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Remember when the sergeant asked for a volunteer to step forward and Moe and Larry took a step back?
Looks like Virgin Pulse has won the best-HRA contest the same way. Yes, it is a complete waste of employee time and employer money. In HRAs, that’s table stakes. It earns a solid “C” not because anyone will learn anything of any value, but rather because the other two are worse. The VP HRA offers so little advice that none of it is really bad. It that sense it is better than Cerner’s (“F”) and Optum’s (F+).
Here’s what Virgin Pulse’s HRA gets points for not doing:
Tell employees to eat nonfat yogurt that is full of sugar (like Cerner):
Imply that employees on opioids should get more opioids (like Optum)
Advise employees against using olive oil (like Optum)
Further, it is actually coherent, instead of containing questions like… (Optum again)
…in which both non-asthmatics and completely uncontrolled asthmatics would give you the same answer.
Virgin Pulse’s “advice”
“Eat a healthy breakfast.” Who can argue with that? It’s like a manager advising the batter to hit a home run. Obviously the key is in the execution, and naturally Virgin Pulse provides none. In that sense, it is the best HRA because the others give such bad advice.
What constitutes a healthy breakfast? Can’t be just any old cereal. Those are full of sugar. Ah, maybe something like Kellogg’s Smart Start with Antioxidants, which is “heart-healthy.”
Oops. That’s on Eat This Not That’s “worst healthy cereals” list. Because it is — you guessed it — full of “heart-healthy” sugar.
Kellogg’s Special K Protein Snack Bars? 10 grams of added sugar apiece (and you’d likely eat 2–they’re small) with six different sugars dispersed throughout the ingredients label.
Eggs? For most people, eggs are a healthier choice than most packaged cereals. Of course, there are exceptions — a bit less than 1% of the population is genetically predisposed to high cholesterol. But wellness vendors would lose money if they actually spent the time to address these nuances. Of course, in this case, the “nuance” is that familial hypercholesterolemia (FH) is a much better predictor of cardiac events than anything in any HRA. As in about 40% of everyone with untreated FH will infarct before age 60.
Oatmeal? Probably the greatest consensus around that. (And that’s the breakfast of choice here at TheySaidWhat? World Headquarters.) Yet plenty of cereal companies, and fast food chains, have turned oatmeal into junk food. Dunkin’s “Brown Sugar Flavored Oatmeal” packs in 28 grams of sugar (none of which is actual brown sugar, as luck would have it).
Orange juice? That counts as a serving of a fruit according to the American Heart Association (AHA) and Virgin Pulse is a big one for telling you to eat up to 11 servings of fruits and vegetables a day, with “1/4 cup” of juice counting as a serving. Using the AHA math, an 8-ounce glass of juice would appear to get you 4/11ths of the way there.
And ads for “healthy” cereal sometimes show a glass of orange juice on the side:
On the other hand, NPR and Consumer Reports advise against considering juice as a healthy alternative. The sugar is “natural,” but there is an awful lot of it. (I myself am not a nutritionist, and don’t even play one on TV, so I don’t have an opinion on whether natural sugar is OK and added sugar isn’t. Except I would point out that grape juice contains natural sugar while grape juice concentrate is an added sugar. Both can’t be right.)
So which is it? Drink more juice, or don’t? Which constitutes “eating a healthy breakfast” ? I don’t know and I suspect neither does Virgin Pulse. The difference, of course, is that TSW isn’t charging lots of money to give employees advice.
Completing the Virgin Pulse HRA
Obviously, employees are going to lie on HRAs, and Virgin Pulse’s is no exception. I was invited to watch a group of employees completing theirs, For each answer, they gamed the system. What is the optimal amount of stress to claim? Too much might harm their career. Too little and someone might give them more work.
How much should they claim to drink? “Not at all” might cause their (well-known!) employer to think they’re lying, so they all decided to cut their true totals in half.
Servings of fruits and vegetables? Most of them just made up a number that would sound good to an employer.
Everyone seems to know employees lie on HRAs (including, of course, Virgin Pulse) except the employers that still use them, whose quest to create a culture of health ends up creating a culture of deceit. No need to take my word for this. Simply complete this chart to see what percentage of your employees with something to lie about are indeed lying — and what the odds are that an employee with something to hide will tell the truth about it:
Let’s try completing this chart, using the most recent winner of the C. Everett Koop Award, Wellsteps.
Result: in the so-called best wellness program, almost 2/3 of employees lie, though in all fairness to Wellsteps, some of those could be the same employee lying twice. And extrapolating from Wellsteps’ result, the odds of an employee coming clean about a bad health habit are about 1-in-4. That’s the average of smoking and drinking. Generally the more socially acceptable habits will show a higher percentage of employees telling the truth.
Keep in mind, too, that there is another way to lie on HRAs, which is understatement. You may recall from Wellsteps that the 23% who drink only imbibe 1.3 drinks a day, while 3% who do admit to smoking indulge in cigarettes only 4.27 times a week, perhaps taking a break on weekends and major holidays, such as Beethoven’s Birthday.
Due to the lying and uselessness, should employers drop HRAs altogether?
In the immortal word of the great philosopher Curly Howard, soitenly.
This came in over the transom today from a wellness executive. I am shocked, shocked, to find that conflicts of interest are going on in here!
Hi, Al! I’ve been a big fan of yours for some time. As I am a senior executive in the “Corporate Wellness” market, I unfortunately cannot reveal myself publicly for fear of ostracism, but have agreed almost completely with the arguments you’ve made about our industry shenanigans for years.
Unfortunately the shenanigans have gotten worse. Don’t know if you noticed this, but the Art & Science of Health Promotion Conference recently appointed Dr. David Katz as their new program chair, replacing Michael O’Donnell. The community had been voicing concerns to Michael for years about ASHPC’s not-so-veiled bias for certain vendors and consultants without disclosure of their financial relationships. Now, seems the conference is willing to blatantly flaunt its conflict-of-interest as Katz has announced Dr. Rajeev Kumar of Virgin Pulse would be the keynote speaker at the next conference. Unsurprisingly, Katz is on the “scientific advisory board” of Virgin Pulse. Links: https://www.virginpulse.com/blog-post/saboard-members/david-l-katz, https://www.healthpromotionconference.com/keynote/how-do-we-adapt-to-the-emerging-growth-and-evolution-of-health-promotion.
I see the same conflict-of-interest at HERO and other conferences. It’s truly sad that our profession has allowed these snake oil salesmen and their proxies to run these events under the guise of “impartiality”.
Recently we described how to cheat one of those worthless, hazardous corporate crash-dieting contests, like the ones run by Wellness Corporate Solutions or HealthyWages or Virgin Pulse (nee ShapeUp). But we didn’t interview any employees who actually did.
Journalist and wellness expert Pat Barone, writing in LifeZette (Laura Ingraham’s popular online magazine) managed to do just that. She found some employees who “confessed” (bragged about) the ways they snooker these vendors — and of course their own employers –every year, starting again in most cases next month.
These employers, like Schlumberger, think they are creating a culture of wellness when in reality they are creating a culture of deceit, diet pills and dyspepsia. Why would any employer sponsor one of these contests? Simple: in wellness, stupid is the new black.
I don’t want to spoil your fun reading the article by giving away all the punchlines, but the keywords are carbs, sodium, and rocks. All the things that employees should eat, as part of a healthy diet. OK, maybe not too many vitamins but certainly lots of minerals.
Attention, employees who want to learn how to cheat in a corporate wellness contest: for the actual cheating hints, skim down to: “How to Cheat in a Crash-Dieting Contest.” The suggestions apply not just to corporate biggest loser contests, but to any corporate weigh-in where money is attached to weight. (This post is actually intended for your company’s HR people who for some reason think encouraging you to binge and then crash-diet is a good idea and don’t realize wellness is an obvious scam.)
Further, the law has changed (as of 2019) and you can now sue your employer if they fine you (or give you a high-deductible plan and make you “earn the incentive”) for refusing to participate in biometric screens and other clinical wellness activities. You can contact us for more information.
If we were real journalists here, we’d have killed a lot of trees in the cause of exposing the massive amount of lying and cheating by wellness vendors. However, as mere bloggers, all we do is kill millions of defenseless electrons.*
And yet we’ve sacrificed nary a single electron to the cause of exposing the massive amount of lying and cheating by the employees themselves. And massive it is. My very own extended family members are swapping Fitbits around to increase their steps. Less for the money than for bragging rights about who can game the contest the best.
Indeed, these corporate “challenges” are really mental challenges, not physical ones, to see who can do the best job outsmarting the wellness vendor. Outsmarting wellness vendors, as past columns have shown, isn’t exactly a heavy lift: we have often observed that the good news about wellness is that NASA employees don’t have to worry about their job security because wellness vendors aren’t exactly rocket scientists.
To that end, the Wall Street Journal wrote an entire article about employees cheating in wellness programs. Apparently, employees are enlisting puppies, hamsters, even power tools and a ceiling fan in their quest to undermine their company’s wellness program. One enterprising employee posted a youtube showing how to cheat on these programs. A Midwestern cadre of truly dedicated employees took cheating a bit farther than most, and got themselves indicted for defrauding Kansas City out of $300,000 by lying on wellness programs.
30-second shameless plug time
Of course, there is one surefire way to avoid the downside of cheating: design cheating into the program. And that’s exactly what Quizzify does. The way to cheat on Quizzify is to look up the answers and learn about health literacy — which is exactly what we want employees to do!
How to cheat in a crash-dieting contest
Employees especially like to cheat in crash-dieting contests, enough so that countermeasures are needed. For instance, a vendor named Healthywage is bragging about how it ferrets out “fraudulent participants.” I figured I’d see what the internet has to offer on corporate biggest loser program cheating, because, after all, these days almost every search generates tons of hits. I say “almost” because if you search on “honest wellness vendors” and “Wellsteps,” there is only one hit: my observation that the latter could never be confused with the former.
In particular, the search found a group called www.healthstatus.com, which has given this topic altogether too much thought, thankfully. In all fairness to the HealthStatus folks (who do seem very well-intentioned and on the level), before they list their recommendations, they provide a cigarette-type warning label, as these programs richly deserve:
It’s getting to be New Year’s resolution time and many companies will try and “encourage” weight loss with a “Biggest Loser” type contest. Frankly, this is really a bad idea, as it can create all kinds of bad habits and damaging activities by the participants, as they starve, dehydrate and supplement themselves in an effort to win.
Having gotten the grownup stuff out of the way, here are their “recommendations” for employees whose employers, like Schlumberger, somehow got the impression these contests are a good idea, perhaps because their mothers didn’t listen to enough Mozart when they were in the womb. A few recommendations are fairly harmless, like drink a lot of water starting 3 days early and don’t pee (or do number twosies) before your weigh-in. And, of course, wear heavy clothes, carry lots of change in your pockets etc. You know, your typical garden-variety dishonesty that is probably woven into the culture of any employer that sponsors these contests. (These employers think they are “creating a culture of wellness” when in reality they are creating a culture of deceit.)
By contrast, some of these other recommendations boggle our minds, and, having written exposes on the wellness industry for two years now, our minds are not easily boggled:
The day before the weigh-in, ideally about 17 hours or less before your weigh-in time, you want to get yourself a good salty snack. A bag of chips, you know the ones that if you eat too many your lips hurt from all the salt and a nice tray of cheese and crackers.
For your dinner meal you want to load up on the proteins and a big glass of whole milk, also, this is a day you want to skip the fiber. This is one day of eating like this, we don’t encourage it, but a binge day also sets up your metabolism to know that is not starving, and can help in when we start burning fat after the weigh-in.
The day of the weigh-in, minimize your activity, another big glass of whole milk with your breakfast that contains some salty options will help you retain more water.
“At this point,” they observe, “you should be a big bloated sloshing mess that needs to go to the bathroom really bad. This is the perfect time to get weighed and measured.” They also remind you to accentuate poor posture, since the long-since discredited Body Mass Index measure still preferred by most of these vendors is a height/weight ratio. (HealthStatus also offers hints for contests that use waist circumference.)
In other words, do all the wrong things — eat badly, slouch, and don’t exercise. Be as unhealthy as possible. So you’re already obsessing with your weight and abusing your body horrendously in the name of wellness…and the contest hasn’t even started yet!
I hate to leave everyone hanging but HealthStatus hasn’t published the rest of its recommendations yet, meaning advice on how to cheat during the contests themselves.
And a good thing because I don’t know how much more wellness a fellow can take.
Since self-abuse is actually a very serious topic, I would like to step out of character here and offer a few serious notes. First, no wonder Optum and HERO and other Wellness Ignorati are stonewalling the Employee Health Program Code of Conduct. Nothing violates it more than their cherished corporate crash-dieting contests. And a particular call-out of the biggest-loser worst offenders: Virgin Pulse (nee ShapeUp), Wellness Corporate Solutions and HealthyWages. You ought to be ashamed of yourselves, even relative to other wellness vendors like Wellsteps, which had just recently established a new plateau for harming employees, that you people are blasting right through.
*Just for the record, we know that writing blogs does not kill or even injure electrons. And while Keas might find that being used in blog posts stresses them out, we would disagree. Quite the opposite: if they enroll in wellness programs, they can live to be 100.
Yes, we know you read this blog for the chuckles. Our most popular and funniest posts are usually the ones showcasing the wellness industry’s race to the bottom. And despite heavy competition, very few industry scams can beat corporate get-thin-quick schemes to that inexplicably coveted nadir:
- Here is Healthywage discussing its newest schemes, like “dieting for dollars” and “paying for pounds.” They also describe how to prevent “fraudulent participants,” a category presumably comprised of zombies and dead voters in Chicago.
- “In Wellness, Stupid is the New Black” shows how Healthywage can’t even read a scale.
- “Shape Up falls down trying to do math for Highmark,” about a weight-loss program so clueless that it got covered by the Pittsburgh Post-Gazette.
- Perhaps our favorite is Wellness Corporate Solutions. We won’t ruin the punchline for you.
In sum, we say: “To call corporate crash-dieting contests a joke is an insult to jokes.”
Unfortunately for those of you seeking a few chuckles, this is not that situation.
Quite the contrary, Rebecca Johnson has penned one of the best articles on corporate weight loss programs we’ve ever seen, so we can’t dismiss it with our usual clever if by now overexposed putdowns like: “She should have had this reviewed by a smart person before publishing it,” or “Perhaps her subscription to the internet expired.”
Instead, rarely have we seen more intelligent observations packed into a tighter space, more thoroughly sourced and clearly explained. To summarize:
- Corporate crash-dieting contests are much more likely to harm employees than benefit them;
- They don’t produce an ROI;
- Our mothers were right. Eat a balanced diet. There are more benefits than one would think to not obsessing with what are the “best” and “worst” foods. (Having said that, some people seem to do very well on a low-carb diet. We leave that debate to others and recommend The Big Fat Surprise to readers with an interest in that topic.)
- It is better to be fit and fat (“health at every size”) than to yo-yo diet, for sure.
She goes on to explain her particular approach to mindful eating. I myself have no expertise in that area so I can’t critique the specifics, except to say that Healthywages, ShapeUp (now Virgin Pulse), and Wellness Corporate Solutions should definitely find a smart person to explain this approach to them, even if it means having to pay for an internet connection.
Two separate reports confirm that employers have finally connected their computers to the internet.
First, the Wall Street Journal just reported that employers are cutting back on wellness programs. This especially includes the very same crash-dieting contests that we just invalidated in Employee Benefit News on Thursday. Those Virgin Pulse/HealthyWage abominations should be right up there with the Pontiac Aztek, New Coke, DDT, hair-in-a-can, and hands-free toilet paper on Time’s list of 50 inventions that never should have been invented. Here is an excerpt:
As employers begin to analyze return-on-investment and participation data, they “may be taking a step back,” said Evren Esen, director of survey programs at SHRM, the world’s largest society for human-resources professionals.
Employers “may be taking a step back”? As an understatement, that ranks with Lyndon Johnson’s 1965 comment that “killing, rioting, and looting are contrary to the best traditions of this country.” (And you thought we only dissed GOP politicians like Donald “Boom Boom” Trump. Quite the contrary. We are equal opportunity jerks.)
Second, after years of steady and hefty increases in employee incentives/penalties, the average non-participation forfeiture for wellness programs fell in 2015, from $693 to $651, according to the National Business Group on Health. So now it is only about ten times the total that employers spend on wellness-sensitive medical events (about $60 PEPY).
This decline was reported three months ago. It took a while for me to post it because it took a while for me to dig it up. Whereas previous NBGH annual surveys — showing the aforementioned massive increases — received a great deal of coverage in the media, NBGH buried the results of this year’s study, due to the decline in incentives. Publicizing facts is contrary to the best traditions of the wellness ignorati, of which NBGH is a founding member.
The bad news in the NBGH report is that even as average incentives declined, median incentives continue to rise. The good news is that NBGH actually understands the difference between the two words “average” and “median.” Quite an impressive feat, by their standards. It could be that they’ve finally taken my advice and hired a smart person.
If employers and consulting firms start taking that same advice, it could be the end of “pry, poke and prod,”…and a great shot in the arm for Quizzify.
Actually, just to clarify, we are quite supportive of screening according to actual clinical guidelines. Within the next month or two, Quizzify will be executing several partnership agreements with vendors to offer screening according to guidelines…and to use Quizzify for employees who are not due for screenings. If you are a vendor and would like to offer a similar program or an employer and would like to buy one, just reach out to us with an email to email@example.com.
We promise that a smart person will follow up.
Who says the country is polarized? In wellness, bipartisanship rules!
Having just been eviscerated by the Guardian on Monday, today wellness got quite literally its worst coverage ever — from the blog of Laura Ingraham. Yes, the very same Laura Ingraham who has her own radio show and guest-hosts The O’Reilly Factor. This may be the only instance ever in which the left-wing Guardian agrees with the right-wing Laura Ingraham.
The wellness industry is running out of wings.
Hers is just the latest media salvo. Right, left, and center — the same media that used to fawn over this stuff (“everybody wins — employees are healthier and employers save money”) — has consistently been savaging these vendors and “pry, poke and prod” programs worse than we do, ever since Penn State.
Because we are an equal-time blog, we’ll review both the Guardian’s and Ms. Ingraham’s. However, read our entire posting. I will hint that, regardless of politics, you will think we are saving the best for last. (Actually, since we strive for 100% accuracy, we should say we are saving the better for later.)
The Left Wing
The Guardian published an extensive article on the privacy invasion that can accompany wellness programs. Much as I am not a fan of “pry, poke and prod,” I do think the folks who attack wellness on the basis of privacy substantially overstate their case. There are many things wrong with wellness, but we need to tell the truth on this site, since we are in the “integrity segment” of the market. And the truth is that wellness vendors don’t hand over employee personal health information (PHI) to employers. Not that we want to give them any ideas.
PHI can also be leaked accidentally, of course. Staywell wasn’t exactly forthcoming about this so you may not have heard about it, but they got breached. Hence we would recommend that you “stay well” away from them as a wellness vendor. Other wellness vendors have managed to keep hackers at bay. It could be airtight security measures on the part of the industry, but it’s more likely that hackers simply have no interest in wellness data because of its worthlessness.
Still, these wellness people have no one but themselves to blame when articles like this get published. Castlight, for example, is feeding this beast by boasting that they can predict who is going to become pregnant. The Guardian called them out on this. I have nothing against Castlight but that is eerily reminiscent of the Highmark/Goetzel/Penn State debacle when women were fined $1200 if they didn’t disclose their pregnancy plans on their health risk assessments.
And how did The Guardian write a couple thousand words on privacy without noticing Aetna’s employee DNA collection-and-storage program? In all fairness, it probably never occurred to them that a major company would ever do such a thing, so they didn’t think to look for it.
And basically every article ever published on privacy starts with the assumption that these programs must save money. Otherwise why would employers do them, given their cost and morale impact? So the Guardian never called out these vendors on lying about savings.
The Right Wing
The Guardian’s smackdown is figuratively and almost literally yesterday’s news. The news got worse today, for the wellness industry. The LifeZette (the name of Laura Ingraham’s website) skewered the wellness industry to a degree never seen outside this blog. The LifeZette article starts by pointing out that no one even pretends any more that there is an ROI from wellness. (We just covered that newfound wellness industry candor from a different angle, in Insurance Thought Leadership.)
The article also laments the lack of regulation in wellness, possibly the only time in history when any even loosely Fox-affiliated publication has opined that there isn’t enough government regulation of something. They are, of course, right. There is literally no defense of unregulated wellness industry practices that are more likely to harm employees than benefit them, just to line their own pockets. No doctor could get away with this.
Absent regulation, the article points out that companies like ShapeUp — specifically, ShapeUp — harm employees with their yo-yo dieting programs. The reporter, Pat Barone, extensively documents the harms that ShapeUp creates with its get-thin-quick “challenges,” and then notes many other harms wellness programs can cause.
We never take sides in politics on this site. Instead we frequently note — as in this posting — that both “wings” agree with us. But I will give a shout-out to this right-wing site here. Ms. Barone’s article absolutely nails the dishonest and harmful business practices of ShapeUp and others.
Usually we try to end these postings with a clever line of our own, but instead we’ll end with one of Barone’s:
The [new] alliance of ShapeUp with the two additional companies [Virgin Pulse being the lead dog], presumably means many more crash dieters wreaking havoc on their future health.
Please add comments here when you’re done reading it. LifeZette doesn’t take comments.
We frequently get complaints from “average” employees about wellness, and our most popular Huffpost was about the fat-shaming aspects of wellness programs that obsess with BMIs. (Weight discrimination under the guise of weight control is one of the hallmarks of wellness, of course.)
But what about triathletes? What about people for whom those wellness incentives are a complete windfall? They can collect money for what they do anyway, sort of like when you buy something at a store and don’t learn it was on sale until you check out. Obviously, as the beneficiaries of these programs’ largesse (at the expense of other employees indirectly, of course), fitness buffs should embrace wellness, like –to quote wellness apologist Larry Chapman — “a beloved pet.”
Sure, if that pet is the Hound of the Baskervilles.
(Note to the literal-minded. This isn’t actually the Hound of the Baskervilles, who declined to sit for a photo session. This isn’t even a dog, as far as we know.)
I’d encourage you to read this critique of Virgin Pulse’s program in its entirety. You’ll have to scroll down through the blog post (not too fast–you’ll miss the review of Quizzify) to Comment #3, but it’s worth a full read to capture the essence beyond these excerpts.
First, Virgin Pulse — here’s a shocker — can’t do math. Because of their innumeracy (also one of the hallmarks of wellness), Virgin is accomplishing exactly the opposite of what wellness is supposed to do:
When I ran 5 miles in 50 minutes, at a 10-min/mile pace, I got more points for having >45 min of active minutes, but when I actually ran it faster, say, 8-min/mile pace which gave me a 40 min time, I only got >30 min activity, and fewer points, despite performing a much harder task. Nothing like being punished for being successful.
And Virgin Pulse apparently can’t do wellness either (yet another hallmark of the wellness industry):
Those of us who lift weights and do things that do not have “steps” but require greater physical acumen are greatly disadvantaged. Sadly, most government programs place a higher priority on “aerobic” activity rather than strength training. This “cardio = fitness” mentality is about is about 30 years behind the times.
She of course is completely correct about this on multiple dimensions. Virgin Pulse’s information is way out of date, outdated information being — you guessed it — yet another hallmark of the wellness industry. Among other things, giving “points” for cardio but not strength will increase back pain and other musculoskeletal problems–which account for a vastly higher share of employer health spending than the 1-in-800 incidence of heart attacks–in two different ways:
- Strength exercises are now shown to be the best way to prevent and control back pain;
- Obsessing with “steps” increases the likelihood of falls, sprains, and repetitive motion injuries.
At the risk of “burying the lead,” here is another thing Virgin managed to do:
It can also be annoying to be reminded constantly to get my mammogram. I am a breast cancer survivor and have had a double mastectomy. No mammograms for me. How insensitive of you!
After several paragraphs of other observations about the intrusiveness (still another hallmark of the wellness industry, in this case including monitoring employee sleep), she concludes:
The entire program is childish and silly. Another “social media” forum for people to get imaginary medals or stupid stuff while [Virgin] surreptitiously inserts little “healthy” reminders that may or may not be considered current health information. [Editors note: the majority of Virgin’s “1440 habit-building interactions per member per year” are either self-evident and cliched, outdated, wrong, unrelated to wellness, or controversial.]
I’m sure there are better ways to promote corporate fitness that are not insulting to the intelligence of adults. As a personal trainer and health coach, I’d be happy to give you a few ideas.
Here’s one idea: require wellness vendors to know the first thing about wellness.