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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.

 

WELCOA: In the Belly of the Belly of the Beast

First, a little background.  For those of you unfamiliar with the Wellness Council of America, or WELCOA, this organization, based in Omaha, Nebraska, was founded by the inventor of the all-you-can-eat self-serve restaurant.

Warren Buffet?

Hey, it’s an honest mistake!  Anyone could misspell their founder’s name on their home page, especially when it’s one of those long foreign-sounding unpronounceable names of somebody no one’s heard of.   Besides, WELCOA in particular can’t be expected to know how to spell “Warren Buffett.”  I mean, it’s not like they’re both based in the same city or anything.

WELCOA is wellness’s perfect storm, exemplifying the standards for literacy, numeracy and integrity that have endeared the wellness industry to us humor writers.  Along with Ron Goetzel’s Koop Award Committee (chronicled at length in these pages and never shy about coming back for more), WELCOA truly does put the “Ig” in “Wellness Ignorati.”

Quizzify 3

Fun + facts = smarter, happier employees

In general, the modus operandi of the Ignorati — and especially WELCOA — is to suppress facts, because facts are their worst nightmare.  If facts are their worst nightmare, we’re their Night of the Living Dead.  We are tickled pink that we are considered so threatening that nowhere on their site is there the slightest hint that we — or any wellness skeptics — even exist.  For instance, the first time ever that the entire wellness industry (as opposed to individual debacles, like Penn State) was newsworthy enough to be covered by Health Affairs, LA Times, Incidental Economist, Chicago Sun-Times, All Things Considered, Huffpost, the Federalist etc.,  WELCOA’s lead “news” story was:  “How to Jump-Start Your Wellness Program with Big Data.”   (This editorial choice echoed the New York Post, which, on the day the hostages were freed and Reagan was inaugurated, led with “Joan and Ted to Split.”)

By contrast, we embrace transparency, and urge you to read the entire WELCOA site, especially the “premier providers,” who are kind enough to pay WELCOA for the privilege of having their creative approaches to grammar and math become TSW? fodder.  (We have a source inside WELCOA who brought our attention to the comedic potential of this material.)

One of our favorite WELCOA premier providers is Trotter Wellness, which gets its own entry in “On the (Even) Lighter Side.“.

trotterlogo.png (359×61)

Remember that scene in Catcher in the Rye when Stradlater gets Holden to write his English composition but tells him not to put all the commas in the right places so the teacher won’t suspect he wrote it?  The good news is, WELCOA could never be confused with JD Salinger.  In their ad for Trotter Wellness, WELCOA didn’t put any of the commas in the right places.

trotterwellnesscommaless

Frankly, we’re not sure WELCOA has ever put a comma in the right place…

At the risk of ruining a joke by explaining it, it’s not just that all the punctuation is missing from the descriptor.  It’s that the exact spot WELCOA’s crack grammarians decided to place a comma is also the exact spot they shouldn’t have placed a comma, according to Trotter’s own website screenshot right above this screenshot.  That gives WELCOA both a false-positive and a false-negative rate of 100%, which even in wellness is a bit on the high side.

Along with Ron Goetzel’s Koop Committee and Health Fitness Corporation, they were a co-conspirator in the Nebraska workplace wellness fraud, thus proving that great minds aren’t the only ones that think alike.  It was actually their website that claimed the famously fictitious “life-saving catches” of the 514 victims of “early stage cancer.”

nebraska life saving catches

koop001.png (394×241)

What boggles the mind, even by the uniquely gauzy ethical standards of the wellness industry is that they still make that claim, albeit on someone else’s website.  We’ll readily admit they posted the claim originally because they didn’t realize that HFC was lying (again), and that screening about 5000 people wouldn’t yield 514 cases of cancer.  (While Ron Goetzel’s Koop Committee was also snookered, It took us about 2 minutes to figure out that the alleged rate of cancers would have been roughly 50-100 times that of Love Canal.  You could come up with this insight too, using ingredients you already have in your kitchen: an internet connection, a calculator, and a triple-digit IQ.)

But two years later – after (1) we told them this was wrong; (2) we “outed” them in the Wall Street Journal; and (3) HFC admitted right in the Omaha World Herald they made up the claim – this statement is still being made.   We must now reluctantly conclude WELCOA is deliberately lying, because nobody, not even WELCOA, could be this stupid accidentally.*

Even Ron Goetzel briefly stopped defending WELCOA and HFC.  He claimed at the Datapalooza conference in June 2014 that the reason they won his award was due to a technicality. Apparently,  because they had only disclosed this particular lie on their website and not in their award application itself, it didn’t count against them.   Even so, a few months later, the Datapalooza conference being a distant memory, Ron once again declared that WELCOA/HFC/Nebraska was a “best practice”:

list-of-best-practices.png (408×108)

Quizzify 4

Just because it’s healthcare doesn’t mean it’s good for you

There is too much to say about WELCOA for a single posting, so we would direct you to two places.  First, in This Is Your Brain on Wellness, WELCOA merits its own entry, of course.  But WELCOA, truly a target-rich environment, also proffered screenshots for Midland Health, Bravo, Balance, Well Nation, the Healthy Company Alliance, Trotter, and Star Wellness.

Second, you can find Chapter 7 of Surviving Workplace Wellness right here.  Even in the target-rich environment of the wellness industry, getting one’s own chapter is quite a feat.  Just to get you in the mood, here is the first paragraph of that chapter:

sww nebraska chapter

Now that we have your attention, you can click on this link and download Chapter 7, with our compliments.


*Our bad!  It turns out WELCOA may very well be this stupid accidentally.  You see, when we pointed out in Surviving Workplace Wellness that they had misspelled the name of their founder, they fixed it on their home page.  (Apparently, while many people can spell and many people have visited their home page, the intersection set consists only of us.)   But it never occurred to them to do a find-and-replace.  You’d think that someone there would have thought: “You know, since we didn’t spell Buffett correctly on our home page, perhaps there are other places we didn’t spell it correctly either.  If only there were some way of testing that hypothesis…”

And that one of WELCOA’s other luminaries maybe couldn’t spell “Buffett” either but had studied the intricacies of Word’s find-and-replace function.  And that maybe — just maybe — these two folks would have bumped into each other, like in those old Reese Cup commercials, and collectively come up with the insight that the “answer” was: run the find-and-replace function on “Buffet.”

But no such luck.  Hence to this very day, the original spelling still appears on their website, in that very same Nebraska case study.

welcoa warren buffet

We’ve just spent 1350 words observing WELCOA’s foibles, but we do like to be balanced in our reporting, so we’ll close with some good news.  The good news is, there is indeed one place where WELCOA is undeniably right:  WELCOA truly has “helped influence the face of workplace wellness in the US”…

…By putting a great big smile on it.

 

 

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