The Ten Worst Wellness Programs and What They Do to Harm Employees

flying cadeuciiIf corporate wellness didn’t already exist, no one would invent it.  In that sense, it’s a little like communism, baseball, or Outlook.

After all, why would any company want to purchase programs that damage morale,reduce productivity, drive costs up…and don’t work 90%-95% of the time?  And that’s according to the proponents.  What the critics say can’t be repeated in a family publication such as ours.

Still, those are the employers’ problems. However, the employers’ problems become the employees’ problems when employees are “voluntarily” forced to submit to programs that are likely to harm them. (As the New York Times recently pointed out, there is nothing voluntary about most of these programs.)

Recently, the head of United Healthcare’s wellness operations (Optum), Seth Serxner, admitted that Optum’s programs consciously ignore US Preventive Services Task Force (USPSTF) screening guidelines. Lest anyone was expecting a wellness vendor to actually apologize for bad behavior, Mr. Serxner went on to blame employers for insisting on overscreening and overdiagnosing their own employees…and overpaying for the privilege of doing so.  This is all on tape. When the Population Health Alliance finally releases the tape, we will be doing a posting on this comment alone. No one would believe it unless they see it.

Funny thing, we’ve asked our own clients who use Optum about why they turned down Optum’s generous offer to do more appropriate screenings at a lower price.  None of them remember receiving this offer. Go figure.

United Healthcare isn’t alone in harming employees. They are just the first company to admit it, and far from the worst offender.  Here, in order, are the ten vendors most likely to harm employees in the name of wellness.

#10 Provant

We would say: “Someone should inform these Einsteins that you are not supposed to drink 8 glasses of water a day,” except that we already did inform these Einsteins of that factoid, but they didn’t believe us. Obsessive hydration remains one of their core recommendations despite the overwhelming evidence that you should drink when you are thirsty.

Provant water

By contrast, grownups like the New York Times — where commentators use internet connections to do actual research — write the opposite:

nyt upshot

nyt upshot text

And in some cases, you can overhydrate…

provant water 2

#9 Cerner

The employee who recorded this blood pressure is essentially dead. Cerner’s diagnosis?  Blood pressure “higher than what is ideal.” Cerner’s recommendation? “Talk to your healthcare provider.”   A real doctor’s recommendation?  “Call an ambulance. The guy barely has a pulse.”

cerner pulse

This is not a random mistake.  This is the front cover of their brochure.

#8 Nebraska/Health Fitness Corporation

USPSTF Screening age recommendations aren’t minimums.  They are optimums, the ages at which screening benefits might start to exceed harms.  Otherwise you are taking way too much risk.  This is especially true for colonoscopies, one of this program’s favorite screens — complications from the test itself can be very serious.

Your preventive coverage is not supposed to be “greater than health care reform guidelines.” That’s like “rounding up twice the number of usual suspects.”  And you aren’t supposed to waive “age restrictions.” That’s like a state waiving minimum “age restrictions” to get a driver’s license.

nebraska screening guidelines

Yet despite or perhaps because of this and other examples of total cluelessness and pure dishonesty, this program won a C. Everett Koop Award for excellence in wellness, not to mention the unwavering support and admiration of leading wellness apologist Ron Goetzel.

#7-#6 (tie) ShapeUp and Wellness Corporate Solutions

Both these outfits pitch exactly the opposite of what you are supposed to do in weight control:  unhealthy crash dieting.  Attaching money to this idea and setting a start date makes it even worse: along with crash-dieting during these eight weeks, you’re incentivizing employees to binge before the initial weigh-in.

Here is ShapeUp:

Lose ten pounds in eight weeks

Here is Wellness Corporate Solutions:

wcs-weight loss challenge

Both also made up outcomes. In ShapeUp’s case they had to rescind their “findings” after their customer, Highmark, skewered them in the press.  And neither seems to care that corporate weight control programs are proven not to work.

#5 Aetna

In addition to its dystopian wellness program that collects employee DNA (partnered, ironically, with a company called Newtopia) and then makes up savings, Aetna owns the distinction of launching the only wellness program whose core drugs are specifically editorialized against in the Journal of the American Medical Association.  This would literally be the most harmful wellness program ever, except that the only employees being harmed are (1) obese employees who (2) answer the phone when their employer’s health plan calls them to pitch these two drugs; (3) have a doctor who would willingly prescribe drugs that almost no other doctors will prescribe due to their side effect profile; and (4) not google them.  Presumably in combination this is a very low percentage of all employees.

The good news is that these drugs, Belviq and Qsymia, should be off the market in a couple of years because almost no one wants to take them, so the harms of this Aetna program should be self-limited.

#4 Star Wellness

Star Wellness offers a full range of USPSTF D-rated screens. “D” is the lowest USPSTF rating, and means harms exceed benefits.  Star gets extra credit for being the first wellness vendor to sell franchises. All you need is a background in sales or “municipal administration” plus $67,000 and 5 days of training and you too can poke employees with needles and lie about your outcomes.  Is this a great country or what?

Also, their vaccination clinic features Vitamin B12 shots. We don’t know which is more appalling–routinely giving employees Vitamin B12 shots, or thinking Vitamin B12 is a vaccine.

star vaccines

#3 Angioscreen

Angioscreen doesn’t have the most USPSTF D-rated screens. In fact, it offers only one screen in total, for carotid artery stenosis.  That screen gets a D grade from USPSTF, giving Angioscreen the unique distinction of being the only vendor 100% guaranteed to harm your workforce.

Carotid stenosis D

Angioscreen’s other distinction is that they admit right on their website that this screen is a bad idea.  This is probably literally the only non-tobacco company in America to admit you are better off not using their product.

#2 Total Wellness

Total Wellness loses the wellness industry’s race to the bottom only because the winner, HealthFair, has out-stupided them.  However, in addition to the usual assortment of D-rated tests, they offer screens that the USPSTF hasn’t even rated, because it never, ever occurred to them that anyone would ever use these tests for mass screening of patients or employees. Criticizing the USPSTF for not rating these “screens” (CBCs and Chem-20s) would be like criticizing Sanofi-Aventis for not warning against taking Ambien after parking your car on a railroad crossing.

#1 HealthFair

Let’s leave aside for a fact that the majority of their other screens are harmful too, and focus on their screening for H.pylori, the strain of bacteria associated with ulcers. To say it is a stupid idea would be an understatement. As Clarice Starling replied when asked if Hannibal Lecter was a sociopath: “They don’t have a word for what he is.”

Likewise, this idea is too stupid for words, certainly for the small number of words we can allot to this overview blog. Visit our full treatment here.  In a nutshell, the majority of us harbor H.pylori–without symptoms. It may even be beneficial. The screening test is expensive and notoriously unreliable, and the only way to get rid of it is with some very powerful antibiotics, a treatment rarely even used on patients with symptoms due to its inconvenience, ineffectiveness and potential long-term side-effects.

A Modest Proposal

So how should we as a country protect employees from these harms?  Our policy recommendation is always the same, and very non-intrusive. We aren’t saying wellness vendors shouldn’t be allowed to harm employees.  That would be too radical to ever pass Congress.  If it did, the Business Roundtable would pressure the White Houseagain, to preserve their hard-earned right to medicalize the workplace.

Instead, we recommend merely a disclosure requirement.  The harms of screens or screening intervals that don’t earn at least a “B” from USPSTF should be disclosed to employees, and employees should get a chance to “opt out” into something that isn’t harmful (like Quizzify, perhaps?) without suffering financial consequences.  Call us cockeyed optimists, but we don’t think employers should be able to force employees to choose between harming themselves and paying fines.

Al Lewis and Vik Khanna are the founders of Quizzify

Categories: Uncategorized

Tagged as: , ,

4 replies »

  1. This is a great help for many employers whose primarily concern is their health by providing them right information on the different health and wellness activity they’re trying to join with. https://www.mcrmed.com/

  2. Al and Vik,
    Today’s (2/13/2016) edition of Barrons has the following nonsense….might this prompt you guys to submit a response?:

    “It appears that going to the company gym or participating in company-organized sports teams has benefits beyond shedding that unsightly tummy bulge or merely having fun.

    A recent study in the Journal of Occupational and Environmental Medicine has found a correlation between companies with wellness programs and their stock prices. The study showed that $10,000 invested in a portfolio of 26 public companies that won the C. Everett Koop award—which recognizes companies that can document how their programs improved health and saved money—produced returns 89% higher than the Standard & Poor’s 500 index from 1999 to 2014.

    “The companies that are most successful are the ones that in their mission statements talk about well-being,” says Ron Goetzel, lead author of the study, who is a senior scientist at Johns Hopkins University and a vice president of Truven Health Analytics. The programs cover physical, emotional, social, and even financial health, Goetzel says, noting that “organization health” is important regardless of the nature of the workplace.

    In that regard, companies on the list include once-troubled names such as BP America, Dow Chemical (ticker: DOW), Citigroup (C), and Fannie Mae (FNMA). To make the cut, companies had to provide evidence that their employees did better on 10 health measures than similar workers at companies lacking programs. The programs also had to save money. Of course, you can’t know whether they “cause” greater returns, or if high performers tend to treat their workers better. But healthier workers seem to equal healthier returns.”

  3. Unless I am missing something or cant see the whole picture, the comments in #9 Cerner are completely invalid and untrue – 110/90mmHg is a perfectly average blood pressure result. I suggest you apologise to the company.

  4. “we don’t think employers should be able to force employees to choose between harming themselves and paying fines.”

    In the (mythical) “free market,” employers can do whatever they wish.