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The Graco-Goetzel-Bravo plot thickens…more twists and turns

The Graco-Goetzel-Bravo-Hopkins case study is turning into another Nebraska fiasco.  As with Nebraska, the numbers all contradict one another.  But unlike Nebraska, there has as yet been no admission of deliberate lying in the Graco case study. That’s why Graco only earned an honorable mention in the Koop Awards, instead of winning one outright like Nebraska did.

Consider Bravo’s case study on Graco covering the exact same population over the same period as Ron Goetzel’s study.  Let’s assume Ron Goetzel is right in that the wellness program should be measured from 2009 rather than 2008, when the program started.  (Bob Merberg’s brilliant analysis points out the cherrypicking of the date has a huge impact on claimed success, but let’s concede this start date choice to Ron, and use 2009 according to his wishes.)

Bravo’s case study displays the PMPM costs by year.  The first thing to note is, they list employee healthcare costs at $328 PMPM, which actually makes sense, instead of the $190 PMPM in the Hopkins report.  I don’t know why these two figures, purporting to cover the exact same population in the exact same period, are completely inconsistent, but I do know that $190 PMPM is an impossible figure, as any population health expert knows.  (“Plausibility checking” would have caught that error but Ron has never taken our course in Critical Outcomes Report Analysis, which would have covered plausibility-testing and likely prevented him from making such a rookie mistake.)

Second, Bravo lists children’s healthcare costs in this report as well.  Funny thing:  over the same exact period in which Mr. Goetzel was claiming that the wellness program was responsible for controlling employee participant costs, children’s healthcare costs trended better than wellness participants’ costs.   Mr. Goetzel obviously had access to this children’s cost trend data (we had no trouble finding it, thanks to Bob Merberg) but elected to — get ready to fall out of your seats — ignore it.  The wellness ignorati rarely step out of character.

This children’s cost trendline appears to invalidate the entire Goetzel-Johns Hopkins conclusion that the healthcare cost trend was due to the wellness program, since not one single child participated in the wellness program.

graco childrens

For some reason Graco’s spouses cost about $7000 apiece a year.  We’ll leave that for someone else to dissect.

As an aside, if anyone thinks they recognize the name “Bravo Wellness” from an earlier posting, it’s because they do.  Bravo is the outfit that brags about their ability to save employers money by fining employees.  Their website is disproportionately about their appeals process when those fines are levied.  This sounds like a company that does wellness to employees instead of for them.

Not sure how bragging about fining employees is consistent with the positive culture that Mr. Goetzel says Graco has, but maybe I’m missing something here.

 

Bravo Wellness Offers “Savings” by Fining Employees

With all the incompetence, innumeracy, illiteracy and downright dishonesty we’ve documented in this field and with all the employee dissatisfaction, revolts and lawsuits, one can’t help but wonder:  Why?

Why would any employer do this to their employees?

Why aren’t vendors held to minimal standards of competence?

Why do vendors and consultants caught lying simply double down on the lies and/or ignore questions about their lies–knowing full well they’ll get away with it because workplace wellness has nothing to do with actual wellness so no one cares that it doesn’t work?

Why are benefits consultants allowed to lie about outcomes for their partnered vendors?

Why, after they get caught lying, do they win awards for those very same outcomes?

Why doesn’t anyone care that much of what they say and do is wrong?

Why doesn’t anyone care that poking employees with needles far more than the USPSTF advises produces no savings?

Why put up with the morale hit from disgruntled employees and possible lawsuits?

Bravo to Bravo for admitting the reason:  It’s to claw back insurance money from employees by making programs so unappealing and requirements so onerous that many employees would rather forfeit their money than have anything to do with them.  Here are Bravo’s exact words:

bravo

You might say, they don’t actually “admit” it.   Well, obviously they aren’t going to skywrite it.  But how else would one interpret this comment?   Obviously they aren’t going to save money right away by “playing doctor” and poking employees with needles.  Especially because they aren’t even adhering to legitimate preventive services guidelines, such as those from the United States Preventive Services Task Force (USPSTF).

They also still subscribe to the urban legend that 75% of an employer’s spending is lifestyle-related, even though that myth has long since been discredited as meaningless and misleading for employers.

bravo screen

Creatinine and thyroid screens are not recommended by the USPSTF, so they shouldn’t be done at all, let alone provide the basis for claiming savings.  So, we have eliminated everything except the obvious:  employers get to collect fines for employees who care too much about their health and/or their dignity to submit to Bravo’s offer to play doctor.

This is the classic example of wellness done to employees instead of for them.  The Bravo website is sprinkled with discussions of appeals processes for employees who face punishments for the crime of weighing too much and/or other personal shortcomings having nothing to do with work performance (and precious little to do with healthcare spending during the working years)…but everything to do with transfering wealth back to the owners.

As is our policy, we offered Bravo a chance — and $1000 — to provide an alternate explanation in a timely way, which they didn’t.  Two differences between that forfeiture and Bravo’s punishments: Bravo lost their $1000 (of our money) for simply being unwilling to jot down a few words, whereas they brag about fining employees $1000 (of their money) for not being able to lose weight and keep it off, which is far harder than writing down a few words.  And the other difference about the $1000?  Having just raised $22-million, Bravo won’t miss it.


August Update: As a result of this expose, Bravo has taken all this stuff off their website.  They no longer brag about fining employees, they no longer discuss their appeals process at length on their site and they no longer pitch their D-rated lab tests like creatinine and thyroid.  This is typical vendor behavior after getting caught.  Score one for They Said What.

 

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