Health Costs with Tom Emerick.  I don’t exactly expect a Nobel Prize for integrity here for simply pointing that out, but typically wellness vendors don’t disclose things like, oh, I don’t know, sponsoring the committee that gives their customers awards or even mentioning that the program they are “applauding” is their own.  Although in this case — Health Fitness Corporation and Nebraska — full disclosure would have also required them to admit that the entire thing was made up.  And therein lies the problem wellness vendors face.  In wellness, ethics is more than just a slippery slope.  It’s more like Half Dome coated with WD40.

 

 

Mr. Goetzel Covers Up his Cover-Up: The latest on the Nebraska Koop Award

To our new readers, while 2016 was the first time a Koop Award ever went to a company that harmed employees, 2016 wasn’t the first Koop Award ever to go to a company whose own data showed they fabricated results. Below is a history of one of the Koop Award’s Greatest Hits.


For those of you who haven’t been following the saga of the Nebraska state employee wellness program, here is a crash course, aka “Lies, Damn Lies, and the Nebraska State Wellness Program.”  If you have been following it, you can skip to the end for the latest installment, Mr. Goetzel’s cover-up of his cover-up.

By way of background, this program is called “wellnessoptions” (imagine e.e. cummings-meets-poking employees with needles-meets-a sticky spacebar).   They used to say the Holy Roman Empire was neither Holy nor Roman nor an Empire.  Likewise, wellnessoptions is neither optional, if you want a decent deal on healthcare, nor wellness. Instead of wellness, it features a hyperdiagnostic anti-employee jihad in which Health Fitness Corporation (HFC) diagnoses employees but does nothing about the diagnosis except take credit for it.

TIMELINE — PART ONE: HFC’S TROUSERS COMBUSTED

September 24, 2012, 2:00 PM

I read Health Fitness Corporation announcement that its customer, the state of Nebraska, won Ron Goetzel’s C. Everett Koop Award for program excellence.

September 24, 2012, 2:01 PM

I recognize that the cancer outcomes were obviously made up.  Until then, I hadn’t been following the Koop award closely enough to realize that making up outcomes was apparently one of the award criteria, as I later came to learn.

October 2012

I read the full write-up on the program and realize that not only were most of the other outcomes made up, but they had actually lied about saving the lives of cancer victims.  If you screen a few thousand people for colon cancer, you don’t find 514 cases of cancer, and you certainly don’t save their lives, as HFC was claiming.  And you absolutely don’t save money, as they were also claiming.  All this is even more true when you waive age-related guidelines and let anyone get screened, and encourage overscreening by sending out 140,000 letters to state employees graced with the picture of a beautiful young model way too young to be getting a colonoscopy.

 

age related colon cancer screenings

How this invalid nonsense ever got by all the eagle-eyed Koop Committee members would be a mystery, except that HFC is a sponsor of the Koop Committee.

December 2012

I review the entire application and all the marketing materials.  It becomes obvious that the entire thing was made up, not just the cancer part. They claimed to save $4.2 million because 161 of their roughly 6000 participants reduced a risk factor.

The math is quite self-evident.  Suppose you doubled the number of participants who reduced risks to 312.  It stands to reason that you could save $8.4-million. Double it again to 624 and you save $16.8.

Now double it one more time. If 1,248 people out of those 6000 reduced one single risk factor, you’d save $31.6-million, which is about equal to the entire spending for all 6000 participants.  And of course most medical spending has nothing to do with identifying previously unrecognized risk factors, so this would be quite a feat. (Do you even know anyone under 65 who had a heart attack that could have been avoided by one more workplace screening?)

I later learn that all the Koop Award-winning program outcomes are made up, using exactly the same math.

November 2012 to June 2013

I try to contact the authorities, like Roger Wilson, who allegedly runs this program for the state, but no one seems to care. The rule of thumb in the wellness industry is that what you say counts.  What you do is pretty irrelevant.

June 20, 2013

Breakthrough: The Wall Street Journal editors decide that I am correct, and that the outcomes were made up.  Vik and I are allowed to publish this on their op-ed page.

July 14, 2013

Breakthrough again: Another very well-read blogger professes shock-and-awe that any vendor could lie so blatantly and apparently get away with it.

July 15, 2013

Breakthrough yet again: Ace reporter Martha Stoddard of the Omaha World Herald gets Dennis Richling of Health Fitness Corporation to admit that the outcomes — at least the “life-saving catches” of “early stage cancer” outcomes — were indeed made up.  Richling tries to spin his gaffe by calling the difference between “life-saving catches of early-stage cancer” and saying someone might possibly get cancer in the future “semantics.”   So, according to Richling, having cancer and not having cancer are the same thing.

February 1, 2014

The hilarious wellness industry smackdown Surviving Workplace Wellness is published.  Since the HFC Nebraska program had too many lies to fit on a page or two, it gets its own chapter.  Here’s the opening paragraph, which in all modesty I must admit is one of my favorite in the book.

sww nebraska chapter

February 23, 2014

Nebraska political blogger ReadMoreJoe picks up the scent.  He points out that this wellness program is an obvious fraud.  The problem is that the same posting is also exposing several other equally obvious frauds, so this one gets overlooked.

TIMELINE–PART TWO: GOETZEL STRIKES BACK

Ron Goetzel isn’t about to sit back and let his friends/sponsors/clients be pilloried for a little white lie about saving the lives of cancer victims who didn’t have cancer.

June 2, 2014

At the Health Datapalooza conference, Ron Goetzel, while admitting the Nebraska cancer outcomes data was made up, claims they/HFC still deserve the Koop Award because he somehow didn’t realize the data was made up at the time the award was granted.  And it is true that HFC didn’t actually announce they had made up the outcomes.  Ron would have had to actually read the materials to figure it out, same as I did.

nebraska cancer cases

September 2014

Ron Goetzel calls the Nebraska program a “best practice” in the Journal of Occupational and Environmental Medicine but refuses to answer any questions about the obvious mistakes and inconsistencies in the article.

list of best practices

November 2014

After knowing for 16 months that they had lied, Ron Goetzel, writing in Employee Benefit Newsfinally drops Nebraska from his list of best-practice programs:

goetzel ebv 1

Being a fair-minded person, I take it upon myself to congratulate him on his newfound sense of ethics.  I don’t specifically agree that what he did was ethical, because the ethical thing would have been to admit complicity, apologize, and revoke their Koop Award.  But I do say that Nebraska being dropped from the list of best practices means ethical “progress is definitely being made,” albeit from a low base.

goetzel ebv 2

Only 29 minutes elapses before Ron erases all my illusions about his honesty and re-adds Nebraska to the list of “best practice organizations.”

goetzel ebv 3

He also adds PepsiCo to the list.  I guess losing only $2 for every $1 you spend qualifies as such in wellness, where most organizations lose much more.

May 2015

In a rally-the-base invitation-only webinar, we are told that Ron has promoted the Nebraska program from “best practice” to “exemplar.”  It seems like the more obvious it becomes that the whole thing was fabricated, the more Mr. Goetzel worships its outcomes.

TIMELINE–PART THREE: RON STANDS ALONE

September 2015

WELCOA finally takes the fabricated case study of Nebraska’s outcomes off their website, 26 months after the fraud was admitted. Perhaps some pressure is being put on them to come clean, given that this is Nebraska’s program and they themselves are based in Omaha.

Just for the record, I’m not saying that an organization founded by all-you-can-eat cafeteria magnate “Warren Buffet” knowingly kept a false document on their site for those 26 months. History suggests they might just be slow learners.  [2016 update: WELCOA is under new management, and they appear to be doing a great job, as exemplified by their development of the Employee Health Program Code of Conduct.]

This means Ron Goetzel is literally the only person left who thinks it’s perfectly OK — indeed, a “best practice/exemplar” — to lie about saving the lives of cancer victims.  Good luck with that in the upcoming debate.  It’s him against the world.

Or, as he sees it, everybody’s out of step but Ronnie.

October 2015

Nebraska tentatively re-awards the wellness contract to Health Fitness Corporation.  I am looking over the precipice towards utter humiliation.

TIMELINE–PART FOUR: THE ORIGINAL DATA DISAPPEARS

November 2, 2015–the original cover-up, on the morning of the Great Debate

At our urging (and we must confess to delighting in creating this “Sting” operation), a third party alerted Mr. Goetzel to the fact that, his protestations to the contrary, the Koop Award Committee did know (even if they had somehow not seen the marketing materials quoted above) that Health Fitness Corporation was making fictitious claims about saving the lives of cancer victims.  It was right in the award application.  The original award application from Nebraska had originally stated (underlining is ours):

nebraska cancer original redlined

But then, a hour following the call from this third party the morning of the debate, the original award application suddenly read:

nebraska doctored application

In the original application, this excerpt appears in a letter from the Governor of Nebraska. Only now the Governor’s letter says the opposite what he actually wrote.  In the real world, this would be considered forgery.  In wellness, a forged cover-up of a blatant and admitted lie about saving the lives of cancer victims who didn’t have cancer is considered business as usual. Johns Hopkins and Truven (Ron’s employers) don’t seem to mind either.

April 2016

The state is rescinding its award to Health Fitness and terminating its wellness program. In the immortal words of the great philosopher Stewey Griffin, victory is mine.


September 2016: The cover-up of the cover-up

Mr. Goetzel finally acknowledges that Health Fitness Corporation told a whopper, and the Koop Committee accidentally overlooked it. He now calls this an “erratum.”  The technical term for it is a “lie-um.”  You can’t forge official state documents and then call the whole thing an “erratum.”  Is a robber allowed to give the money back after he gets caught and just uncommit the crime?

nebraska-erratum

So now, having admitted that the award-winning vendor told the biggest lie in wellness history (once again, quite a feat), and knowing that all the obviously fabricated outcomes were mathematically impossible, and that waiving age restrictions for screening is akin to waiving age restrictions for buying beer, the Koop Committee finally, after 4 years, rescinded the Nebraska award.

Haha. No one falls for that line any more.  Quite the opposite, they are doubling down. They say that whopping lies like this one don’t matter, if you are an award sponsor. You get to keep your award.

Ditto, if your entire claim of “separation” between participants and non-participants is shown to be false but you are sponsor, Ron merely doctors the data and you get to keep your award.

Also, if it turns out you lied about your savings because there was no change in the biometrics to attribute the savings to, but Ron was a consultant on your project, you get to keep your award.

Likewise and as was confirmed in 2016, if you are a committee member, as Wellsteps’ CEO was until recently, despite your own data showing that you actually harmed employees, you get to keep your award.

Bottom line: as a friend-of-Ron, you might get to keep your award even if you shoot someone on Fifth Avenue.

 

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.”

separated at birth

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.

staywell grossmeier quote

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.

graco sales

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.

HFC full color

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.”

hfc 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:

hfc rewritten

The original was:

HFC Eastman Chemical wellness data

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.

pfizer

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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