Tag Archives: McKesson

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 Winter Street #208, Waltham MA 02451

In case you decide to sue me between June 22 and Aug. 8, use:

8 Paddock Circle, Chilmark, MA 02535

And don’t leave out my attorney:

Josh Gardner, GARDNER & ROSENBERG P.C.33 Mount Vernon St., Boston, MA 02108

I don’t know how much more I can do for you, other than lick the envelope. So go for it. Don’t make me beg.

But, remember, unlike with your usual business model, in court you are required to actually tell the truth (I would be happy to explain to you how that works), meaning there is no chance of your winning — or likely even avoiding summary judgment, because none of the evidence is in dispute. It’s all your own writings. Oh, and I do my own cross, which means you won’t be able to find an expert witness. Anyone who knows enough about wellness to be an expert witness also knows enough about wellness to know that attempting to defend you would be a humiliating, on-the-record experience.

And there is always the chance that some annoying jerk might blog about it…

The 2017 Runners-Up

Springbuk and Fitbit

As many of you recall, earlier in the year we analyzed the study done by Springbuk that was secretly financed by Fitbit. Or maybe I need new glasses, because I just couldn’t find the disclosure in the Springbuk report that this paean to Fitbit was financed by Fitbit, much as Nero used to have the judges award him Olympic medals.

Coincidentally, the study showed Fitbit saving gobs of money because employees taking more than 100 steps a day spend less money than those taking fewer. However, a simple tally of one’s own footsteps shows that it is impossible not to take 100 steps a day unless you are both:

  1. in a hospital bed; and also
  2. on dialysis.

This 100 steps-a-day threshold was repeated many times in the study, with no explanation of how that number came to be. However, it turns out we owe these two outfits an apology. Fitbit and Springbuk have told a number of people privately (not publicly, to avoid an embarrassing news cycle) that they didn’t really mean to say that 100 steps a day constituted activity. They meant to say that taking 100 steps a day implied you had your Fitbit on. My apologies for failing to read their minds that their conclusions were based on reading people’s minds to determine whether they wore the Fitbit deliberately, or simply forgot/remembered/cared to put their Fitbit on.

Springbuk and Fitbit never did explain — privately or publicly or to anyone — how employees who took an average number of steps during the baseline year could show huge savings by taking an average number of steps in the study year, too.

They also never explained how these two statements didn’t completely contradict each other, even though I specifically asked them to in a personal letter, excerpted here:

Third, can you reconcile this statement…:

“The materials in this document represent the opinion of the authors and not representative of the views of Springbuk, Inc. Springbuk does not certify the information, nor does it guarantee the accuracy and completeness of such information.”

…with this statement:

“This demonstration of impact achieved by integrating Fitbit technology into an employee wellness program reinforces our belief in the power of health data and measurement in demonstrating ROI,” said Rod Reasen, co-founder and CEO of Springbuk. 

National Business Group on Health

Next up is the National Business Group on Health. Last year, they made the list for criticizing the U.S. Preventive Services Task Force for not demanding enough screenings, in a country that is drowning in them. Not content to rest on those laurels, this year they earned an Honorable Mention for inviting Dr. Oz to keynote on the role of quackery in corporate wellness, and perhaps tell us about his latest lose-weight-by-eating-chocolate miracle diet.

See also: How Advisers Can Save Healthcare  

Health Enhancement Research Organization

HERO, of course, also earns a runner-up award. 2017 will be remembered as the year they finally came to grips with the realization that a business model based on fabricating outcomes requires that perpetrators possess that critical third IQ digit. Without that extra “1”, an organization trafficking in math that can at best be considered fuzzy is going to be outed.

This year’s set of lies?  By way of background, their 2016 poison-pen letter insisted they had fabricated that data set showing that wellness loses money without disclosing that it was fabricated — and also never reviewed their fabricated data before publication. Early in the year, I had the insight that, wow, this “fabricated” chapter in their guidebook is so much better than the other chapters that something is amiss. No one at HERO can analyze data competently…and yet, here it was, a competent data analysis.

I did something I had never thought to do before, which was look up the actual author of that chapter. It was Iver Juster, MD. He was a great analyst even before he read all my books, took all my courses and achieved all my certifications in Critical Outcomes Report Analysis.

So I called Iver. Here’s what I learned:

  1. Whereas Paul Terry and Ron Goetzel had insisted that Iver fabricated the data, Iver said that, of course he didn’t — whatever made me think that?  (“If it wasn’t real, I would have disclosed that,” he observed. Of course, he would have. Iver has tremendous integrity.)
  2. The board discussed and reviewed his chapter at length and made helpful suggestions, for which he was quite grateful. This review process required “countless hours,” just as the HERO document says:

The number of  transparent lies HERO tells could make a president blush. In the immortal words of the great philosopher LL Cool J, they lied about the lies they lied about.

Even though 2017 was an off-year for them in terms of the number of lies, they still told enough to be named a runner-up.

Wellness Corporate Solutions

Next is Wellness Corporate Solutions, famous for its crash-dieting contests. WCS now offers a water-drinking contest. The idea is to set up a “challenge” for your team to drink more water than other teams. They call this a “healthy competition.” I guess they didn’t get the memo that forcing yourself to drink when you don’t want to drink, just to make more money, is anything but healthy. Here is a novel idea: Drink when you are thirsty.  Evolution 1, WCS 0.

Perhaps as an encore, WCS, Dr. Oz and the National Business Group on Health could team up to offer a chocolate-eating contest.

I looked into this outfit to see where they get their ideas. The CEO previously ran something called the Washington Document Service. That qualifies her to run a wellness company. As Star Wellness says, to run a wellness company successfully, your background needs to be in sales, or “municipality administration.” After all, what is more central to administering a municipality than documents?

Wellsteps

What fun would a list of runners-up be without Wellsteps, the  proud recipient of the 2016 Deplorables Award? While their streams of consciousness weren’t as memorable in 2017 as in 2016 (“It’s fun to get fat. It’s fun to be lazy“), they get credit for trying. Their 2017 weight-loss campaign was headlined: “This campaign is not really about weight loss, it is about helping you apply the behavioral secrets of those who have lost weight.”

So if your kids ever want you to teach them how to ride a bike, say: “It’s not really about riding a bike. It’s about helping you apply the secrets of people who have ridden bikes.”

And what secrets are we talking about? What person who has lost weight doesn’t brag to everyone or even write a book?  If there is a secret to weight loss, like eating chocolate, Wellsteps owes it to the country to tell them. Don’t make us beg.

See also: Should Wellness Carry a Warning Label?  

Odds and Ends

No Koop Award winner this year, but an honorable mention to past winners and runners up for their commitment to wellness:

Sounds like in 2018 the logical winners would be Philip Morris, or maybe the Asbestos Corporation of America.

Veering briefly into the public sector, kudos to Rep. Virginia Foxx, (R-NC5) for introducing the Required Employee DNA Disclosure Act. Even HERO thought it was a dumb idea…and their threshold for thinking something that increases wellness industry revenue is a dumb idea is quite high, having all rallied behind the Johnson & Johnson fat tax, in which companies would be required to disclose the weight of their employees.

Next up…the winner of the 2017 Deplorables Award

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 program effectiveness. Most recently, Ron Goetzel, head of the committee that bestows the C. Everett Koop Award, told the new healthcare daily STAT News that only about 100 programs work, while “thousands” fail.

In that estimate, which works out to a failure rate well north of 90%, he is joined by Michael O’Donnell, editor of the industry trade journal, the American Journal of Health Promotion (AJHP). O’Donnell says that as many as 95% of programs fail. (For the record, I have no beef with him, because he once willingly admitted that I am “not an idiot.”)

The best example of this Goetzel-O’Donnell consensus? McKesson, the 2015 Koop Award winner. McKesson’s own data –even when scrubbed of those pesky non-participants and dropouts who are too embarrassed to allow themselves to be weighed in – shows an increase in body mass and cholesterol:

graph1

Vitality Group, which contributed to this McKesson award-winning result as a vendor, wants your company to publicly disclose how many fat employees you have. Why? So that you are “pressured” (their word) into hiring a wellness vendor like Vitality. Yet Vitality admits it can’t get its own employees to lose weight.

McKesson and Vitality continue a hallowed tradition among Koop Award-winning programs of employees not losing noticeable weight. For instance, at Pfizer, the 2010 award-winner, employees who opened their weight-loss email lost all of three ounces:

graph2

Maybe it’s unfair to pick programs based on winning awards. Awards or not, those programs could have cut corners. Perhaps to find an exception to the rule that wellness can’t improve outcomes, we should look to the most expensive program, Aetna’s. Unfortunately, even Aetna registered only the slightest improvement in health indicators, throwing away $500/employee in the process. Why that much? Aetna decided to collect employee DNA to predict diabetes, even though reputable scientists have never posited that DNA can predict diabetes.

So even award winners, wellness vendors themselves and gold-plated programs can’t move the outcomes needle in a meaningful way, if at all. Bottom line: It looks like we finally have both consensus on the futility of wellness, and data to support the wellness industry admission that way north of 90% of programs do indeed fail to generate outcomes.

Savings

Because wellness promoters now say most programs fail, it is no surprise they also say most programs lose money. Once again, this isn’t us talking. The industry’s own guidebook – written by Goetzel and O’Donnell and dozens of other industry leaders — shows wellness loses money. We have posted that observation on ITL before, and no one objected.

However, very recently, the sponsors of this guidebook (the Health Enhancement Research Organization, or HERO) did finally take issue with our quoting statistics from their own guidebook. They pointed out — quite accurately — that their money-losing example was hypothetical. It did not involve numbers they would approve of, despite having published them. (At least, we think this is what HERO said. One of their board members has learned that they have sent a letter to members of the lay media, telling them not to publish our postings. We are told HERO’s objection centers on our quoting their report.)

To avoid a lawsuit for quoting figures they prefer us not to quote, we substituted their own real figures for their own hypothetical figures — and using real figures from Goetzel’s company, Truven Health Analytics, multiplied the losses.

This very same downloadable guidebook notes that these losses, as great as they are, actually exclude at least nine other sources of administrative costs–like internal costs, impact on morale, lost work time for screenings, etc. (Page 10). Truven also excludes a large number of medical costs (Page. 22):

graph3

One could only assume that including all these administrative and medical losses in the calculation would increase the total loss.

Lest readers think that this consensus guidebook is an anomaly, HERO is joined in its conclusion that wellness loses money by AJHP. AJHP published a meta-analysis showing a negative ROI from high-quality studies.

Productivity

RAND’s Soeren Mattke said it best:

“The industry went in with promises of 3-to-1 and 6-to-1 ROIs based on healthcare savings alone. Then research came out that said that’s not true. They said, ‘Fine, we are cost-neutral.’ Now research says: ‘Maybe not even cost-neutral.’ So they say: ‘It’s really about productivity, which we can’t really measure, but it’s an enormous return.'”

The AJHP stepped up to make Dr. Mattke appear prescient. After finding no ROI in high-quality studies, proponents decided to dispense with ROI altogether. “Who cares about ROI anyway?” were O’Donnell’s exact words.

Because health dollars couldn’t be saved, O’Donnell tried to estimate productivity impact. But honesty compelled him to admit that workers would need to devote about 4% of their time to working out to be 1% more productive on the job. Using his own time-and-motion figures, and adding in program costs, his math creates a loss exceeding $5,200/employee/year.

I would have to agree with O’Donnell, based on my experience in the 1990s as the CEO of a NASDAQ company. Ours was a call center company, which meant someone had to answer the phones. If I had let employees go to the gym instead of working, I would have had to pay other employees to cover for them. Our productivity would have taken a huge hit, even if the workouts bulked up employees’ biceps to the point where they could pick up the phone 1% faster.

Where Does This Leave Us?

Despite our using their own figures, wellness promoters may object to this analysis, saying they didn’t really intend for these conclusions to be reached. Intended or not, these are the conclusions from their figures, and theirs largely agree with ours, expressed in many previous blog posts on ITL. And, of course, our website, www.theysaidwhat.net, is devoted to exposing vendor lies. The bottom line is, no matter whose “side” you are on, the answer is the same. Assuming you look at promoters’ actual data or statements instead of listening to the spin, the conclusion is the same: Conventional wellness doesn’t work.

It’s time to move on.