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Wellness imitates Dilbert
Incredibly, events unfolded almost exactly this way at Penn State during their well-publicized wellness debacle 5 years ago. It was even funnier in real life because while exercise does of course promote wellness, faculty and staff were very restricted in their use of campus recreational facilities. Making those free to employees and dependents was not part of their wellness initiative.
No, instead employees were being forced into an outcomes-based wellness program, one that was supposed to save “millions of dollars.”
Coincidentally, while the Penn State HR department — ably assisted by Ron Goetzel, who later denied having anything to do with them despite being in their press conference – was trying to force employees into these programs, the Penn State bakery announced an expanded selection of pastries and desserts for the upcoming semester.
Penn State’s was, to paraphrase the immortal words of the great philosophers Gilbert & Sullivan, the very model of a modern forced wellness program. Sure, they violated clinical guidelines. That seems to be the price of entry for wellness. More head-scratchingly, women had to disclose whether they intended to become pregnant, or else pay a $1200 fine. This requirement was designed to, in the Highmark representative’s own words in a rather contentious faculty meeting — “help” them. That would be like offering to “help” the proverbial little old lady cross the street — but if she declines assistance, saying: “OK, then pay me $1200. The choice is yours.”
Full disclosure: Highmark has now abandoned their old outcomes-based wellness program on which Penn State’s was based in favor of a much lighter and more appropriate program, and we wish them the best at it. All indications are that it is going very well and is a model for others. A total turnaround.
Back to the storyline…
There is something about forced outcomes-based wellness programs that brings out employers’ inner stupid, and Penn State was no exception. Consider: almost by definition women who are planning to become pregnant have thought about it and have done the basic research. It’s the women who accidentally become pregnant who may possibly have the need for assistance. And even the dumbest HRA wouldn’t ask the question: “Are you going to accidentally become pregnant?”
So, using the very unlikely assumption that women completed the HRA honestly, Penn State’s forced disclosure requirement would have identified 100% of the people who did not need “help,” while missing 100% of the women who might. If you’re keeping score at home, that’s 100% false positives and 100% false negatives. That’s a lot even by wellness industry standards. Eat your heart out, Interactive Health.
And did I miss the memo where carriers were anointed the prime providers of medical “help”? Has anyone ever said to you: “You don’t look so good today. Better call your health plan”?
See https://theysaidwhat.net/2016/04/22/the-story-of-an-employee-who-benefited-from-wellness/ for the back story.
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Pittsburgh Post-Gazette Bullies Shape-Up
In wellness, “bullying” is apparently defined as “asking hard questions, particularly to people who make claims they refuse to defend.” This time it’s not us bullying anyone. It’s the Pittsburgh Post-Gazette bullying Shape-Up, in a reprise of the last time Shape-Up challenged our numbers.
Guess who won, again? (Hint: you won’t see this link on Shape-Up’s website.)
And kudos to the Pittsburgh Business Group on Health for its forward-thinking quotes on the value of wellness programs.
Mrs. Brooks, whose business group members represent some of the region’s largest employers, said workplace wellness “has become a commoditized multibillion-dollar industry versus a value-based solution that addresses the whole.
What happens when Jeopardy collides with Comedy Central and healthcare?
“We need to figure out how to motivate employees. Many programs today aren’t strategic or focused and, more importantly, culturally integrated into how companies do business.”
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ShapeUp Falls Down Trying To Do Math For Highmark
ShapeUp
“By uniting people based on common health interests and goals, and empowering them to spread the word by inviting their colleagues to join, the program created thousands of connections and enabled Highmark to build a grassroots communication strategy that reached the company’s entire employee population. This strategy, combined with the organic spread of peer-to-peer motivation, support and accountability, helps launch and sustain successful company-wide wellness challenges year after year.”
Materials Being Reviewed
ShapeUp’s Case Study of Highmark employees’ weight-loss program. Highmark is a 19,600-employee Blue Cross health plan headquartered in Pittsburgh, PA.
Summary of key figures and outcomes:
Questions for ShapeUp:
Out of Highmark’s 19,600 employees, are we right in calculating that only 163 (0.8% of the total, or 1.3% of participants) improved their BMI status?
ANS: Refused to answer
If about 9000 people (46% of 19,600) lost an average of 5.6 pounds, how come only 163 shifted to a lower weight category? Statistically speaking, shouldn’t roughly 1800 people have crossed the threshold into a lower category if the average weight loss was 5.6 pounds?
ANS: Refused to answer
Do you have a sense of how many people, on average, would improve their BMI status over this same (undisclosed) period absent a formal workplace wellness program, through initiatives undertaken on their own?
ANS: Refused to answer
How come you didn’t reveal the number of employees whose BMI status deteriorated over that period?
ANS: Refused to answer
How many people dropped out of the program, due to disappointing results or other factors?
ANS: Refused to answer
The program was quite brief, and it’s generally accepted that short-term weight loss rarely translates into long-term weight maintenance. Were participants able to keep the weight off after the program ended, or was this largely short-term weight loss?
ANS: Refused to answer
If indeed you were to add back in non-participants, dropouts, people whose BMIs went up, and people who were unable to keep the weight off after the program ended, it is possible that the 0.8% success rate would actually be lower?
ANS: Refused to answer
You equate “improved health” with reduced weight and propose “losing 10 pounds in 8 weeks,” but couldn’t reduced weight in a short period be due to crash-dieting, which would not be healthy?
ANS: Refused to answer
Why would a program as “motivating” (using your own word) as ShapeUp’s need to be accompanied by Highmark’s $4200 fines for non-participation, believed to be the highest in the country?
ANS: Refused to answer
August 20–Score one for They Said What: ShapeUp has taken down its boast about this 0.8% short-term improvement in weight classifications. We hope that this is a step in the right direction and that they will seek validation from a legitimate validation source going forward. We doubt it but look forward to being proven wrong.
March 8–Pittsburgh Post-Gazette lets Highmark pile on, explaining why they fired ShapeUp.
They Said What? 