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An apology for my previous dismissive statements made publicly on Linkedin

Usually when I post an “apology” it is phony, like: “I apologize for calling Wellsteps’ arithmetic fabricated. I should have called Wellsteps’ arithmetic completely fabricated.

Here’s a similar apology, for Professor Baicker’s infamous “Workplace Wellness Can Generate Savings” meta-analysis claiming the 3.27-to-1 ROI from wellness that RAND also eviscerated:

I had been quite adamant in the previous post that this meta-analysis was likely just a gold-plated package of garbage case studies. I compared it to packaging subprime home loans into AAA-rated collateralized mortgage obligations (CMO).

That was before I looked at the individual studies comprising this meta-analysis. I realize now that comparing the Harvard Study to the CMO scam was unfair. So I owe an apology to Bear Stearns, Lehman Brothers, and Countrywide.

Next, I apologize for pointing out that Ron Goetzel, as recently as last week, is still quoting this very same thoroughly discredited 7-year-old study, as well as many other outdated analyses. For example, he insists on continuing to quote the New York Times economists’ September 2014 analysis that wellness programs “generally” don’t work, even though they subsequently made their conclusion much clearer: “We’ve said it before, many times and in many ways: workplace wellness programs don’t save money.” They then specifically criticized Mr. Goetzel’s own methodology (“industry studies based on study designs that cannot produce valid causal estimates”).

I apologize for thinking that this deliberately selective misinterpretation of these economists’ previous conclusions makes him sound deceitful.  And I apologize for being sure that the people who forwarded me this slide would agree with that assessment. And I apologize for once again making phony apologies.

goetzel-watson-health

goetzel-nyt-clipping


The real apology

Now that I’ve checked off the usual Wellsteps-and-Goetzel-integrity boxes, it’s time to step out of character and seriously apologize. Here’s what I did that I really do need to apologize for:  not cutting wellness professionals enough slack on giving them enough time to learn what took me several years to learn about wellness losing money.

I was once guilty myself of believing this 3-to-1 ROI nonsense, specifically about disease management (DM).  Why DM in particular? I had some ego wrapped up in it because I am actually credited with inventing DM. Really.  Just google on “invented disease management.” Whether or not I did (and plenty of others could share the credit), I was not just drinking the DM Kool-Aid. I was mixing it up and selling it to others.

Then, 10-12 years ago, a few people told me none of the DM savings numbers added up. I didn’t believe them. I thought it was sour grapes because they missed the boat.

True, I had enrolled a few of my own extended family members and friends into DM programs. Vendors were more than happy to offer me their best nurses, VIP treatment, you name it. Yet no one I referred thought these free programs were even worth a second free phone call.

Nonetheless, I was sure that somewhere there existed a whole lot of employees who did benefit from DM. Yes, in my fantasy world tons of people really appreciated these unsolicited calls from their health plan offering to help. After all, who among us doesn’t trust an unsolicited caller from their health plan offering to help?

In my worldview, the lucky recipients of these calls would respond: “You’re right. I should be taking my pills. Hey, thanks. I never would have thought of that on my own. And I was just about to have a heart attack, so you saved a ton of money.”

Yes, I realize this made no sense. Yet I never questioned my own findings. Basically, I ignored the warning signs about DM’s sketchy economics for years.  When I finally had the epiphany, it got quite the headline:

A Founding Father of Disease Management Astonishingly Declares: “My Kid Is Ugly.”

Once I questioned my own figures, the rest because immediately obvious to me — one after another after another, sets of numbers in this field simply did not add up. Wellness was a far worse offender than DM, which does appear to roughly break even or better.  No surprise about wellness. Screening costs about 10 times as much as DM and whereas people who qualify for DM are already well down the slope to infirmity, screens are performed mostly on healthy employees, who can’t generate any savings. (We of course support screenings according to guidelines, for the health of employees rather than an ROI. But most vendors ignore guidelines and screen the stuffing out of employees.)

Still, it had taken me years to have the initial epiphany…and yet now I was quite curt and dismissive with other people who didn’t immediately get it, and were defensive in support of their lifelong assumption.  I was basically saying to others in the field: “You know all those savings claims? Total malarkey.  Prying, poking and prodding doesn’t save any money.”  I’d expect everyone else to get this right away.  When they didn’t, I was not gracious with them in many cases.

Over time, a large number of folks have come around. They did it at their own speed, same as I did.  Take WELCOA, for example. They were among the worst (and God bless ’em, funniest) offenders…and yet now you won’t find an organization more committed to getting wellness right, helping employees, and being honest than WELCOA. (In their case, a night-and-day change of leadership helped.)  I’m not just saying this–I’m walking the walk. Quizzify is joining WELCOA’s Premier Provider Network for 2017, joining vendors I have a lot of respect for, like It Starts with Me, Populytics, and SelfHelpWorks. The first two, also like Quizzify, are validated by the Validation Institute.


Making good on the apology

A good apology comes with an offer to make it up. So if you feel like I dissed you prematurely, while you were learning wellness economics on your own, you can have one of:

  1. a free pdf of any of my books — Surviving Workplace Wellness, Cracking Health Costs, or Why Nobody Believes the Numbers
  2. half-price on a hardcopy of those books (order direct, not through Amazon, of course)
  3. a free analysis of any outcomes report
  4. a free month of Quizzify with no commitment (there is a minor asterisk on this one, please inquire)

Is Katherine “3.27-to-1” Baicker Coming in from the Dark Side?

In the workplace wellness epidemic, Harvard School of Public Health Professor Katherine Baicker is Patient Zero. However, she may soon come up with the cure for the disease she spread. This would be like when the inventor of the PSA test said it shouldn’t be used.

By way of background, her original dalliance with wellness in Health Affairs–timed and designed to get the Business Roundtable’s “Safeway Amendment” allowing a 30% to 50% clawback of insurance premiums into the Affordable Care Act–introduced the infamous “3.27-to-1 ROI” into wellness vendor vernacular.  That was almost seven years ago, but wellness vendors continue to cite this figure as gospel even though RAND demolished it and Professor Baicker herself walked it back four times.

For good reason, as it turns out — this Pulse posting says it all.  The 10-to-30-year-old studies comprising her meta-analysis are even more amusing in retrospect.  Lots of overcreening, overreliance on now-discredited BMIs, and of course recommendations for low-fat diets–even for employees with metabolic syndrome. Most published in third-tier journals, by the Wellness Ignorati and their friends.

And almost every one of them compared active motivated participants to non-participants.  6 years ago we suspected that design was invalid.  Today we know for certain, thanks to Health Fitness Corporation and Aetna. Two more elegant studies to prove that point could not be imagined. No “investigator bias” or “publication bias” there, since both were hoping for the opposite finding.

However, mindful of her reputation, Professor Baicker recently announced (in as many words) that she is going to redeem herself.

Wellness Workdays

Her protestation that she is no longer interested in wellness appears to have taken a backseat to her desire to remove this one blot–granted, a blot of Lady MacBeth proportions–on an otherwise excellent curriculum vitae.

She is going to do a study for BJ’s Wholesale Club, in conjunction with an outfit called Wellness Workdays.  Wellness Workdays is a classic wellness vendor. That is to say, they won’t be winning a Nobel Prize anytime soon, or even a spelling bee. Let’s start by examining their analytic and clinical prowess.

To start with, their “White Paper” doesn’t just quote the infamous 3.27-to-1. They’ve upped the ante to 6.00 to 1, maintaining the two significant digits while almost doubling the savings.  How? They’ve added the 3.27-to-1 for healthcare savings to the 2.73-to-1 for absenteeism reduction from that same 2010 study. Those two separate conclusions were reached from almost totally different studies. Anyone can tell that from reading the original.  Anyone, that is, except Wellness Workdays.

Their analytic qualifications are matched only by their clinical qualifications. One member of their medical advisory board is Chief of Allergy and Clinical Immunology at the Indian River Medical Center in Vero Beach, Florida.  While this expertise is not exactly central to the mission of the pry,poke, and prod industry, in all fairness it should be noted that the Indian River Medical Center runs one of the best allergy programs in all of Vero Beach.

Another is an OB-GYN in Colorado.  Perhaps this advisor will develop a protocol for employees who want to be screened and induced at the same time.  A third consults to orthopedists at “Lennox Hill Hospital,” a role that probably doesn’t require too much heavy lifting, because there is no hospital by that name.

lenox hill

This guy is also an expert on steroids and other performance-enhancing products, and has “published rseveral esearch studies.”

wellness workdays

So they can’t spell, can’t proofread, can’t understand study design, and can’t cobble together a qualified advisory board.  In other words, to paraphrase the immortal words of those great philosophers Gilbert & Sullivan, they are the very model of a modern clueless wellness vendor.

Katherine Baicker’s proposed study design

We are confident she is going to get it right this time and “discover” that wellness loses money. By selecting a vendor of the caliber of Wellness Workdays, she isn’t leaving anything to chance.

Having learned her lesson — and I’ve been pretty conscientious about forwarding helpful study design materials to guide her — she will certainly tally wellness-sensitive medical events across the entire population. More importantly, here’s what she is not going to do with this study:

  • “Match” volunteer participants to — you guessed it — non-participants. This nonsense that keeps the wellness industry afloat, and Professor Baicker no doubt sees right through it;
  • List the “unobservable differences” between participants and non-participants as a “limitation.” It’s not a limitation. It’s a baldfaced lie.  It is now known that this face-invalid study design is truly invalid. She wouldn’t lie, right?  That would damage the reputation of the entire Harvard School of Public Health in what will certainly be a high-profile study;
  • Show a high ROI even though the change in health risk factors is trivial. This of course is the stock-in-trade of the Koop Award committee, but a real academic researcher would know better;
  • Compare the costs to “trend” and say “costs were projected to rise by [this amount] but they only rose by [this lower amount], and therefore a huge pile of money was saved”;
  • Attribute all cost differences to the program, whereas a real researcher would look only at utilization differences that could actually be attributed to urging employees to eat more broccoli. (By contrast, one of the studies in her previous meta-analysis credited the wellness program with a reduction in cat scratch fever.)

How do we know she isn’t going to make up phony outcomes again?  She “tipped her hand” with the Oregon Medicaid lottery study.  A terrific natural experiment, her study emphasized the value of a “lottery control,” meaning every subject had the same intent-to-treat. Exactly the opposite of the wellness participants-vs-non-participants study design.

Further, who wants to be known as the Typhoid Mary of workplace wellness? The Oregon study was an excellent one, so naturally it showed exactly the opposite of what wellness studies show. Specifically, facilitating access to care doesn’t reduce the cost of care or improve physical health status. And that was for people — newly minted Medicaid recipients — who didn’t have any insurance to begin with.  Wellness, of course, takes employees who already have plenty of access to care and drown them in even more, unwanted and largely unneeded, screenings and checkups.

As for BJ’s Wholesale Club, I suspect they got suckered into this. Who volunteers to become the next Pepsico, a case study of how wellness programs fail?  BJ’s obviously isn’t studying their own competitors: Target has one of the best programs in the country — precisely because they are far too smart to use a vendor like Wellness Workdays.

In any case, we look forward to her research study. Or perhaps, since this is in conjunction with Wellness Workdays, to rseveral esearch studies.

 

Wellness Industry Leaders Help the CDC Build a Maginot Line Against Disease

If you listen to the Centers for Disease Control and Prevention (CDC), you would think chronic disease is the main health problem we face, and workplace wellness is the main weapon we have to face it with.  I know what you’re thinking (at least for the former): isn’t it?

Nope.  The country’s main health problem — at least among those addressable by the CDC as opposed to by Congress — is something else altogether, essentially the opposite of what the Wellness Ignorati say it is. But before we reveal the answer, let’s review the CDC’s chronic disease talking points, which naturally are hilarious, as most talking points in support of wellness tend to be.

First, in the screenshot below, they quote the “arresting” statistic that “7 out of 10 deaths are due to chronic disease.” Um, that is called civilization, folks. Countries where 7 out of 10 deaths are due to causes other than chronic disease would love to have this arresting statistic. In case anyone doesn’t believe that the CDC — or indeed, that any human being other than a wellness vendor — could possibly be so stupid as to think civilization is a problem that needs solving, here is the screenshot, and here is the link.

cdc statistic

Second, they recently bumped the “75% of costs are due to chronic disease” urban legend in the first line of the screenshot to a mind-boggling 86%.  Surely even the dumbest CDC employee can’t believe this. Surely they can back-of-the-envelope an estimate that birth events, preventive care, and trauma alone account for much more than 14% of spending. Birth events by themselves account for about 16% of all hospital discharges.

Meanwhile, wellness vendors are now flogging those “7 of 10 deaths” and “86% of the nation’s healthcare cost” statistics to lobby Congress for wellness subsidies. Congress had wisely stopped funding one of the CDC’s many wellness boondoggles (Work@Health). That didn’t sit well with the industry, so they are starting a lobbying campaign. Fortunately, if their lobbying prowess is anything like their wellness prowess, the budget deficit is not likely to increase anytime soon. The letter reads:

wellness lobbying letter


Here is the real problem

This would all be very amusing, as the CDC and wellness vendors converge on these two statistics like monarch butterflies of innumeracy, except that our health is stake. And that (finally) brings me to the title of this posting.

The Maginot Line, as you might recall, proved about as worthless combating the Nazis as the CDC’s wellness obsession is today in combating the real healthcare problem: a massive explosion in blood-borne infections, or septicemia. While the CDC, wellness vendors, and of course the Health Enhancement Research Organization are all atwitter about diabetes and heart attacks (which none of these people can prevent and whose admissions in combination have been in check in all subpopulations for many years), consider ICD-9 038.9, Septicemia. There were 928,000 inpatient cases in 2013, the last year available.

hcup septicemia underlined

It’s not just that it’s huge, almost twice as costly as the next most costly ICD9. It’s also exploding:

septicemia

How can the CDC run around fulminating that chronic disease costs have jumped from 75% to 86% of total spending, when septicemia, the most acute condition of all:

  1. has increased almost sevenfold;
  2. is now the by far the largest single diagnosis code;
  3. twice as costly as the second-largest…
  4. …and its growth is accelerating?

More importantly, why doesn’t anyone at the CDC seem to care about pathogens? This is what they are supposed to do–identify pathogens and prevent, contain or eradicate them.

Literally anyone (almost 1 in 300 people annually) could get a cut or injury or infection in the hospital, get septicemia, and, 13% of the time, die. Yet the CDC is blissfully unaware of this. If you’ve heard this “blissfully unaware” song before, the CDC’s Wellness Watchdogs also completely missed the workplace opioid epidemic. That happened right under their noses. The drugs were legal, prescriptions were filled, and PBMs paid for them.

Where was the CDC when this was happening? The same place the wellness industry was: nowhere.  Most health risk assessments queried about illegal drug use and alcohol, but abuse of legal opioids? Off the table.

We can’t let the CDC overlook this epidemic too, due to their singularly misguided wellness obsession. We need to embarrass them into action–please send this note around to as many people as possible.


And if you’re wondering how the CDC (with the very notable exception of NIOSH!) has dumbed down so fast, so was I. These were, after all, the people who rid the US of malaria and rid the world of smallpox. So I did a little search on their site.

The first thing I noticed was that their workplace wellness information is “science-based.” That was the giveaway. In wellness, the phrase “science-based” means “not science-based.”  To use one example, Wellsteps’ claim that their ROI model is “based on every ROI study ever published.” This translates as: “We made the whole thing up.”

Additionally, the references the CDC relied upon should look familiar.  Besides being comprised of the usual serial liars, serial cheaters, and serial idiots, the list of references ends with Katherine Baicker, truly the Typhoid Mary of the workplace wellness epidemic–and hence one of the people most responsible for advising the CDC to create the Maginot Line that failed to prevent or event identify the opioid and bacteria epidemics that have taken millions more lives than workplace wellness has ever saved.


By the way, while you were reading this and the links, 6 to 12 more people (depending on how fast you read) just contracted a hospital-acquired infection, with probably 1 or 2 people dying from it.

To put that in perspective, the comparable statistics for wellness would be that 6 to 12 vendors just lied to their prospects, with 1 or 2 prospects believing them.

It’s Time to Retire the Infamous “3.27-to-1 ROI” from the “Harvard Study” (Part 1)

“You know that laundry detergent that gets bloodstains out of t-shirts?  I’d say if you’re routinely coming home with bloodstains in your t-shirts, laundry probably isn’t your biggest problem.”

Recognize that line?  That was Jerry Seinfeld’s signature joke, the one that more than any other propelled his early fame.  Having used it for a decade, he retired it shortly after Seinfeld went on the air.

Now it’s time to retire the wellness industry’s signature joke: the so-called Harvard Study and its 3.27-to-1 ROI. Among other things, as we’ll see, a large chunk of the data in that study also predates Seinfeld, a show which recently celebrated its 25th anniversary.  You know the old line: “How can you tell a lawyer is lying?” Answer: “His lips move.”  Well, the way you can tell a wellness vendor is lying is that they still cite that study, knowing it to be completely invalid.  (If they actually think that 3.27-to-1 is valid, in a way that’s even worse.)

Some Background

The article, which today wouldn’t pass peer review by the normally cautious Health Affairs, was rushed into publication during the healthcare reform debate as a favor to David Cutler, a healthcare advisor to President Obama and an author on the study.  Along with the results from the Safeway wellness program — which turned out not to exist (and I’m referring not just to the results but literally to the program itself) — this meta-analysis provided cover for the 30%-to-50% clawback provision (for non-smokers and smokers respectively)  in what became ironically known as the Safeway Amendment to the Affordable Care Act.

In turn, this clawback was needed to secure the support of the Business Roundtable (BRT) for the Affordable Care Act. The BRT was and is obsessed with this provision. Not because they are especially concerned about employee health — the guy who ran their wellness lobbying also ran a casino company, exposing thousands of employees to second-hand smoke.  Rather, because this clawback provision creates billions in forfeitures that go back into the coffers of its member organizations.  Bravo Wellness accidentally spilled that secret.  The worse the program, the more an organization can save via forfeitures. For instance, Wellsteps saved millions for the Boise School District even though healthcare spending/person jumped–simply by creating a program so unappealing that employees preferred to obtain insurance through their spouses. (Either that or they outright lied–you make the call.)

How Prof. Baicker Invalidated Her Own Study

The title was definitive and the conclusion was amazingly precise. The title was: “Workplace Wellness Can Generate Savings.”  Not “might” or “possibly could on a good day” but “can.” And the conclusion itself left little doubt.  The ROI wasn’t “approximately 3-to-1” or even “approximately 3.3-to-1” but rather a statistically precise 3.27-to-1.  You don’t make such a definitive pronouncement without being ready to defend it.

Or maybe you do. Here’s how Professor Baicker’s story changed on various occasions once it became clear that her result was a major outlier, and that wellness loses money:

  1. It’s too early to tell whether these programs pay off, and employers should experiment on their employees;
  2. She’s not interested in wellness any more;
  3. People aren’t reading the paper right. They aren’t paying enough attention to the “nuances.” Shame on the readers!
  4. “There are few studies with reliable data on the costs and the benefits”

This may be unique in healthcare history: writing a paper and then almost immediately retracting its key finding, claiming you have no interest in the topic even as your fans deify you, and then blaming readers for believing the conclusion.

But the biggest head-scratcher is the 4th item.  Here is someone who just published a conclusion with two-significant-digit precision now saying (accurately, as we’ll see) that, oh, by the way, the studies she analyzed are mostly garbage.  You know the old saying: “In wellness, you don’t have to challenge the data to invalidate it. You merely have to read the data. It will invalidate itself.”  She was kind enough to save us the trouble.

When RAND’s Soeren Mattke saw this stuff along with her refusal to defend it, he went ballistic.  If you know RAND’s wellness uberguru Soeren Mattke, you know he is a very even-tempered, even-handed guy.  it takes a lot to annoy him…and yet she did.  Here is his smackdown of her work.

Studies Comprising the Meta-Analysis

If you’ve been following the Baicker saga for a while, none of this is news.  Here’s what is news:  thanks to a long plane ride with both an internet connection and an assortment of in-flight films I had already seen, I was able to dig into the actual studies.  My conclusion: combining these third-rate studies in third-rate journals into a Health Affairs meta-analysis was like combining a hodegpodge of individual subprime mortgages written for first-time homebuyers with 5% downpayments and no credit history into an AAA-rated collateralized mortgage obligation.

In terms of timely relevance, of these 22 studies:

Keep in mind too that the average time between when a study begins and publication is about four years, meaning much of this data was collected before some TheySaidWhat? readers were born.  Wellness-sensitive medical events (in both exposed and non-exposed populations of all ages, for reasons having nothing to do with wellness) have fallen by about 70% since most of this data was collected, meaning even if these studies were valid at the time (they weren’t), they have no relevance today. Likewise, dietary recommendations are now the opposite, people can no longer smoke in their offices etc.  There is nothing else in healthcare where data on interventions from 20 and 30 years ago is considered relevant.

In terms of publication bias, consider the journals:

Piling investigator bias on top of author bias, 14 of these studies were authored or co-authored by members of the Koop Award Committee, a committee that can’t spot obviously fabricated outcomes even after I point them out, people whose entire livelihoods depend on making up savings figures, and who endorse admitted liars.

The Actual Data

Every study that used a comparison group employed some variation of the demonstrably invalid participants-vs-non-participants methodology.  Not one study was plausibility-tested.   Almost every one of them showed savings far in excess of what could be saved if all wellness-sensitive medical events were wiped out.

Quite literally no one thinks savings can be achieved within 18 months, and yet the majority of studies with a comparison group were 18 months or less.  All showed massive savings.  One study lasted only 6 months, but showed roughly 20% savings nonetheless.


 

You might ask, how could all that money be saved in such a short period of time? For that answer, you’ll have to wait a couple of days. For Part 2, we will dig into a few of the studies themselves to see where the magic happens…and we do mean “magic”, since nothing else can explain those preternatural results.

RIP for BMI — New Research Proves It’s Worthless for Employee Wellness Programs

Looks like a lot of you employees should be getting your employers to refund your penalties for not losing weight…or retroactively award you your incentives…read on. One way or the other, it’s time to end corporate fat-shaming.


 

Here is yet another in the unending stream of reasons to be certain all those Koop-award-winning savings claims and just about every other announced wellness savings figure are fabricated:  they are all based partially or totally on Body Mass Index (BMI) reductions among active motivated participants — but BMI turns out to be a worthless indicator of health status.  (We’ve already pointed out that the whole concept of measuring anything on “active motivated participants” is garbage anyway, as Aetna recently proved by accidentally telling the truth.)

How worthless?  A study due out in the International Journal of Obesity says 75-million Americans are misclassified, meaning their BMI doesn’t match their true underlying health status. (As an aside, this scoop comes from this morning’s STAT News, the new must-read healthcare daily.)  Many people with high BMIs are healthy, while many people with low BMIs are high-risk. Shocking! Who knew?

Naturally (cue the smirk on our faces), we did. As recently as in last month’s expose of The Vitality Group‘s squirrely outcomes claims, we pointed out that BMI is a 200-year-old construct based on faulty reasoning to begin with — and noted it has been challenged on multiple bases for years.  We were also the first to observe that BMIs don’t correlate with a company’s financial success.  And our series: “The Belly of the Beast” chronicled one vendor’s misunderstanding of BMIs as well, though I understand they are improving quite a bit now and we wish them the best and look forward to telling you about their improvements.

The implications of this new research are staggering:

  1. Companies need to refund penalties, and also award incentives retroactively, to people who were unfairly denied their money because wellness vendors don’t know how to measure outcomes;
  2. The “subject matter experts” who wrote the HERO Report need to retract basically their whole ball of wax, since it obsesses with BMI — and they need to apologize to me for inaccurately calling my claims “inaccurate” when they are specifically and relentlessly urging readers to do the wrong thing;
  3. Wellness vendors need to learn a thing or two about wellness, for a change.
  4. And guess who’s 3.27-to-1 ROI was based on studies obsessing with BMI?  Kate Baicker, that’s who.  Despite multiple hedges and walk-backs, she has yet to issue a formal retraction of her puff-piece on wellness economics. This gives her a good excuse.

Of course, in wellness, “the implications are staggering” means: “business as usual,” and they won’t do a thing to address these new findings.

The EEOC can’t ignore this.  How can they give employers more leeway — as they now intend to do — to fine employees based on a variable they now know to be wrong?

Quizzify 1, Wellness Vendors 0

Those of you who use Quizzify don’t have to fret, by the way.  The correct answers to the Quizzify question: “What is a BMI?” already include:

  • “A crude measure comparing your height and weight,”
  • “Can be very misleading if you in otherwise good condition,” and
  • “Is good to know but not to obsess with.”

(For those of you keeping score at home, Quizzify’s incorrect answer is: “It stands for ‘Bowel Movement Intensity,’ and indicates how much effort you required in order to stay regular.”)

Even so, we will be adjusting the answers going forward to take into account this new research, starting next week.  We expect the wellness ignorati will follow suit in a few years — once they stop advocating lowfat diets, PSA tests, and annual mammograms.  The good news is that they generally no longer recommend bloodletting.

 

 

 

Greatest Hits Collection: Staywell

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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).

Quizzify Q in B and W

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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