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Tag Archives: Katherine Baicker
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:
- 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;
- 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;
- Wellness vendors need to learn a thing or two about wellness, for a change.
- 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.
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).
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?