Over the years as an HMO executive and later founding a disease management and Healthcare IT company, I have analyzed a lot of medical claims and quality data. One of the largest was an analysis of a State Medicaid program with about 675,000 beneficiary lives with two years of inpatient, outpatient and pharmacy claims. The pharmacy file alone contained about 15 million prescription fills.
More recently I became certified as a Professional by the Care Innovations Validation Institute and sit on their Advisory Board. This certification tested my ability to look at data and decide whether the outcomes reported were likely to be valid or not. As you look for vendors or consultants I would suggest you start with the Validation Institute. The following example is a good reason why.
Cruising around the web looking at various healthcare consulting firms and company websites I came across a company that is targeting employers and claims they have vetted and can bring in vendors to lower the costs for a company’s self funded health plan. Their website says they can identify, evaluate, oversee, manage and report on the vendors they propose.
On their home page is a chart used to show the savings an employer can expect to see by implementing their various cost saving approaches. Can you spot the flaw(s)?
Let’s start with the first and most glaring error and its on the first line. Continue reading
As many of you know, I am on the advisory board of the Care Innovations Validation Institute. This is an important organization for the Population Health and Wellness industry. The advisory board is chaired by Dr. David Nash, Dean of the Jefferson College of Population Health.
Our industry is facing some questions; one need only look at the multitude of population health and wellness vendors and their reports of amazing outcomes to know that something is not right. RAND has published some very good studies (here, here and here) that showed limited to negative returns from various wellness and employe health improvement programs and Al Lewis has published many examples in his books (here and here) and on his website. While on the other side, Ron Goetzel at the Institute for Health and Productivity Studies within Johns Hopkins Bloomberg School of Public Health, has a whole section devoted to programs that do work.
Last year the Population Health Alliance held a debate between Ron and Al. The event was standing room only and came to the conclusion that many of the programs do not work, while a few very well designed and implemented programs do.
As employers continue to push employee health improvement or Wellness programs, they are looking at gathering more “validated” results instead of relying on the always questionable self reported data. In particular the tracking of physical activity is one that has gotten much attention and companies now hand out Fitbits, Garmin devices, Jawbones and even Apple watches to track people’s walking and running. These are often tied to incentives for participation and many are associated with premium reductions.
The question is, just how accurate are these things and might there be some negative legal liability associated with their use? I can tell you from having used a few including Fitbits, Garmin, and Basis as well as some GPS trackers, there are clearly issues, which I’ve highlighted in other posts. For instance, one can often get more steps for driving on a bumpy road, brushing one’s teeth, drying off after a shower and a myriad of other ways. On the flip side, some devices worked while I was operating a power mower and others did not count any steps at all.
Now an article comes out that places even further doubt regarding the use of some of these devices. You can read it here: