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AngioScreen gets caught in the Deplorables Award dragnet.

Dumb-de-dumb-dumb.

In the wellness industry’s very stable genius pandemic, AngioScreen is Patient Einstein. 

The Deplorables Award, as many of you might remember (you’re excused if you’ve forgotten — it’s been 2 years since a vendor was deemed worthy enough to qualify) goes to that vendor whose combination of dishonesty and patient harms would make Ron Goetzel blush. Angioscreen is all that and more — the kind of outfit that gives clueless wellness vendors a bad name.

Angioscreen had earned the pole position for 2021’s award even before this month’s Journal of the American Medical Association (JAMA) reminded us that — for the third time in as many plate appearances (2007, 2014 and now 2021) —they struck out with the US Preventive Services Task Force (USPSTF). They gave Angioscreen’s go-to carotid artery screen a “D.” In no uncertain terms, JAMA and USPSTF say: “Don’t do these screens to your employees.” 

I “profiled” Angioscreen years ago…but never gave them a Deplorables Award on the assumption that they would asymptotically approach irrelevance on their own merit. After all, what benefits manager would ever retain this outfit? Surely no actuary would be dishonest enough to be paid to “find savings” in these screens, and no consultant or broker would be corrupt enough to take money to pitch them, right? 

Surely someone would notice that right on their very own website, they cited the fact that the USPSTF gives them a “D.”

And surely someone would notice that Angioscreen’s other business is convincing hospitals to screen communities in order to find new well-insured patients to admit for major surgery…and make the obvious inference that the same screens that are designed to generate admissions can’t also reduce admissions, right?

Haha, good ones, Al.


The hospitals nailed this

Angioscreen is a surgery-generating machine.  Here is an employer, who at least had enough sense to withhold his name, bragging about the major vascular surgeries his employees underwent for asymptomatic carotid artery stenosis (CAS) thanks to Angioscreen:

Two of our employees were found to have blockages in their carotid arteries. Through follow-up visits with their physician, these employees found arteries that were significantly blocked that required surgery. 

Maybe the employees really needed the surgery?  In the immortal word of the great philosopher Brittany Spears, oops. The National Institutes of Health warns against precisely this:

Despite a D recommendation from the USPSTF… many surgeries or interventions for asymptomatic CAS continue to be performed [due to] free screenings.

Wait, you might say, maybe those patients needed those screens to avoid a stroke.

Haha, good one again, Al:

  • As JAMA says, “only 11% of strokes” are caused by internal carotid stenosis. Since only about 1 in 1000 employer-covered people has a stroke, you’d have to screen almost 10,000 <65 employer-covered people to possibly have a slight chance of preventing a stroke with a major surgery. 
  • If Angioscreen’s test is 95% accurate (in their dreams), you’d also refer 500 false positives to their doctors, and some would undergo risky, painful, and expensive major vascular surgery as well, probably like those two in the mercifully unnamed employer above.

The employers got snookered for a change

Funny that Angioscreen wouldn’t attach a name to that reference site, because it’s only a slight exaggeration to say Angioscreen’s customer list includes practically every non-Quizzify-customer (the latter tend to have triple-digit IQs, making them poor prospects for Angioscreen) in the Fortune 500. Here it is:

You might say, that’s not many. True, but that excerpt is only a tiny fraction of the total – I didn’t want to hog the internet by listing all of them

Perhaps you see some employers on that list that make you think: “Why would a smart, capable company like so-and-so be an Angioscreen customer?” I asked myself the same thing, as I was surprised to see a Quizzify customer on the list. So I asked them, mentioning my surprise.

Turns out they were every bit as surprised as I was. They had no idea they were on that list and had never heard of Angioscreen. 


But wait…there’s more. Now how many inappropriate screens would you pay for?

Another reason I had originally demurred from bestowing this award on them was that I also thought that maybe after a while their conscience would get the better of them, and they would stop doing these screens. Perhaps they might pivot from decidedly harmful screens into the more mundane screens that are simply a useless waste of money.

How silly of me.

Quite the contrary, once they realized they had stumbled upon a huge untapped market for employee hyperdiagnosis, they added several more inappropriate screens:

If “Ankle Brachial Index” screening sounds familiar, it’s precisely what Marty Makary warned us against in The Price We Pay as the poster-test for generating unneeded and harmful surgeries.

If ”peak systolic velocity” sounds unfamiliar, it’s because it’s such a stupid idea for a screen that the USPSTF has never even bothered to recommend against it, on the theory that no one would screen their asymptomatic patients for this. A doctor would literally lose their license for routinely doing these screens and billing insurance for these.

And, just in case there is still any employee naively of the mistaken impression they are living their lives diagnosislessly, there’s the D-rated ECG/EKG.  These are not supposed to be done because they — get ready — often “reveal” abnormalities that don’t really exist or are harmless…but once revealed, generate follow-up tests.


Fortunately, this next inappropriate screen costs extra, which might discourage a few employers.

Of course, if you indicate to a real doctor something that might suggest you are at risk for an aneurysm, you should get tested, and if the aneurysm is truly large and life-threatening, be referred for this surgery, despite its mortality rate exceeding 7%.  That’s different from an unlicensed vendor playing doctor by screening unsuspecting employees for no reason other than to earn “supplemental” fees. Or, as one commentator put it:

My main objection, however, is that I’m uneasy about taking people off the street who think they are perfectly well and subjecting them to a procedure from which 1 in 14 will die.

Ya think?


And so it is with great honor that I bestow the Deplorables Award on Angioscreen as the fourth recipient of this august distinction, joining Wellsteps, and bankruptcy court denizens Interactive Health and Provant.  (The latter avoided a Deplorables Award only by going bankrupt after our initial expose, before we had time to bestow the award.)

Six reasons to attend today’s webinar on the new EEOC rules. (Much less boring than it sounds.)

Unless you follow the EEOC very closely, you are likely unaware that the Biden Administration is putting the kibosh on conventional “pry, poke and prod” wellness programs.

Here are six things about this kibosh that will be covered in today’s webinar at 1:00 EST.

  1. Your Safe Harbor is kaput. If your program has a strong clinical component, you are out of compliance, period.
  2. The AARP v. Yale decision, likely within the next 8 weeks, will arouse the plaintiff bar, and we can expect more lawsuits.
  3. At the very least, that decision will spur many more EEOC administrative hearings/sanctions. While financial exposure there is very limited, the career-limiting embarrassment of being caught out of compliance for two years is not.
  4. How sure are we that the court will rule against Yale’s program? Quizzify is offering to double our contract lengths free to anyone who signs up before that happens, if we are wrong.
  5. There will be no “grace period” or “transition period.” In the 2017 AARP v. EEOC case, the judge stayed compliance until January 2019. The grace period train has left the station.
  6. If you don’t attend, you’ll be one of the few people who aren’t. 800+ people are already signed up.

This webinar will show you how you can easily comply within days…and immediately make your program more effective and more engaging. All with no changes to incentives,  penalties, clinical components, or even your budget.


PS Register today even if you can’t attend. You can access the recording later. Or just cut to the chase by contacting us directly at Al@Quizzify.com

 

Your employees won’t think COVID is just a “bad flu” after they read this

Remember “El Paso” by Marty Robbins?  At the end you were pretty sure he was going to die because he “felt the bullet go deep in his chest.” Somehow he made it back to the bar where the guy whose girlfriend he tried to steal (before he stole the guy’s horse) let him and her profess their love while he (Mr. Robbins) was apparently bleeding to death.

The only way you know he survived is that he recorded a song about the mishap.

Well, likewise, the only way you know the author of this blog post about COVID survived is that he wrote the blog post about it.  it is a richly detailed, harrowing, painful seemingly unending tale that will scare anyone who reads it into wearing a mask anad taking other safety precautions beyond just the “six foot rule.” Makes Mr. Robbins’ bullet wound sound like a mosquito bite.

I would recommend forwarding Mr. Bujalski’s posting to your employees if they have any doubt whatsoever about whether COVID is a “hoax.” (Mr. Bujalski is very much on the mend but nowhere near 100%, and I’m sure he would appreciate a visit to his blog to send him best wishes for a full recovery.)


When I created this blog, it was my intent to post thoughts, insights, or musings at least once a week. Unfortunately, it has been over two months since I last posted an entry here. The circumstances that interfered with those intentions are suggested in today’s title.

It is important to note that from the beginning of the public health warnings regarding the coronavirus, my wife and I took every advised precaution. We were dedicated “maskers.” We washed our hands frequently. We avoided unnecessary social contact, and when we needed to go out (grocery store, take-out food), did our best to maintain six feet or more between us and other people. If anything, I was compulsive in adhering to the guidelines, perhaps taking them to extremes: I wore nitrile gloves to the grocery store and washed the purchased fruit and vegetables when I got home. Sadly, we had to cancel two planned trips to see grandchildren in other states. We were careful.

Yes, we were careful, but not 100% isolated from the outside world. We’ve given much thought to where we might have been exposed to the virus. As dining out restrictions were lifted in NC, we did venture out to dinner once a week, typically on a Wednesday. We wore masks into a restaurant, only took them off to eat or drink, then wore them as we left the restaurant. The staff at these restaurants always wore masks. The restaurants never had many people, and we were at least 8 to 10 feet away from other diners.

(Editor’s note: 8 to 10 feet helps, but there is no magic in a specific distance in indoor spaces. Just probabilities of infection that decline fairly linearly with distance.)

One other possibility: My wife attended pottery classes at a community college. Everyone wore masks, and attendance was limited to allow for social distancing. However, there was a pair of “shared goggles” that people wore when using the grinder to smooth edges of fired pieces. While most of what we’ve read suggests that it is unlikely that COVID can be transmitted via the eyes, we’ve considered this as a possible source…

Blog post continued here.

Sharon Begley, renowned journalist and wellness chronicler, dead at 64.

I am saddened to report the loss, over the weekend, of perhaps the best health/science writer of her generation, Sharon Begley.  Though a “never-smoker,”, the cause of death was lung cancer.

To appreciate the full scope of her accomplishments over her 43-year career at Newsweek, the Wall Street Journal, Reuters and STATNews, peruse this obituary. A highlight (along the many other highlights, including 5 books) might be:

She won more awards and accolades than could fit in an obituary. The accomplishments she was prouder of were making complex ideas accessible to anyone — and beautiful — through her articles and books, and in doing so, training and inspiring generations of science journalists. She taught by example, showing that you could be tough-minded while being kind, that you could be literary without any big-personality bull.

And kind she was. We found common ground and shared hilarity in our respective exposes of the wellness industry and its many foibles. We bonded over this and became good social friends over the last four years of her life, as she and her husband Ned joined our group for bridge and games nights, while Ned played ultimate frisbee with us.

But let’s get to the “kind” part and — rather than duplicate what other obits have said — focus on her contributions to the wellnss industry.

One of her gifts as a journalist was interviewing people in such a kind, low-key, manner that they would accidentally tell the truth. While she wrote many articles on wellness, one article exemplifies this talent, as we bridge players might say, in spades: Top Wellness Award Goes to Workplace Where Many Health Measures Got Worse.

In it, she documented the dishonesty/corruption of the Koop Award, and the harms to the employees of the Boise School System caused by the “award-winning” Wellsteps program. Over the course of two years, Boise teacher risk scores deteriorated by 20%, self-reported health status declined, and costs increased.

Needless to say, the perps wouldn’t talk to me, but she got them to spill their guts before they even realized they had just self-immolated. Specifically, Wellsteps’ CEO, Steve Aldana, admitted to:

  • knowingly using regression to the mean to fabricate a claim of risk reduction among the highest-risk employees
  • recognizing that trivial self-reported changes in (for example) fruit and vegetable consumption had no effect on healthcare costs
  • recognizing that wellness programs increase overall costs
  • violating US Preventive Services Task Force guidelines.

She got Ron Goetzel to admit to bestowing an award on Wellsteps for improving employee health despite knowing they harmed employees.  (Mr. Aldana served on the awards committee but was the only committee member vendor who hadn’t won one of its own awards, so his award was predictable — and actually predicted.)


But her kindness wasn’t used just for the purposes of extracting self-incriminating information. When Steve Aldana called her a “lier”, her reaction was: “I need to find out what I got wrong, correct and acknowledge it,” as opposed to my own reaction, which was to quote him verbatim. Of course, she never heard from him again.

And the truly kindest thing she ever did was, despite the delicious irony, decline to write anything more about Ron Goetzel after he suffered his heart attack. I should be so kind! (On the other hand, he still maintains enough of an ejection fraction to summon the energy to attempt to sully my reputation, so I still defend myself.)


Two other articles — subsequently picked up by major media outlets — probably helped galvanize opinion to prevent employers from genetically testing employees and their dependents for hidden disease as part of workplace wellness programs:

She also helped put the kibosh on yet another Goetzel-infused idea, this one to create a so-called “fat tax,” which would require employers to disclose the number of overweight employees, the idea being this would encourage employers to use more punitive and expensive wellness programs. (She handed this one off to a colleague.) It would likely have backfired, but wiser heads prevailed, largely thanks to this article, and Ron’s idea was stillborn.

Two others:


Sharon, we miss you already and it’s only been 2 days. Thank you for your great contributions to the workplace wellness field. They played a major role in curbing its excesses, and also for generally improving the health-and-science literacy of the population for more than four decades. And for that time you didn’t double my rather aspirational 6-hearts bid even when you had the other five hearts in your hand.


June 14, 1956 to January 16, 2021

R.I.P.

 

 

 

 

 

“New” EEOC wellness incentive rules now DOA!

Within minutes of Quizzify’s blast email predicting that the EEOC’s rules released two weeks ago would be DOA, it is now a lock that they are toast. The White House made two announcements last week confirming this:

This means the huge loophole in the announced rules, allowing most outcomes-based wellness programs, will be closed.

Is this an existential threat to the wellness industry? At first glance, it would seem to be. But you can join our webinar to learn so this existential lemon can be turned into existential lemonade.


 

Leading wellness attorney Barbara Zabawa and I are hosting a webinar on this topic on Monday, February 1st, 1:00 EST. You can register here (and get access to the recording and slides as well.)  Focus will be on how to ignore the new rules, and maintain your program as is. Yep, just like with surprise bills, we’ve figured out how to game the system.


The EEOC has just released their rules for clinically based wellness programs.This step is called the “Notice of Proposed Rulemaking,” or NPRM, to be published in the Federal Register’s mellifluously named Notices of Proposed Rulemakings for public comment. “Public comment” is code for “the perps with the most to lose will flood the thread with disinformation.” Expect the US Chamber of Commerce, the vendors and Ron Goetzel and his cronies to weigh in heavily, each more shamelessly than the next. They have a lot of (your) money at stake here.

When NPRMs are posted for public comments, you know who never makes public comments? The public. So it’s up to you and me to pick up the slack, and point out that these perps have no clothes. Feel free to grab posts from TSW to add to the comments.


And the envelope please…

Most importantly,  incentives for participation-based programs need to be cut back to “de minimis.” And, unlike when the rules were first floated (and true to the intent of the judge who found that forced wellness programs were not voluntary), de minimis has been defined. It looks like the IRS definition — water bottles, t-shirts, small-denomination gift cards.  I had thought perhaps $200 would be OK. That is clearly outside the realm of de minimis. That could change if the perps flood the comments.

My own opinion: it is perfectly ok, even desirable, for organizations to offer employees screening.  Just don’t make them do it. I myself voluntarily get my Hb a1c screened every year, to make sure I’m playing enough ultimate frisbee to offset my consumption of LA Burdick’s insanely good chocolate.

And it is perfectly OK to educate employees on why they should want to get screened (or, in the case of younger, healther employees, why they shouldn’t). Screening would then be truly voluntary.

However, many organizations want to maintain their current participation-based programs with their current incentives or penalties…and many vendors want to keep their revenues intact.

For these groups, Barbara and I are offering this webinar, to show how to do exactly that.


So far, so good, but…

That was all about participation-based programs. Health-contingent, or outcomes-based, programs are a different story altogether. The EEOC is basically pro-employer these days. So they have figured out how to circumvent the spirit of Judge Bates’ December 2017 decision vacating the old rules in which forced programs were defined as “voluntary,” without violating the letter of his decision. But this massive loopholecould circumvent the ruling only for outcomes-based programs, not participatory ones.

This loophole allows you to continue to be able to subject employees to fines of thousands of dollars in outcomes-based programs. Most employees hate being forced to submit to these programs (“I’d like to punch them in the face,” said one), and they invariably lose money. However, the losses in program fees and employee morale — all admitted by the wellness industry trade association — is more than offset by the “immediate employer cost savings,” as Bravo puts it, generated by collecting the penalties from employees who refuse to let unlicensed wellness vendors play doctor.

However, most outcomes-based programs, while arguably complying with these new rules under the Americans with Disabilities Act, violate the Affordable Care Act. With the well-documented, Validation Institute-validated exception of US Preventive Medicine, they invariably fall short of the ACA’s standard of being “reasonably designed to reduce risk or prevent disease.”  That hurdle was set low enough to allow even the worst outcomes-based wellness vendors to clear it, and yet they don’t. They violate guidelines with impunity, forcing employees to undergo tests that no doctor would ever order and that get D ratings from the US Preventive Services Task Force (USPSTF).

Just too many epic fails, all documented for the last five years on this blog and sometimes in the media, including Koop award winners like Wellsteps, arguably the industry’s worst program now that Interactive Health has gone bankrupt. Ironically, Wellsteps is also among the best-documented programs. Why they insisted on publishing their own self-immolation is anyone’s guess. No one can argue that programs violating the USPSTF guidelines and, as we’ll see, harming employees, could possibly be considered “reasonably designed to prevent disease.”


This is not just about the money.

Outcomes-based programs can and do harm employees. Sometimes wellness vendors — I’m looking at you, Wellsteps — even admit their harms.

Yale employees sued Yale, for example, due to the psychological and physical harms of their program. One Yale breast cancer survivor was almost forced into getting a mammogram, even though she had already undergone a double mastectomy. Had it not been for Yale’s union and the AARP’s support, she would have been fined $1250.

TSW has published many stories of harms, summarized here. Not to mention what happens when you fine your employees for not losing weight. Guess what — they respond in very predictable fashion, packing on the pounds before the weigh-in and then crash-dieting to take them off. And our #1 most-searched phrase?  “How to cheat in a corporate wellness program.” https://dismgmt.wordpress.com/2019/01/07/breaking-shocking-news-employees-cheat-in-wellness/


Still, if you insist on keeping an outcomes-based program, the “hack” we’ve figured out of the new regs applies to outcomes-based programs as well. Seriously.

So if you have a program (and very few people with outcomes-based programs read this blog, or else they would have already dropped them), you’ll want to attend the webinar to figure out how to preserve it. And if you don’t have a program, you’ll want to attend just to understand what the EEOC tried to do with this massive loophole and how we got the better of them.

 

Scary new COVID strain will be landing in your neighborhood soon

As though the current COVID isn’t transmissible enough, this new strain spreads about 70% more easily. Hence 70% more urgency to educate your employees/members here and now. (Not quite sure that’s the way the math works, but close enough.)

The strain has already been found in 3 states. And the two countries in which it is already firmly established –Britain and South Africa — have already suffered dramatic increases in case rates.


It is believed that the vaccine(s) will protect against that strain too. Unfortunately, the anti-vaxxers have launched a disinformation campaign featuring enough lies to make a wellness vendor blush. And that doesn’t even include lying about the new strain, at least not yet.

Here is an example of an antivax myth perpetrated by someone on a health-and-wellness listserve, no less, that is so embarrassingly stupid that — even though this site is devoted to publishing embarrassingly stupid things that wellness vendors say — we aren’t going to mention any names:

According to actual infectious disease experts (Dr. William Schaffner at Vanderbilt, Dr. Anthony Fauci), and government and FDA documents in regards to vaccines, Pfizer has caused 6 deaths (within 3 days of vaccination)

Here’s what really happened:

  • Randomly, about 6 deaths would be expected in 9 months and 40,000 adults
  • Within 3 days of the vaccination, no one died
  • No deaths were attributable to the vaccination at all, and (drumroll)
  • 4 of the 6 deaths were in the control group.

It kills us to withhold the perp’s name (we will make it available upon request) but because COVID is life-threatening, we thought it would be better to focus instead on the positive, such as it is. 

The “positive” is that the coming “surge” within your own organization — and, don’t kid yourself, it is coming, due both to holiday gatherings as well as the new strain — can be mitigated, if you choose to do so. You have four choices:

  1. Send out information and link employees/members to your “COVID resource center” which has more information — and hope that no one relies on social media instead for their “information”;
  2. Within the next week or two, write concise and thoughtful sets of COVID educational trivia questions about both safety precautions in light of the new strain and myths about the vaccines, put them in an elegant user interface, and get a major medical school, like, to use one random example, Harvard, to let you put their name on the questions to ensure credibility;
  3. Retain Quizzify, which has already done exactly that and is ready to go tomorrow with two full quizzes, and a customized and linked landing page like the one at the bottom, for your organization
  4. Do nothing.

If history is any guide, the overwhelming choice will be #4. Those people should also have their names named, but we won’t. Instead, we’ll just observe that every time one of your employees takes ill with COVID, remember that you could have done something about it, starting tomorrow. 

 

 

Announcing the 2020 Vendor of the Year Awards

In the past, we’ve lovingly bestowed Deplorables Awards upon wellness vendors whose multicolinear combination of dishonesty, incompetence, ignorance, and friendship with Ron Goetzel have also earned themselves Koop Awards and in at least two cases, a trip to bankruptcy court.

Fortunately, the “pry, poke and prod” industry is asymptotically approaching irrelevance. It’s not just that many companies’ employees are remote and therefore difficult to screen, or that the EEOC is about to put the kibosh on financial inducements to screen.

It’s that screenings have now been proven not to save money. I don’t mean workplace screenings are not proven to save money. I mean they are proven to actually lose money thoroughly enough to disprove the maxim that it’s impossible to prove a negative. 


Consequently, the “pry, poke and prod” companies now operate mostly in the shadows, their market being limited to employers who lack internet connectivity.  The downside of their reticence is that we don’t have any vendors to laugh at anymore. Last year we turned that lemon into lemonade by naming the individuals who had contributed the most to employee health services through 2019, winners of the “Not the Deplorables Awards.

Continuing in that vein but switching from people to companies, this year we are recognizing the vendors who have contributed the most to employee health services. To qualify, a vendor must:

  1. Not have been, uh, “profiled” in They Said What? That rules out most companies;
  2. Be validated by the Validation Institute;
  3. Have seen selected or will be selected as a “Valid Vendor of the Month” By Quizzify, which means their performance is partially guaranteed by Quizzify in joint accounts.

Here is the list. We’ll put it in alphabetical order.  


Ault Medical Management

They take utilization review and case management to a Quantum-like level, for companies not big enough for Quantum. Here is our write-up of them and the webinar. Reviewing their figures very carefully showed us that in fact they do reduce utilization qutie noticeably. 


Drexi

In lieu of a major PBM, giving your employees who fill prescriptions a Drexi card is a cash-on-cash no-brainer. Notice anything missing from my family’s claims summary?  Yes, that’s right. Claims.

 

In case you can’t read that, it says a grand total of — get ready — $44.30 was spent by our family on healthcare in 2020. Actually we spent a little out-of-pocket on drugs, but a Drexi card means no PBM and hence no reporting. I was never even asked who my insurer was.

The Drexi all-in price was lower than the co-pays alone would have been had we involved the PBM. Fewer middlepeople mouths to feed means lower prices. Oh, that $44.30 was an antibiotic I needed in a hurry and was nowhere near a store contracted with Drexi. It would probably have been $4.75 if I had taken the time to find one. (Note: you do need to give your prescription-using employees a Drexi card, but the annual cost of those can be recouped in one fill, for many drugs.)


finHealth

They are the leaders in the unfortunately altogether-too-necessary category of reviewing provider bills to uncover, challenge and recoup insanely and often hilariously inappropriate charges, like $139,741 for an outpatient procedure to remove a few unslightly veins.

They are so certain to find savings that they usually don’t even charge. They merely take a share, so you can’t lose.


Leapfrog Group

OK, so they are technically not a vendor but they did accomplish a milestone this month: reaching their 20th birthday without a hint of scandal and no potshots other than by hospitals with low scores. (Those potshots actually increase their street cred, just like potshots from wellness perps improve mine.)  In 2021, they will be adding a financial component to their ratings:  measuring a hospital’s use of surprise bills settled by judicial decree. 


Medencentive

Never has a journal article showing savings been as thoroughly reesearched, as carefully vetted, as comprehensive, as valid, or as contrary to my expectations as theirs. It generated a lot of interest. I myself was skeptical enough of their findings to make them jump through a bunch of plausibiltiy hoops on behalf of the Validation Institute, to ensure the continuation of VI’s 7-year streak of zero challenges to their validations.

The Bottom Line: their program actually saves money…and the Validation Institute will now guarantee that.


Quizzify

So we’re already up to Q. I’d be lying if I didn’t admit this is my favorite letter.

Quizzify has revealed enough ways to save money through education that it’s almost impossible not to sign up for employee health literacy. After all, is there any other expense line item where employees receive an unlimited budget with no training in how to spend it? We didn’t think so.

Among the things we’ve taught this year, uniquely in all cases, are:

Further, while those insights make Quzzify the industry’s leading content tool, Quizzify offers the ultimate engagement tool: twice as engaging as your other benefits or your money back.


Sera Prognostics

Remember those old Wendy’s ads where someone would be asked whether they wanted a fresh and juicy Wendy’s hamburger or a dry patty on a stale bun…and they’d always pick the latter?

Well, likewise, the vast majority of employers cover prematurity tests that are 17% accurate instead of educating pregnant employees on why they might prefer a test that’s 88% accurate.

And yet, that’s exactly what they would get with Sera.


Validation Institute

In 7 years, they’ve never being successfully challenged on a validation, so one could call them the anti-HERO.  And, finally, after enjoying those seven years of zero challenges, they’ve announced a rock-solid Credibility Guarantee as a bet that they never will be called out on a validation. Assuming they add the VI-recommended clause to their contract, any customer of any validated vendor that feels the validation was in error can collect up to $25,000 from the VI, in addition to whatever guarantees the vendor offers. So in the case of Quizzify, you get their guarantee and ours.



Honorable Mention: Health Enhancement Research Organization (HERO)

Yes, that HERO. Without them as a soft target, we wouldn’t have a website, now that Interactive Health is defunct. While it has been a blast quoting them verbatim, they’ve finally come to the realization that none of their claims of savings from “pry, poke and prod” programs overlap with reality, and they’ve finally stopped defending them. 

On the one hand, their stupidity was pretty astounding. On the other hand, you had to admire their commitment to stupidity.

So obviously they aren’t validated and never will be. We haven’t done a webinar with them and never will. And we don’t guarantee their allegations and never will. They are getting this Honorable Mention for having gone 12 months without saying anything preternaturally stupid or dishonest, at least in public.

They are the lucky beneficiaries of the immortal words of the great philosopher philosopher George W. Bush: “The soft bigotry of low expectations.”

Answer Leapfrog’s 20th Birthday Trivia Question to win $100

Dear They Said What Nation,

To celebrate Leapfrog’s 20th Birthday Week, Leah Binder posted 3 questions in our chat on Linkedin. One of the 3 remains unanswered…and I am personally upping the ante to $100 for the first correct answer!

So have at it.  Here is a hint: this person was an overnight sensation before become the person with the most things un-named for him. The full question is in the interview.

Once again, Hppy 20th Birthday to Leapfrog!


Dear They Said What Nation,

Happy 20th Anniversary to The Leapfrog Group.  In 20 years they have become arguably the most untainted healthcare not-for-profit in DC.  It’s not easy to stay untainted for 20 years, but they have. By contrast, providers, PBMs and vendors “sponsor” other groups, and — get ready — the other groups advance their agendas instead of consumers and employers. Simply doesn’t happen with Leapfrog.


Even though it’s their birthday, you’re the ones getting the presents. Yes,  members of TSW Nation can actually win prizes. Not for blowing the whistle on dishonest wellness vendors (though that too), but rather by answering a couple of general interest trivia questions right. If someone does the Mary Wells thing and guesses ahead of you, you can still at least be entered in a runner-up drawing

As of this writing, there are no correct answers yet…though everyone has heard of the two people and you’ll kick yourself for not guessing right.

Once again, here is the link. No time to waste, as the deadline is 4 PM today.

Architect of Wellness’ Biggest Victory Dead at 84

Michael O’Donnell, former prevaricator-in-chief of the wellness industry trade magazine and best known proposing that employees be charged for insurance by the pound, once claimed that “pry, poke and prod” programs were as important to public health as antibiotics and sanitation.

You can debate that premise (or, more likely, laugh at that premise) all you want, but there is no debate about the #1 public health victory of all time: the conquest of smallpox.

Smallpox likely disabled or disfigured a billion people and killed hundreds of millions (including most of the native population of the New World).

Until it didn’t.

The man most responsible for the conquest of smallpox, Dr. J. Michael Lane, died yesterday at 84. He spent much of his lengthy CDC career on this quest, taking him all over the world. And, as you can seee below, I do mean literally all over the world.

Dr. Michael Lane, in Mali, 1966

He also happened to be my uncle.

What this lengthy New York Times obituary — recounting the history of smallpox, among other things — doesn’t mention is that he was also the nicest guy in the world. His modesty, apparently a recessive gene in my family, became him. He opened his keynote at the 25th reunion of his Harvard Medical School class by saying: “I’m the lowest-paid guy in the room.”

This will shock everybody but he also hated corporate wellness. He and I used to get a chuckle out of the hilarious chronic-disease statistics that his very own CDC published, like their “arresting fact” that 7 out of 10 deaths in the US are due to chronic disease. Not sure what else the CDC would like people to die of, but Mike observed: “Most countries I visit are lucky if it’s 2 out of 10.”

The CDC is quite controversial now, but this victory shows that when they put their mind to it, they can accomplish great things, this being perhaps the greatest of all.

Congratulations to Medencentive!

Hear Vintage Episodes of Buck Rogers, the Sci-Fi Radio Show That First Aired in 1932 | Open Culture

Some people think this blog reports only report Vendors Behaving Badly, of which there is no shortage. Hence that’s what most of the posts are about.

However, on those rare occasions when a vendor does, in the immortal words of the great philosopher Peter Noone, something good, we report that too. It just doesn’t happen very often.

It seems that the Something Good for Jeff Greene and his colleagues at MedEncentive is that Buck Consultants, one of the five largest HR consulting houses in the world, is partnering with MedEncentive. This partnership, which resulted from Buck witnessing the effectiveness of their program, firsthand, will involve introducing the Program to Buck’s clients, as well as the adoption of the Program by Buck for its own employee health plan.

I have personally reviewed all of Medencentive’s results, both for validation by the Validation Institute and for publication, and can vouch for the fact that all their numbers add up, nothing contradicts anything else, and my “plausibility tests” are passed.  I rarely make such bold assertions, both:

  1. to keep my track record intact (>500,000 words published, three arithmetic mistakes spotted), and
  2. because when the wellness industry makes such assertions, they are invariably wrong, usually obviously and hilariously so.

What excites me about this announcement is the fact that a health-improvement and cost containment solution, validated by the Validation Institute, is not only being endorsed, but also adopted by one of the largest HR consulting firms. Very impressive.

Good luck to Buck and MedEncentive!

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