We are proud (but also insanely jealous) of our friend Soeren Mattke, whose PepsiCo article was named the #2 most-read for the year 2014 in Health Affairs. We, as our avid albeit narrow fan base may recall, ranked only #12–and even then that was just for blog posts, not articles in print.
Yes, we know it’s not always about Ron “The Pretzel” Goetzel and his twisted interpretations, but he seems to have come up with what appears to be exactly the opposite interpretation of what the PepsiCo study said. Don’t take our word for it — we’ve cut-and-pasted both what the study says about PepsiCo’s results and what he says about the study.
Here is what the article says about the financial impact of health promotion at Pepsico: ROIs well below 1-to-1, meaning a net financial loser, for health promotion. (DM, though, was a winner.)
As low as these ROIs are, several major elements of cost were not available for the calculation — probably enough extra cost to literally make the financial returns so meager that even if the program had been free, PepsiCo would have lost money.
Clear enough? Negative returns from health promotion at PepsiCo, even without tallying many elements of cost. Nonetheless, Mr. Goetzel pretzelized that finding in his recent wellness apologia. Listed under “examples of health promotion programs that work” as a program that is a “best practice” is: PepsiCo. It stands proudly beside the transcendant programs at Eastman Chemical/Health Fitness and the State of Nebraska.
We look forward to a clarification from Mr. Goetzel about how a program that lost a great deal of money on health promotion can be an “example of a health promotion program that work(s),” which we will duly print…but don’t be sitting by your computer screens awaiting it.
By Al and Vik
Oh, the twists and turns as Ron “The Pretzel” Goetzel tries to wriggle out of all his ethical stumbles.
This time around, we thought we had nailed both him and his cabal handing out the ironically named C. Everett Koop Award to themselves and their friends based on made-up outcomes. Specifically, this time they gave their sponsor (Health Fitness Corporation, or HFC) an award based on data that was obviously made up, that no non-sponsor could have gotten away with submitting. This was the third such instance we’ve uncovered of a pattern of giving awards to sponsors for submitting invalid data while making sure that the award announcement contains no reference to the sponsorship. (There are probably others; we’ve only examined 3, which might explain why we’ve only found 3.)
How obviously was the data made up? Well, take a looksee at this slide, comparing participants to non-participants. This is the classic wellness ignorati ruse: pretending that non-motivated inactive non-participants can be used as a valid control for comparison to active, motivated participants. The wellness ignorati would have us believe that any healthcare spending “separation” between the two groups can be attributed to wellness programs, not to inherent differences in motivation between the two groups. Unfortunately for the ignorati, their own slide invalidates their own argument: in 2005, the label “Baseline Year” shows there was no program to participate in, and yet – as their own slide shows – participants (in blue) significantly underspent non-participants (in red) nonetheless. In Surviving Workplace Wellness, we call this “Wellness Meets Superman,” because the only way this could happen is for the earth to spin backwards.
Given that the 2005 baseline label was in plain view, we just assumed that HFC did not indeed have a program in place for this customer (Eastman Chemical) in 2005, which is why they called 2005 a “Baseline Year” instead of a “Treatment Year.” Not actually having a program would logically explain why they said that didn’t have a program, and why they used that display or variations of it like the one below for 4 years with the exact same label. Presumably if they had had a program in 2005, someone at HFC would have noticed during those 4 years and relabeled it accordingly.
Originally we thought the Koop Award Committee let this invalidating mistake slide because HFC — and for that matter, Eastman Chemical — sponsor the awards they somehow usually win. But while trying to throw a bone to HFC, the Koop Award luminaries overlooked the profound implication that the year 2005 separation of would-be participants and non-participants self-invalidated essentially the entire wellness industry, meaning that is is an admission of guilt that the industry-standard methodology is made up.
Goetzel the Pretzel to the rescue. He painstakingly explains away this prima facie invalidation. Apparently the year 2005 was “unfortunately mislabeled.” Note the pretzelesque use of the passive voice, like “the ballgame was rained out,” seemingly attributing this mislabeling to an act of either God or Kim-Jung-Un. He is claiming that instead of noticing this invalidator and letting this analysis slide by with a wink-and-a-nod to their sponsor, none of the alleged analytical luminaries on the Koop Committee noticed that the most important slide in the winning application was mislabeled — even though this slide is in plain view. We didn’t need Edward Snowden to hack into their system to blow up their scam. They once again proved our mantra that “in wellness you don’t need to challenge the data to invalidate it. You merely need to read the data. It will invalidate itself.”
We call this the “Dumb and Dumber” defense. Given two choices, Goetzel the Pretzel would much prefer claiming sheer stupidity on the part of himself, his fellow Koop Award committee members like Staywell’s David Anderson and Wellsteps’ Steve Aldana, and his sponsor HFC, rather than admit the industry’s methodology is a scam and that they’ve been lying to us all these years to protect their incomes.
Still, the Dumb-and-Dumber defense is a tough sell. You don’t need Sherlock Holmes, Hercule Poirot or even Inspector Clouseau to detect a few holes in the Pretzel’s twisted logic:
- How could no one – no member of the Koop Award Committee or employee of Health Fitness Corporation (which used this as its “money slide” for years) – have noticed this until we pointed it out for the third time (the first two times not being as visible to the public)?
- In early 2012, this slide was reproduced–with the permission of Health Fitness Corporation–right on p. 85 of Why Nobody Believes the Numbers, with the entire explanation of its hilarious impossibility. We know Mr. Goetzel read this book, because he copied material out of it before the publisher, John Wiley & Sons, made him stop. So we are curious as to why it has taken until now for him to notice this “unfortunate mislabeling.” Hmm…would the fact that it was just exposed to the world in Health Affairs have anything to do with this sudden epiphany? We’re just sayin’…
- If indeed it was just an “unfortunate mislabeling,” how come HFC has now expunged all references to this previously highlighted slide from their website, rather than simply change the label?
As regards the third point, we would recommend that next time Mr. Goetzel invokes the Dumb-and-Dumber defense, he coordinate his spin with his sponsor.
But let’s not overlook the biggest point: the entire Koop Committee – including “numbers guys” like Milliman’s Bruce Pyenson and Mercer’s Dan Gold — is apparently incapable of reading a simple outcomes slide, as they’ve proven over and over.
So, as a goodwill gesture, we will offer a 50% discount to all Koop Committee members for the Critical Outcomes Report Analysis course and certification. This course will help these committee members learn how to avoid the embarrassing mistakes they consistently otherwise make and (assuming they institute conflict-of-interest rules as well to require disclosure of sponsorships in award announcements) perhaps increase the odds that worthy candidates win their awards for a change.
Questions for The Chapman Institute’s Larry Chapman:
We are looking all through the study you cited in defense of Health Risk Assessments (HRAs) and cannot find the 50% savings from HRAs that you say is hidden in here somewhere. This study, despite your CAPITALIZED insistence to the contrary, seems to show the opposite: In 4 of the 6 study periods — and in all 6 periods combined compared to baseline — the control group spending was actually lower than the study group. So where is the 50% savings that we can’t find?
ANS: Refused to Answer
You say HRAs should be treated like “one of your children or at least a beloved pet”. Have you taken into account the possibility that some HRA respondents may lie, as Professor Woessner advised his Penn State colleagues to do, and as most of the people I know do since most people feel their personal lives should not be the concern of their employers?
ANS: Refused to Answer
Many people have questioned your understanding of arithmetic even before you found a 50% total healthcare cost reduction due to HRAs by reading the data excerpted above, so here is your chance to enlighten them. In this article below, you originally stated that Baicker’s analysis (which she has now backed off) reduced medical claims by “327%” and absenteeism costs by “273%”. How is it possible to reduce a number by more than 100%?
ANS: “Workplace Wellness Management” January 10 comment:
“You seem to conveniently forget that the editor of the CFO blog made the error, not me.”
Followup: You submitted, reviewed and signed off on the original “327% savings” and “273% reduction.” However — after a commentator pointed out the impossibility of those figures — the editor does acknowledge that you did notice at that point that 327% and 273% reductions in any number are not possible, and asked him to change the figures, first to the above 32.7% and 27.3%, but then to the 3.27-to-1 and 2.73-to-1 (now discredited) figures that were in the Baicker article. So in the narrowest sense of the word — after you made the initial, most revealing, mistake by misunderstanding that “3.27-to-1 ROI” and “327% savings” are not interchangeable figures — the editor of the CFO blog is acknowledging “the error,” by not making the final correction in a timely way. The larger point is that you did submit “327% savings” and “273% reduction” originally, raising the question of why anyone should believe the research findings of someone who doesn’t know that you can’t reduce a number by more than 100%.
ANS: Refused to answer
You also wrote in 2012 that studies show you can save 25% through wellness. Most of these studies took place in decades (1980s and 1990s) when dietary advice consisted of telling people to eat more sugar and less fat, and when the AHA gave Kellogg’s Frosted Flakes a “heart-healthy” label?. How could that kind of misinformed advice show not just savings, but savings 6x greater than the total amount that employers spend on wellness-sensitive medical events, which is 4%?
ANS: Refused to answer
Perhaps the strategy of the leaders of the wellness ignorati (who constitute the Koop Committee) is to overwhelm us with so many lies that we don’t have time to expose every one and still get home in time for dinner.
No sooner have we finished pointing out the numerous (and unrebutted) implausibilities and internal inconsistencies in Ron Goetzel’s posting on the value of workplace wellness, than the Koop Committee (Mr. Goetzel and his cabal) feeds us even more red meat: They gave the 2014 Koop Award to British Petroleum. However, apparently only British Petroleum wants to tell the world about it. The Koop Committee hasn’t even updated its own website to list 2014 award winners.
Recall that we’ve spent months excoriating Goetzel and his sidekicks (Wellsteps’ Steve Aldana, Milliman’s Bruce Pyenson, Mercer’s Dan Gold and the rest of them) for doing three things in the Nebraska award, for a program that prima facie seems to be in violation of Nebraska’s state contractor anti-fraud regulations:
(1) Gave it to a program where the numbers were obviously fabricated and later admitted to be
(2) Gave it to a program whose vendor sponsors the Committee
(3) Forgot to disclose in the announcement that the vendor sponsors the Committee
Perhaps what you are about to read isn’t their fault. Perhaps their mothers simply failed to play enough Mozart while the Committee members were in their respective wombs, but here’s how they applied the learning from the Nebraska embarrassment to their decision to award British Petroleum. This time they:
(1) Gave it to a program where the numbers had already been shown to be fabricated
(2) Gave it to a program whose vendor sponsors the Committee
(3) Forgot to disclose in the announcement that the vendor (Staywell) sponsors the Committee
(4) Forgot to disclose in the announcement that the vendor sits on the Committee
(5) Forgot to disclose in the announcement that the consulting firm (Mercer) sponsors the Committee
(6) Forgot to disclose in the announcement that the consulting firm sits on the Committee
I suspect we will be writing a similar analysis again next year, when once again, the Committee will attempt to demonstrate the value of sponsoring a C. Everett Koop Award.