The good news about wellness is that many very well-intentioned people and groups are making some major, disruptive strides in replacing wellness done to employees with wellness done for employees. So we see less of this…
and more of this… (photo courtesy of Limeade)
The bad news is that nominees for this posting in previous years have been so few and far between that I used to be able to effuse at length about each of the winners. However, there are so many of them now that this will be more like a listing than a posting.
Nonprofit and Advocacy Organizations
Many honorable mentions here, but only one winner. First, the honorable mentions. The National Association of Healthcare Purchasing Coalitions and their affiliated groups, notably Philadelphia, one of the fastest-growing regional coalitions, with additional kudos to the Colorado Business Group on Health and the Northeast Oklahoma Business Group on Health for being way out in front of the move towards the intersection of culture of health and culture of health literacy. Despite great pressure from sponsors and vendors, these regional coalitions stick to their charter and actually represent the constituency they say they represent–the employers. Doing your job may seem like a pretty low bar, but it’s one that the National Business Group on Health needs a telescope to look up at, having invited Dr. Oz to give a keynote on the role of quackery in a wellness program.
Next, the US Preventive Services Task Force. “Screen according to USPSTF guidelines” remains the mantra of the Welligentsia. Conversely, wellness vendors brag about how they ignore guidelines. Along with often testing for far too many things, they ignore the frequencies set by USPSTF, instead testing annually, because they say: “We need to measure progress.” Two thoughts on that:
- They don’t need to “measure progress” for one simple reason: there is no progress to measure. Annual prying, poking and prodding employees generates virtually zero positive impact. Hence my reward for showing cost-effective progress using “pry, poke and prod” is now $3 million.
- Flouting the guidelines just to measure the cholesterol of the employees would be like burning the roast just to measure the temperature of the oven.
Since hyperscreening is one humongous medical error, it’s no surprise the The Leapfrog Group wins plaudits again this year.
On the conference side, both WELCOA and Global Health Resources hosted excellent conferences, with emphasis on wellness done for employees instead of to them. Here in Massachusetts, the New England Employee Benefits Council conference last week was also a big hit. The exhibit hall included only one antediluvian wellness vendor, but that only reminded attendees of how far we’ve come. In sharp contrast, the speaker roster featured Brian Klepper, one of the most disruptive people in healthcare.
Just in terms of sheer drama and enjoyment, though, the Rock Stars of Health conference would be the winner. Worth traveling all the way to Montana for.
However, among nonprofit and advocacy organizations, the hands-down winner for 2017 is AARP, specifically Debbie Chalfie. Unlike us here at TSW, who simply report the news, or HERO, which simply fabricates the news, AARP makes the news. In 2017 they got a court — and this should not have been a heavy lift, but it was — to agree that maybe, just maybe, the words “forced” and “volutary” are not synonyms, meaning that employers can’t make employees choose between submitting to vendors playing doctor or paying large fines. We still don’t know how this will turn out, ultimately, but at least it is now up for debate. The EEOC is supposed to propose new rules next year. For now, there are still no constraints on fining employees large sums for not participating in these programs.
As usual, the media is lined up 100% against the pry-poke and prod agenda. The winner this year is the law-medicine journal of Case Western Reserve, HealthMatrix. It is the oldest law-medicine journal in the country and arguably the most respected. This year they tried to do an issue on wellness with representation from both advocates and critics…but couldn’t find any of the former who weren’t conflicted out by their role in the industry. Literally, there is not one single non-industry-connected person who supports wellness on its merits enough to write about it. So all five articles were critical conventional wellness-done-to-employees-not-for-them, representing five different authors (or groups of authors) detailing five different major issues.
Vendors and Other Groups
In wellness, the big news was the establishment of the Employee Health and Wellness Program Code of Conduct. Jon Robison, Rosie Ward and Ryan Piccarella get the credit for that. We just added our first Amendment, urging crash-dieting vendors to disclose the likelihood of weight regain and the possibility that weight-cycling could be harmful. As you can see if you visit the site, there are now many endorsers of the Code, and only three opponents — Optum, HERO and Wellsteps. Having seen data from all three, I can understand how ethics would be incompatible with their business model.
Looking beyond wellness, perhaps the year’s big news was the ascent of Dave Chase, Brian Klepper, and their disciples (of which I am one). Apparently, wellness is not the only industry sector in healthcare corrupted by greed at the expense of the employee and employer. The providers, PBMs, carriers and drug companies all have their hands in the cookie jar as well. The difference — as described in Dave Chase’s book — is that whereas employees actually need access to drugs, providers etc. and therefore employers are exposed to vendor rapaciousness as a byproduct, wellness is a self-inflicted wound. Simply cutting back from annual screenings to doing wellness according to guidelines immediately reduces wellness expense by about 60% – 70%. That is still frequent enough to identify issues to address — but without the hyperdiagnosis that some vendors salivate over. And it frees up far more than enough money to undertake other initiatives, such as employee health literacy.
And the Validation Institute continues to be seen as the “gold standard” for measurement of outcomes. No one else even close.
Some vendors distinguished themselves this year too. Sterling Wellness, It Starts With Me, Switchbridge, Sustainable Health Index, Impact Health, SelfHelpWorks, HealthAdvocate, Redbrick, Wellable, American Institute of Preventive Medicine, USPM, Healthcheck360, and Limeade, for starters.
Likewise some brokerages clearly distinguished themselves as well — Connect Healthcare Collaboration, Arthur J. Gallagher, Hayes (Boston Office), Gibson Group, AIA-BRG, Lake Norman Benefits, Axion-RMS, Benefits Services Group.
I would normally name a number of workplaces here — and there are many deserving ones — but in the public sector, it looks like a tie between Hilliard City Schools and the City of Chelmsford, MA, part of the innovative and equally deserving Massachusetts Interlocal Insurance Association. In both cases, the level of voluntary participation in a wide range of programs, with no coercion and surprisingly modest incentives, has been over the top. In the private sector jumbo employer category, there is only one: Cummins. There’s a reason that when Fortune asked me who they should profile for wellness, I recommended Cummins. Among mid-sized employers, Pace Industries and PTA Plastics lead the way.
I’m sure I’m leaving some people out. If I did, just mention them privately and I’ll slip them in. I’m also not re-naming names of people in organizations already mentioned. Bob Merberg, Jayne Schmitz, Wendy Gammons, Tom Emerick, Bill McPeck, Mitch Collins, Kristie Howard, Julie Fulton, Justin Leader, Brian Uhlig, David Contorno, Marty Makery, Craig Lack, Andy Neary, Aaron Witwer, Cassidy Posey, Sean White, Kristie Howard, Samantha Gardiner, Matteo Zanella, Dan Cronin, Linda Riddell, Gretchen Day, Romy Antoine, Krisna Hanks.
Don’t miss the upcoming finale…
…In which a worthy 2017 successor to Wellsteps will be named as winner of the annual Deplorables Award.