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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?)

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.

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.

 

 

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.

News flash: The Wellness Ignorati are ignoring facts for a change

No more deception

There has to be a limit, even to deception

The Wellness Ignorati got their name by ignoring facts. Facts, of course, are the wellness industry’s worst nightmare. They ignore them In order to avoid creating news cycles that might reach human resources departments despite the best efforts of their consultants and vendors to shield them from actual information.

And they’re at it again.

First, Atul Gawande wrote a scathing article in the New Yorker about massive overscreening earlier this month. As Mitch Collins noted in The Health Care Blog, not a peep in response from the perpetrators of those hyperdiagnostic jihads. Nor has their been any response to Mitch’s article itself. Literally, no one defends wellness industry practices. And yet somehow all the laws are on their side.

Speaking of which, Mitch mentioned the famous Nebraska debacle, in which the vendor, Health Fitness Corporation, lied about making “life-saving catches” of “early-stage cancers.”  Since HFC was a sponsor of Ron Goetzel’s Koop Award, Ron naturally gave them that prize for these lies.

However, we’ve thrown down the gauntlet. HFC, come on out and fight. Give us your side of the story. How was this not a deliberate lie designed to score political points in Nebraska?  If it was a mistake, why didn’t you change it and apologize? How do those 514 cancer non-victims feel? And Mr. Goetzel, why do you not only keep defending HFC, but have even upped the ante? They’ve been promoted from “best practice” to “exemplar” in your most recent webinar.

Quizzify Q in B and W

As long as wellness vendors are silent, we won’t shut up.

Speaking of non-responses from Mr. Goetzel, where is the correction of or explanation for the massive mistake in Mr. Goetzel’s most recent wellness program evaluation? All those readers have been misled by his blog into thinking Graco’s costs/employee are $2280/year when in reality the cost per employee contract holder — according to Mr. Goetzel’s own blog — is about  $11,100, like almost every other company. (That includes spouses and dependents but any reasonable dependent ratio would yield more like a typical $5000 to $6000 per employee rather than $2280.) I know he knows about this mistake because I’ve submitted a comment to his blog, which shockingly hasn’t been posted.

So, please, could someone actually respond for a change, even if it’s just to accuse us of bullying.

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