Tag Archives: boise school district

$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 wellness works.

See also: What Trump Means for Workplace Wellness  

Beyond that $2 million, I would also send a $1 million donation to the Boise School District to atone for the highly unfavorable coverage it has received about its program, coverage apparently so biased that the CEO of Boise’s vendor, Steve Aldana, called the award-winning STATNews journalist who wrote it a “lier.”

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To win the $2 million reward for yourself and the $1 million for the school district, you just need to prove (using the more-likely-than-not civil standard of proof), the following (to bend over backward to be fair, I will start out by offering to use only materials prepared by your side):

  1. During this millennium, the wellness industry has reduced hospitalizations by enough to break even, using the government’s Healthcare Cost and Utilization Project database. For this one, I will concede in advance that the wellness-sensitive medical event methodology (“potentially preventable hospitalizations”) as described on pages 22-23 of the HERO Outcomes Guidebook is the one to use. (HERO and I agree that non-hospitalization expenses increase.)
  2. The vendor anointed in 2016 as the “best” vendor, Wellsteps, indeed did reduce the costs of the Boise School District by about a third (as the company claimed), specifically by making the employees sufficiently healthier to support that savings (as the company claimed). For this one, I will concede in advance that the raw data collected by Wellsteps is accurate. In other words, we are both working off Wellsteps’ own published reports.

Here are the rules. This is a binding legal offer, as any attorney will tell you.

Panel, Venue and Judges

We each pick two panelists from Peter Grant’s “A-List” of the leading 260 health economists and policy experts (this is an invitation-only email group where health policy and health economics concerns are addressed and debated) that are unaffiliated with either the wellness industry or with my company, Quizzify, and together they pick a fifth.

The parties will convene in Boston for a 2.5-hour finalist presentation, featuring:

  • 10-minute opening statements, in which as many as 15 slides are allowed;
  • 30-minute cross-examinations with follow-up questions and no limitations on subject matter;
  • 60 minutes in which panelists control the agenda and may ask questions of either party based on either the oral or the written submissions;
  • Five-minute closing statements.

Entry Fee and Award

I give you a lien on $2 million as soon as you put $200,000 in escrow to cover the costs of the program, for panelist honoraria, venue, etc., as well as for wasting my time with your quixotry. If I win, I will make a $100,000 in-kind donation to the Boise School District to help compensate them for the fees the district wasted on its wellness program.

Length and content of Submissions

Each side submits up to 2,000 words and five graphs, supported by as many as 20 links; the material linked must pre-date the award application to discourage either side from creating linked material specifically for this contest.

Publicly available materials from the lay media or blogs may be used, as well as from any of the 10 academic journals with the highest “impact factors,” such as Health Affairs, published within the last five years.

Each party may separately cite previous invalidating mistakes made by the other party that might speak to the credibility of the other party.

Either side may cite an unlimited number of “declarations against interest” made within the last five years — meaning comments made by the other party so prejudicial to their own position that the other party would have said them only if they believed these statements to be true. Example: If I said, “Wellness definitely saves money” (except when I said that as an April Fool’s gag a few years back), you could cite that. There is no word limit on these.

See also: There May Be a Cure for Wellness  

Each party can then rebut the other party in writing with up to 2,000 words and five graphs as well as 20 links.

Additionally, we both take a lie detector test. Each side will present the polygraph operator with five questions, and all 10 questions will be asked of both parties. Results are then sent to the panelists.

What if you want to claim the award?

Send $1,000 via Paypal to alewis@dismgmt.com to hold your spot. I will set up an escrow account at Bank of America. Once we both sign the escrow papers, you send the $200,000 to that account, and I’ll give you first lien on $2 million of asset

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 only with your help.

The Bad News

It’s that time of year again, when traditionally the C. Everett Koop Award Committee bestows an award upon a fellow committee member or award sponsor, in recognition of doing the best job of fabricating dramatic savings while making only trivial improvements in employee health. That’s par for the course, and isn’t even news any more.

See also: The Yuuuuge Hidden Costs of Wellness

However, this year, the Koop Award Committee apparently decided that actually improving employee health was too high a bar for a wellness program to clear, so the committee gave the award to a committee colleague, Wellsteps, for a program in which the health status of Boise School District employees deteriorated. We’ve done the arithmetic so you don’t have to. The award application below shows that 5,293 employee biomarkers improved, while 6,397 got worse.

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In addition to the objective failure of the program, consider employee self-reported health. The single most important question to ask to gauge the state of someone’s health is: “How is your health?” Wellsteps buried the answer to that question at the end of a long list, but squint hard enough and you can see that Boise employee self-reported health status declined, by a small but statistically significant (p=0.0007) amount:

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There are many other problems with this program, too. Wellsteps is shaming even the lightest drinkers, attributing massive savings to improved health despite the deterioration in health, suppressing data showing increased health spending and flouting clinical guidelines. All that is covered in this Linkedin Pulse.

In all fairness, here is the response from Wellsteps’ Troy Adams (best known in the wellness industry for posting that ”It’s fun to get fat, and it’s fun to be lazy”) to my initial observations that Wellsteps is harming employees and fabricating savings. Surprisingly, I agree with both points:

  1. Yes, the Wellsteps data is “rock solid;” and,
  2. Yes, having just walked into from 92-degree heat, I am at least temporarily full of “hot air.”

The Good News

Fabricating savings is part of the Koop Award DNA, but bestowing an award on a vendor that actually harmed employees crosses a bright red line. Rather than complaining about it (or more accurately, in addition to complaining about it), I thought it might be time to take steps to prevent this type of performance from being considered acceptable, let alone prizeworthy.

So I convened a group, including WELCOA‘s respected and forward-thinking new CEO, Ryan Piccarella, and leading wellness gurus Jon Robison and Rosie Ward of Salveo Partners. Together, we crafted a very simple and minimalist Code of Conduct. (I don’t want to take more than my share of the credit. This was a joint effort. I just happened to be the one who initiated the email chain.) In full, it appears below. It is definitely “minimalist,” a Code of the first-do-no-harm variety. And yet, as low a threshold as it is, many vendors – including Wellsteps and many previous Koop Award winners – would not be able to meet it.

What we would ask of ITL’s readership is:

  1. Circulate this posting/the Code widely;
  2. As brokers or customers, insist that your vendor(s) follow the Code of Conduct…and add it as an actual contractual term;
  3. As brokers or vendors, announce that you will be following the Code. (While this blog is my own effort, I am also affiliated with Quizzify. Quizzify will be announcing this week that it intends to make this Code of Conduct a contractual term, meaning that failing to adhere to it would constitute a breach of our obligations under the contract.)

The Employee Health Program Code of Conduct

Our organization resolves that its program should do no harm to employee health, corporate integrity or employee/employer finances. Instead, we will endeavor to support employee well-being for our customers, their employees and all program constituents.

Employee Benefits and Harm Avoidance

Our organization will recommend doing programs with/for employees rather than to them, and will focus on promoting well-being and avoiding bad health outcomes. Our choices and frequencies of screenings are consistent with U.S. Preventive Services Task Force (USPSTF) and CDC guidelines and Choosing Wisely.

See also: Wellness Promoters Agree: It Doesn’t Work  

Our relevant staff will understand USPSTF guidelines, employee harm avoidance, wellness-sensitive medical event measurement and outcomes analysis.

Employees will not be singled out, fined or embarrassed for their health status.

Respect for Corporate Integrity and Employee Privacy

We will not share employee-identifiable data with employers and will ensure that all protected health information (PHI) adheres to HIPAA regulations and any other applicable laws.

Commitment to Valid Outcomes Measurement

Our contractual language and outcomes reporting will be transparent and plausible. All research limitations (e.g., “participants vs. non-participants” or the “natural flow of risk” or ignoring dropouts) and methodology will be fully disclosed, sourced and readily available.