Al Lewis, Author at Insurance Thought Leadership



Al Lewis

Al Lewis

Al Lewis, widely credited with having invented disease management, is co-founder and CEO of Quizzify, the leading employee health literacy vendor. He was founding president of the Care Continuum Alliance and is president of the Disease Management Purchasing Consortium, the leading procurer and evaluator of valid programs for health plans and large employers. 

Named one of 13 Unsung Heroes of Healthcare to Watch in 2013, he is a visiting scholar at Brandeis University and formerly taught economics at Harvard . He is also author of the critically acclaimed trade-bestselling Forbes Healthcare Book of the Year Why Nobody Believes the Numbers: Distinguishing Fact from Fiction in Population Health Management and of the recently released Surviving Workplace Wellness…: With Your Dignity, Finances and (Major) Organs Intact.

Recent Articles by Al Lewis

Are Your Vendor’s Claims Valid? (Part 2)

The first installment covered regression to the mean. This installment features the fallacy of using non-participants as a control for participants.  This “control” fallacy led the Food and Drug Administration to reject this methodology more than half a century ago.  And, as we’ll see through examples below, correctly so. The news of the fallacy and […]

Did Biden Just Kill Wellness Programs?

After a decade of criticism from me (here on ITL, in particular) and a growing number of others, workplace wellness died last week. It had been on life support since Jan. 7.  The bottom line: Brokers and advisers should now be aware both of the professional risks they are taking by pitching clinical wellness programs […]

A Workplace Wellness Skeptic Lets Loose

This an excerpt from an interview that HIStalk conducted with Al Lewis, JD, the author of several books on healthcare outcomes, the operator of the website, They Said What? Because the Wellness Industry’s Pants Are On Fire, and the founder and CEO of Quizzify. The full interview can be found here.  Tell me about yourself and what […]

Why to Rethink Dental Checkups

Four out of five dentists recommend twice-a-year teeth cleaning. Here’s why the fifth dentist is right. Ask yourself these questions: Are you healthy? Do you brush your teeth every day? Is your mouth free of problems such as bleeding gums or sensitivity to cold or hot foods and drinks? Do you dislike wasting your money […]

5 Ways to Snooker Employers on Diabetes

The diabetes industry is far more sophisticated than the wellness industry when it comes to dramatically overstating outcomes and savings. Excluding vendors by the Validation Institute like It Starts with Me and US Preventive Medicine, wellness industry claims can easily be shown to be fraudulent. It’s equally easy to back that assertion with a $3 million reward, knowing that no […]

The Evil Genius of a Wellness Program

Arkansas recently contracted with an out-of-state vendor called Catapult Health to come in to the state’s schools and “play doctor” with the teachers, asking them personal questions, taking their blood and then telling them everything that’s wrong with them. This is a classic example of a “pry, poke and prod” program. This is followed by […]

Faulty Math Behind Over-Treatment

The American Cancer Society (ACS) recently decided that, because the rate of colon cancer has increased by an “alarming” 22% in the 45-to-49-year old cohort this century, colon screenings should start at age 45. This is a very instructive decision, though not because it is a good idea. Rather, it’s instructive because it’s a “teachable […]

Why We Should All Keep Drinking

Apparently, the wellness industry does not have a monopoly on invalid research. A study came out in The Lancet–the British equivalent of the New England Journal of Medicine — finding that the only safe level of alcohol consumption was: none.  As the principal investigator said: “Alcohol poses dire ramifications for future population health in the absence of policy […]

‘Wild West’ of Suits Coming for Wellness

A group of screening vendors and their trade associations have drafted a letter to senators in which they reveal their hitherto unpublished level of panic over the December 2018 sunsetting of the EEOC’s safe harbor for incentives and penalties for health risk assessments and biometric screenings. Their specific words are: “Without clear guidance from the […]

Wellness Programs Lack Health Literacy

The more informed your employees are about health and healthcare, the wiser and more confident they’ll be when it comes to making the right lifestyle and healthcare choices. Health Literacy Health literacy improves health outcomes, while controlling health spending. The Institute of Medicine (IOM) defines it as: “the degree to which individuals have the capacity […]

Employee Wellness Plans’ Code of Conduct

The Employee Health Code of Conduct calls for employee wellness programs to commit to the improvement of employee health while avoiding harmful practices. Quizzify is proud to be the first wellness program to embrace the code, and the Employee Health Code of Conduct will be a contractual term in all contracts moving forward. See also: A Wellness […]

Wellness Industry’s No-Good, Very Bad Year

OK, this time I’m not the one causing the kerfuffle in the wellness industry, though I will confess to being a force multiplier. Not since 2014, when the very unstable morons at the Incidental Economist made fun of the very stable geniuses who give out the Koop Award and also unequivocally concluded that wellness loses money — combined with […]

Wellness Works? Prove It–and Win $$$

The reward for showing your wellness program works is now $3 million! As almost everyone in the wellness industry knows, we have offered a $2 million reward to anyone who can show that conventional annual “pry, poke and prod” wellness saves money. I’m feeling very generous today, so let’s make the reward $3 million. Even more importantly, let’s […]

Dissecting Landmark Decision on Wellness

This is a follow-up to the announcement and “back story” of the Dec. 21 wellness decision in AARP vs. EEOC, a decision that could severely curtail incentives and penalties…and that could, to paraphrase the most memorable G-rated words ever spoken by Bill Clinton, end wellness as we know it. That’s the bad news. The good news is that this […]

2017 Deplorables Awards — Runners Up

It’s time for the 2017 Deplorables Awards, lovingly bestowed on those vendors who do the best job making other vendors look good.  The good news is that you don’t have to actually win the Deplorables Award to sue me.  Runners-up are eligible, too. Here is my address for hand-service delivery most of the year: 890 […]

Stents Provide a Lesson on Healthcare

Intuitively, stents make sense. If you’ve got occasional chest pain due to reduced blood flow to your heart, having a stent—a thin mesh tube inserted into a coronary artery to hold it open—is a seemingly logical solution. Half a million of these procedures, called angioplasties, are performed every year, at a cost of roughly $20,000 […]

Should Wellness Carry a Warning Label?

You know those “three biggest lie” jokes? The third biggest lie would be: “I’m from Interactive Health, and I’m here to help you.” Hilarious… unless you are one of those unfortunate souls who are: paying their bills; believing their outcomes; or taking their advice. The first and third are closely related in the sense that […]

6 Shocking Facts on Opioid Abuse

What is your most pressing employee health issue today? It’s not cholesterol, weight, sitting or probably anything else you are prioritizing. Instead, by far the major health menace facing your employee population is the opioid epidemic — which, according to Harvard Medical School psychiatrist John Kelly, has reached “DEFCON 5.” DEFCON 5 is right. There […]

Wellness Isn’t the Only Scam in Healthcare

Healthcare meets Network. That is the one-sentence summary of Dave Chase’s new book, A CEO’s Guide to Restoring the American Dream: How to Deliver World-Class Healthcare to Your Employees at Half the Cost. Dissecting the title, the “restoring the American Dream” reference is as follows: While wages have barely budged in the last 20 years, employee compensation […]

Wellness Vendors Keep Dreaming

Alice laughed: “There’s no use trying,” she said. “One can’t believe impossible things.” “I daresay you haven’t had much practice,” said the Queen. “When I was younger, I always did it for half an hour a day. Why, sometimes I’ve believed as many as six impossible things before breakfast.” Six impossible things before breakfast?  The wellness industry would just be […]

Fitbit’s Impossible Claims on Wellness

In wellness, it’s totally legal to lie to customers. Indeed, if you don’t, you’ll probably lose them, since your competitors are happy to do exactly that, and most customers aren’t going to notice anyway. In securities, though, it is totally illegal to lie to shareholders or to pay someone to write a favorable but dishonest […]

A Wellness Program Everyone Can Love

I’ve been quite vocal about supporting only wellness done for employees and not to them…but what if there could be a “conventional” wellness program – even including screening, HRAs etc. – that both you and I could love? People manage what’s measured and what’s paid for. If employers want people to stay healthy in the […]

Shattering the Wellness ROI Myth

There is a 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.” Indeed, if there is one thing you can take to the bank in this field, it’s that articles intending to prove that wellness works inevitably prove the opposite. […]

$2 Million Reward if Wellness Works!

Does wellness save money? I say no. The wellness industry — specifically its trade association, the Health Industry Research Organization (HERO) — says yes. We both can’t be right. The difference is that I am backing up my conclusion with a $2 million reward, up from last year’s paltry $1 million offer, for showing that […]

What Trump Means for Workplace Wellness

Assume, reasonably, that voters chose Donald Trump to be the next president because they feel big business and government are in bed together. If indeed they are, workplace wellness is their sex toy. There is nothing, certainly in healthcare and possibly anywhere, that more embodies the complete disdain for the average worker than the joined-at-the-hip […]

A Proposed Code of Conduct on Wellness

So many wellness industry misdeeds to expose, so little room on the internet. This posting will start out as one of my typical shock-and-awe postings featuring a wellness vendor raising the bar for dishonesty and employee harms. Uniquely, though, we will close with a surprisingly uplifting slam-bang conclusion that could change the wellness industry forever…but […]

Opioids Are the Opiates of the Masses

One day in 2014, before most people could even spell “opioids” (two “i’s), the CEO of a company named Healthentic asked me to review a white paper based on the output of its new analytics tool. Healthentic’s tool is far more focused on the “80” of the “80-20” rule than competing tools are. So, rather […]

EEOC Caves on Wellness Programs

In a deep dark recess of the Federal Register this week, large corporations quietly received permission to “play doctor” with their employees. Corporations can now impose even more draconian and counterproductive wellness schemes on their workers. The hope of the corporations is to claw back a big chunk of the insurance premiums paid on the behalf of employees who refuse to […]

Employers: Don’t Pay for ‘Never Events’

The initial installment in this series expressed concern that too narrow a focus on wellness diverts companies’ attention from more compelling opportunities to save money and improve employee health outcomes. This installment starts with a related  shocker: By far the most costly inpatient diagnosis code, septicemia, is not addressed by any wellness program in the […]

The Yuuuuge Hidden Costs of Wellness

We  have written extensively on the direct costs of dealing with wellness vendors, which often do wellness to employees instead of doing it for them. Employers in self-administered programs tend to focus much more on cultural improvements—the “for” instead of the “to.” However, there’s not really a vendor business model in doing wellness for employees. Cultural […]

Should You Announce How Fat Workers Are?

A shockingly serious proposal has been floated to first persuade (and later possibly compel) publicly traded companies to disclose to shareholders quite literally how fat their employees are. Also, how much they drink, how well they sleep and how stressed and depressed they are. This proposal, advocating what is known as a fat tax, shouldn’t […]

Wellness Promoters Agree: It Doesn’t Work

How many times do wellness promoters have to admit or prove that wellness doesn’t work before everyone finally believes them? Whether one measures clinical outcomes/effectiveness, savings or productivity, the figures provided by the most vocal wellness promoters and the most “successful” wellness programs yield the same answer: Wellness doesn’t work. Outcomes/Effectiveness Let’s start with actual […]

Federal Court OKs Huge Wellness Fines

While most of us were buying supplies for partying on New Year’s Eve (in my case, I was in charge of bringing broccoli and Boggle), the federal court in the Western District of Wisconsin quietly handed down an earth-shattering decision in the Flambeau case, which went pretty much unnoticed due to the timing. You may recall this […]

Triathlete’s View on Workplace Wellness

We frequently get complaints from “average” employees about wellness, and our most popular article on the Huffington Post 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 […]

10 Most Dangerous Wellness Programs

If corporate wellness didn’t already exist, no one would invent it. In that sense, it’s a little like communism, baseball, pennies or Outlook. After all, why would any company want to purchase programs that damage morale, reduce productivity, drive costs up…and don’t work 90% to 95% of the time? And those are the results reported by wellness proponents. Those are […]

Genetic Testing: The New Wellness Frontier

The Wall Street Journal just reported that Genetic Testing May Be Coming to Your Office Soon. This is all well and good, assuming employees want their health insurer’s buddies collecting their DNA for no good reason, handling it, selling it and possibly losing it. This is not us talking. This is what the genetic testing […]

New Wellness Scam: Value on Investment

What do you do if your entire industry has a negative ROI? If your industry and its lack of ROI have been skewered in the media? If even RAND, which is the most neutral, grownup organization in all of healthcare, now says your industry, wellness, produces no savings and no reduction in utilization of healthcare […]

$1 Million Reward to Show Wellness Works

We hope at least a few of you have lamented –we’ll settle for noticed — our absence from ITL for the last six months. There are two reasons. First, in the immortal words of the great philosopher Gerald Ford, “When a man is asked to make a speech, the first thing he has to do […]

Wellness War Is Over; Wellness Lost

What if we told you that “pry, poke, prod and punish” wellness programs are bad for morale, damage corporate reputations and cost more money than they save? You’d say: “Al, you, Tom Emerick and more recently Vik Khanna have been telling us that for years.” You might add: “And while your opinions are usually well-reasoned […]

Wellness Programs Save Money!

April Fools. Of course wellness doesn’t save money. Even the industry trade association itself, the Health Enhancement Research Organization, admits wellness loses money. That doesn’t mean the industry lacks other benefits, such as levity. And in the spirit of the wellness field’s most appropriate holiday, we present “On the (Even) Lighter Side,” a compendium of […]

How CDC Sparked the Wellness Legend

The wellness emphasis in the Affordable Care Act is built around the Centers for Disease Control and Prevention’s (CDC) call to action in 2009 about chronic disease: The Power to Prevent, the Call to Control. On the summary page, we learn some of what the CDC calls “arresting facts”:  “Chronic diseases cause seven in 10 deaths […]

Common Ground on Wellness? Not So Fast

[Editor’s Note: A debate about the effectiveness of corporate wellness programs began on this site in late November, with the publication of a piece arguing that rigorous analysis showed no savings. A prominent proponent of wellness responded with a piece acknowledging some common ground but pushing back on the need to have wellness programs show a […]

11 Questions for Ron Goetzel on Wellness

We thank Ron Goetzel, representing Truven Health and Johns Hopkins, for posting on Insurance Thought Leadership a rebuttal to our viral November posting, “Workplace Wellness Shows No Savings.” Paradoxically, while he conceived and produced the posting, we are happy to publicize it for him. If you’ve heard that song before, think Mike Dukakis’s tank ride […]

Wellness Industry’s Terrible, Horrible, No-Good, Very Bad Week

Just as the Bear Stearns implosion presaged the 2008 financial crisis, the events of the last few days, building on earlier events, are presaging the collapse of the “pry, poke, prod and punish” wellness industry. For those readers still living in Biosphere 2, here is a brief review of how we got here: First was […]

CEOs Defy Common Sense on Wellness

By now, readers of this and many other outlets know that conventional workplace wellness doesn’t work. Period. It’s not that there is no evidence for it. It’s that all the evidence is against it. The “evidence” in favor of conventional wellness is easily disproven as being the result of gross incompetence or dishonesty. Occasionally, as […]

Workplace Wellness Shows No Savings

During the last decade, workplace wellness programs have become commonplace in corporate America. The majority of US employers with 50 or more employees now offer the programs. A 2010 meta-analysis that was favorable to workplace wellness programs, published in Health Affairs, provided support for their uptake. This meta-analysis, plus a well-publicized “success” story from Safeway, coalesced into the so-called Safeway […]

Inoculating Your Wellness Program Against the EEOC

Two months ago, a posting appeared in this column titled: Are Obamacare Wellness Programs Soon to be Outlawed? Truthfully, that headline was picked for its sky-is-falling value, treating one EEOC lawsuit against one wacky wellness program as a risk for wellness programs everywhere. As luck would have it, the sky just fell yesterday — right […]

UPMC Wellness Plan Meets Seinfeld: It’s About Nothing

There is a saying:  “In wellness, you don’t have to challenge the data to invalidate it. You simply have to read the data. It will invalidate itself.” Nowhere is this truer than in the University of Pittsburgh Medical Center’s (UPMC) wellness program, results of which were just released in the October issue of the American […]

The Wellness Industry Pleads the Fifth

The wellness industry’s latest string of stumbles and misdeeds are on the verge of overwhelming the cloud’s capacity to keep track of them. First, as readers of my column may recall, is the C. Everett Koop Award Committee’s refusal to rescind Health Fitness Corp.’s (HFC’s) award even after HFC admitted having lied about saving the […]

Arianna Huffington Embarrasses Herself

Yesterday, the highest-profile person ever to address the topic of wellness — Arianna Huffington — posted this. I don’t think I’ve ever seen anyone get a story more wrong when a few simple mouse-clicks could have cleared up any misconceptions. (Note: Unlike probably everyone else who attacks Ms. Huffington, I have no political agenda, because she is in the […]

11,000 Producers Can’t All Be Wrong. . . or Can They?

Just when you’d think that wellness vendor claims can’t get any wackier, here comes Wellsteps’ ROI Calculator, which claims that companies can reduce healthcare costs to a level below zero (meaning, by the way, that you would have pay commissions to your clients). Even crazier — if that’s possible — look at the left-hand part of the […]

Pinch Me! A Healthcare Program That Works

Those of you who are regular readers of this column may have noticed my postings usually observe that most vendors don’t save money — for example, Wellness: An Industry Conceived in Lies, Retractions and Hypocrisy. (Note that this particular article was accompanied by an editorial in which Paul Carroll, ITL’s fearless leader, described how he had […]

‘Surviving Workplace Wellness’: an Excerpt

Our series of excerpts from Surviving Workplace Wellness starts with the epilogue, because Aetna managed to incorporate everything that is wrong with workplace wellness, as described in the book, into one press release. It is the book’s epilogue because Aetna’s announcement followed the completion of the text. We actually held up publication of the print version to […]

Wellness: An Industry Conceived in Lies, Retractions and Hypocrisy

Wellness has failed.  Get used to it.  Understanding why wellness has failed requires a brief history lesson of the wellness provision of the Affordable Care Act (ACA). The wellness provision was based on the success story at Safeway and a seminal article in Health Affairs — both of which turn out to be made up.  […]

Wellness Programs Take a Punch to the Gut at PepsiCo

The report in the journal Health Affairs about PepsiCo marks the first time a major organization has been found to be losing money in a wellness program (not including the ones that my colleagues and I are exposing as frauds, like British Petroleum and the Nebraska state employee program).  Highlights are as follows: Disease management […]

Everything That Ails Our Healthcare System … Squeezed Into One 12-Minute Doctor Visit

A few weeks ago I taped the first episode of my new public radio show. I thought I sounded good enough, and the producer assured me that I would sound even better after I got over my cold. This would have been reassuring, except that I didn’t have a cold. Fearful of being fired my […]

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