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Wellsteps Stumbles Onward: Costs Go Up and Down at the Same Time
As our regular readers know, we have often had a very slight issue with Wellsteps’ math Nothing major. Just the fact that it’s completely made up.
So it’s no surprise that they’re at it again. Before we get to the math they’ve done for the Boise School District to justify costing taxpayers as much as adding a number of extra teachers, there is another little tidbit. They decided to use the classic fallacy of listing the improvements in the highest-risk sliver only –“those with the worst health behaviors.” These “improvements” of course, omit dropouts, and — more importantly — the deterioration in risk factors among the overwhelming majority, the ones who didn’t have the “worst health behaviors” to begin with. As the paper says: “There was consistent risk reduction among those who had the unhealthiest numbers at baseline.”
It’s not just us (and common sense) saying that. Dee Edington’s “natural flow of risk” model showed that the cohort with the worst health risk behaviors always improves, even in the absence of a program. (In this version below, Dee circled the low-risk bucket to make a different point. The point for Wellsteps is that a very significant portion of the 4691 initially high-risk people decline on their own, and are replaced by others whose risk is increasing. Wellsteps isn’t showing us the replacement people, just the cohort that declined on its own.)
There is a bit of irony in that this Wellsteps White Paper cites him several times…but somehow “forgot” to take account of Dr. Edington’s most important finding, which coincidentally disqualifies their own.
Saving the best for last, Wellsteps once again demonstrates our mantra from Surviving Workplace Wellness: “In wellness you don’t have to challenge the data to invalidate it. You merely have to read the data. It will invalidate itself.”
On one page, they show a declining overall cost trend by roughly 15% since the start of the Wellsteps program:
Now, compare that chart of the “actual” cost decrease among the entire population (participants + nonparticipants) since 2011 (“Wellsteps Begins”) to the chart below of cost/person, which shows a dramatic cost increase over the 2011-2013 period among the entire population (participants + non-participants):*
So which is it? Did overall population costs go up or down? Even using wellness math, which Wellsteps excels at, overall population costs can’t have both gone up and gone down at the same time.
There are four possible explanations for this, all of which are plausible given Wellsteps modus operandi:
(1) They are stupid;
(2) They are lying;
(3) Their program is so unappealing that employees are switching to their spouses’ coverage simply to avoid it;
(4) The number of employees in the school district declined, making it possible for total costs to decline even as costs/employee jumped. However, even the most dishonest wellness vendor wouldn’t claim credit for that, and even the most gullible customer wouldn’t let them if they did.
One explanation we can rule out: Wellsteps is doing a great job and telling the truth about it. But anyone who knows this outfit could have ruled out that possibility before we even posted this.
As of this writing, Wellsteps has now “rebutted” these findings. They say these dueling trendlines are “rock solid” and that we are full of “hot air.”
(Postscript: In 2014, for some undisclosed reason, non-participants costs dropped almost 40% while participant costs increased. No one has any idea why, and whatever the reason is has nothing to do with wellness. Total costs were still up from the start of the program.)
*Wellsteps didn’t mention the participation rate, so we are inferring a participation rate to the vector of this arrow based on them saying 60% were overweight of 3269 employees, but the number of overweight people listed in their report as participants is 1421.