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Four of the most stable genius vendors in the wellness industry have penned a letter to Montana’s junior senator, in which their usual wellness savings propaganda — contrary to all evidence, of course — ends with a plea to confirm EEOC appointees who they hope will institute new rules by January designed to allow them to continue to harass employees in order to enhance their own revenue streams.
Being wellness vendors, naturally they got the facts wrong. Even if a new chairperson were appointed, the EEOC has already said it won’t issue rules by January. Besides, the idea of just adding a staff member and then immediately issuing rules is ludicrous. Anyone with any insight into how the rulemaking process works knows that’s not how the rulemaking process works.
Facts and insights are two of the many things wellness vendors have trouble comprehending, along with data, integrity, math, and — as we’ll see below — irony. (And, also, as we’ll see below, wellness.)
Their specific language:
Without clear guidance from the EEOC, we fear a Wild West of litigation could re-emerge as did it prior to the EEOC guidelines…jeopardizing programs that are improving the health of America’s workforce.
For months, we have been urging companies to take an obvious and painless step — requiring no government regulation or intervention or plaintive pleas to seemingly random junior senators from seemingly random states — to insulate themselves from this pending “Wild West” litigation.
Specifically, by offering alternative vendors such as Quizzify to indemnify themselves from this possibility, employees save money immediately and educate employees at the same time they avoid liability.
Having to offer Quizzify would be these vendors’ worst nightmare (since most employees would much rather learn something useful than be screened and told to eat more broccoli), and yet the letter’s four signatories are probably the four vendors most likely to be sued by employees if they don’t offer Quizzify as an alternative. Let’s look at each in turn.
Bravo is the only vendor in the wellness industry to publicly brag about how much “immediate employer cost savings” can be obtained by fining employees who decline to have the stuffing screened out of them in violation of all US Preventive Services Task Force guidelines. Of course, Bravo’s program itself saves no money according to its own findings. There is also a question about their financial solvency, since they apparently can’t afford an internet connection.
Health Fitness Corporation
Health Fitness Corporation (HFC) bragged incessantly about its “life-saving, cost-saving catches” of 514 Nebraska state employees who had cancer. This was fairly easy to accomplish because it turned out, as HFC later admitted that they didn’t have cancer in the first place. (Ron Goetzel kindly forged a portion of a letter from Nebraska’s Governor to replace the old braggadocio with the new admission. I have to give him credit for loyalty here. He was willing to risk a felony charge in order to support his friends.)
Bragging about how many sick employees they hyperdiagnose is a pillar of the wellness industry. In this case, HFC found all these false positives likely because they “waived” screening guidelines so that anyone of any age could get a colonoscopy, and sent out solicitations featuring a model way too young to be indicated for one.
“Waiving” screening guidelines is the wellness industry equivalent of “waiving” the minimum age requirement for a driver’s license. Fortunately for the very stable geniuses in the wellness industry, there is no regulation requiring wellness vendors to understand what they are doing, and they take full advantage of that loophole.
HFC also saved 20% on a wellness program with Eastman Chemical. This was also quite easy to accomplish because it turned out they didn’t even actually have to implement the program. Simply splitting the group into participants and non-participants did the trick. As you can see from their Koop Award application below, the program already “saved” about 20% between 2004 and 2006 during the baseline period, before they started giving employees the aptly named “treatment.”
The Incidental Economist was very impressed with this study design. (Not!) But I’ll tell you who really was impressed: Ron Goetzel. He gave HFC Koop Awards for both studies. For those who are not familiar with the it, the Koop Award recognizes the most stable geniuses in the wellness industry who are also sponsors of the Koop Award.
Wellness Corporate Solutions
Along with whining about how “shrill” I am (examples being…?), Wellness Corporate Solutions is worth “siting” (add English to the list of things wellness vendors don’t understand) for its crash-dieting contests, in which employees binge and then starve themselves to win prizes. Lately they’ve added a new twist: water-drinking contests. Obviously the first is bad for you. Overhydration turns out to be a bad idea. It doesn’t exactly enhance your productivity, if you catch my drift. Oh, yeah, and you also have to make sure you don’t die.
Viverae may or may not harm employees. Obviously it fabricates its savings (claiming a $739/employee savings on a health score improvement of 2.4% creates an industry-leading Wishful Thinking Multiplier of 307), but catching a vendor lying is dog-bites-man in this industry. The more amusing thing is their “savings guarantee” which, this being the wellness industry, doesn’t guarantee savings for many reasons, not the least of which is there are none. You also have to “require” employees to submit to screens. No wonder they are worried about being sued.
Here is a guarantee of my own: I guarantee (and will put all consulting fees at risk) that I can prove that if Viverae says you saved anything, you didn’t.
Here’s another guarantee: while hiring these wellness vendors may very well get you sued, this one flyer (plus the Quizzify indemnification) will prevent that from happening.
Goofus and Gallant is a Highlights for Children feature contrasting different behaviors. Example:
Viverae’s and Quizzify’s guarantees lend themselves to this type of comparison. Honestly, we don’t even know if Viverae still offer theirs. Nonetheless, through the years a number of people have sent it to us and asked for our help interpreting it. (That’s a polite phrasing of what the emails said, and of course we are nothing if not polite.) It provides an excellent opportunity to learn how to read a guarantee with a discerning eye, and we thank Viverae for offering it and hope they too are able to gain some insights from our analysis of it.
Here is Viverae’s guarantee, which we will review clause by clause:
Goofus: Viverae’s Clause #1 doesn’t allow any leeway in program design.
Gallant: Quizzify offers the guarantee even if you want to tweak the program design.
Goofus: Viverae’s Clause #2 is an EEOC violation. You can’t “require” employees to do biometric screens. The program wouldn’t be voluntary. You might as well just send a memo to your employees with the phone number of the EEOC and tell them to sue you.
Gallant: Quizzify guarantees no EEOC lawsuits, and actually indemnifies against them.
Goofus: Viverae’s Clause #3 would seem fairly self-evident–except that in wellness, as the example at the end of this posting* shows, some wellness vendors don’t know there are 12 months in a year.
Gallant: Quizzify assumes its customers know that a year has 12 months in it, so this clause isn’t part of our guarantee.
Goofus: Viverae’s Clause #4 requires you to not only sign up for 3 years to get this 20% guarantee in the third year only, but also to waive your rights to early termination. So basically they are saying: “If you sign up for 3 years with no ‘out’ clause, we might possibly give you a guarantee worth 6.67%/year on average, assuming we measure validly.”
Gallant: Quizzify’s price list offers customers discounts exceeding 6.7% a year for multiyear contracts anyway, even before any guarantee, and allows not-for-cause termination for a small upcharge.
Gallant: Quizzify’s guarantee is 100% in all years, not 20% in year 3.
Goofus: Viverae’s Clause #5 requires a minimum number of 1000 employees, making it off-limits to more than 98% of America’s employers.
Gallant: Quizzify offers a straight 100% satisfaction guarantee if the number of eligible employees is too small to measure savings objectively.
Goofus: Viverae’s employee incentive/penalty requirement in Clause #6 is the “maximum allowed by law.”
Gallant: Quizzify requires a minimum incentive of only $100. We believe that the program should be attractive enough that you don’t need to force employees to participate.
Goofus: Viverae’s Clause #7 requires all carriers and PBMs for all years to turn over all employee-identifiable claims files. Since Viverae is not HIPAA-compliant, that creates a HIPAA issue. (In all fairness to Viverae, most wellness vendors are not HIPAA-compliant. Quizzify is the exception. Quizzify doesn’t collect or store private health information, so HIPAA doesn’t apply.)
It also means Viverae determines how much money Viverae saved, with no oversight.
Gallant: Quizzify allows the customer or its consultant to complete its simple claims extraction algorithm and determine savings, or Quizzify can do it for them. Its claims extraction algorithm is the industry standard required by the Intel-GE Care Innovations Validation Institute.
Speaking of the Validation Institute, Goofus’s guarantee is not validated by them.
Gallant reminds readers that both he and Goofus are trademarks of Highlights for Children so don’t even think about using these characters without attribution.
Goofus sprinkles Gallant’s DNA at crime scenes.
*Avivia “three-year” study of drug adherence:
If you like this example, you’ll love This Is Your Brain on Wellness
Short Summary of Company:
“Viverae gives our clients a platform for managing healthcare costs by motivating their employees to make healthy choices. Our comprehensive wellness programs address your organization’s goals to meet your employees where they are.”
Materials Being Reviewed:
Questions for Viverae:
General: What customers have actually signed up for this and are willing to admit it?
ANS: Refused to answer
Provision #2: Since your biometrics are out of compliance with USPSTF guidelines, wouldn’t a customer be risking an EEOC lawsuit by “requiring” every employee to do this against their will, subject to a large fine?
ANS: Refused to answer
Provision #4: Isn’t this the same as saying “If you sign up for two years, we’ll give you a third year maybe at a 20% discount if you do everything perfectly, but by doing so you waive your right to cancel after one or two years” ?
ANS: Refused to answer
Provision #5: Has any customer of Viverae or any other wellness vendor with 1000 or more employees completed HRAs and submitted to biometric screens at a 100% rate, as you require in Provision #2?
ANS: Refused to answer
Provision #6: How could a health plan get a positive return on this program by offering people $720 apiece, when wellness-sensitive medical events account for less than $200/person in claims spend?
ANS: Refused to answer
Speaking of Provision #6, if your very own website says savings are $500/person (I’d be curious what legitimate academic research supports that), how can you guarantee savings when the cost of the incentive alone is $720?
ANS: Refused to answer