Tag Archives: Validation Institute

The Validation Institute – How they can Assist Employers

The vast majority of employers are continuing to experience rising health insurance costs. We know there are areas of healthcare from quality differences to the variation in utilization that can negatively impact an employer health plan and its estimated that 30% of healthcare is unnecessary, waste and/or fraud. To solve this there have been many solutions proposed including wellness, imaging management, PBMs, High Deductible Health Plans, Direct Primary Care, Value Based Care, direct contracting and many, many others. In each of these solutions there is typically some sound belief that the concept will work, but there are also a lot of vendors or healthcare providers out there claiming they have the answer and this is often filtered through a broker who may or may not have your best interest at heart (Read about some the egregious behavior here “Insurers Hand Out Cash and Gifts To Sway Brokers Who Sell Employer Health Plans“).

So how can one identify providers of services who can achieve results? Well that’s where the Validation Institute comes in. To get a sense of the why and what the Validation Institute can do for you, watch this short video:

 
 

For full disclosure I was involved early with this group and since then have assisted in various capacities. I currently serve as a Senior Advisor, Standards and Compliance and also serve as a Judge for the Health Value Awards which are given annually at the World Health Care Congress to companies, employers and brokers who can show that they demonstrably improve the outcomes for their employees and lower costs. The validated Health Value Awards are also reviewed by the Validation Institute.

Advertisements

Leave a comment

Filed under Healthcare Costs

The Continuing Errors of the Wellbeing/Wellness Industry: Notes from a recent conference.

At some point the industry needs to come up with some way to police itself. Why?  I recently attended a meeting of the key companies and leaders in the wellbeing industry. Here were some statistics presented by a large corporation during a panel that included one of the Senior Executive’s of the company offering the employer their wellness service:

Incentives Associated with the Company Wellness Program

Annual Physician Visit –  $100

So why are they incenting employees to get an annual visit? Amongst the many screenings recommended by the USPSTF it gives it an A Grade to annual screening for adults aged 40 years or older and for those who are at increased risk for high blood pressure. Adults aged 18 to 39 years with normal blood pressure (<130/85 mm Hg) who do not have other risk factors should be re-screened every 3 to 5 years.

Health Risk Appraisal (HRA) $100

I believe this one is fine.

Annual Biometric Screenings $300

Again this is over-testing and not recommended annually. Per the USPSTF various biometric screens such as abnormal blood glucose a typical screening included in these gets a B Grade. The USPSTF recommends screening for abnormal blood glucose as part of cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese.

Both the annual physician office visit and the annual biometric screening are not recommended for many in the younger age categoris or those with no known risk factors.  So why would the conference, the company and the senior population health executive offer up this information as an example of an excellent program?

Then they presented a slide on outcomes:

82% of all continuously enrolled maintained or improved their health continuum status.

This one is just bogus as presented, but let’s go through it.

  1. Selection bias, by only measuring those who enrolled and then were continuously enrolled (2 out of 3 strikes) selection bias is all over this one. See the Illinois Workplace Wellness Study.
  2. How many didn’t enroll at all?
  3. How many enrolled, but quit?
  4. What was the definition of maintain or improved health?
    1. Might it have been one measure and others got worse?
  5. What was the net overall change in risk a la Dee Edington (Natural Flow) or perhaps the movements for each of the individual health measures?

Again as a Wellbeing expert why would the vendor allow their client to put this slide up?

The weight loss program they ran offered by one of the well-recognized national vendors had 2,600 participants who lost 9,226 lbs during the year.  Wow an average of 3 lbs! Was that at 12 months? How many gained versus lost weight during the period? How many dropped out?

And the next line showed a weight loss challenge at 12 weeks. In which over 1,300 participants had lost about 12,000 lbs or about 10 lbs each.  Again these weight loss challenges have not been shown to create sustainable weight loss.   How did they look at the end of the year?

But to add insult to injury, this presentation was the final one of the day that began with a nationally recognized academic who when asked which is the best weight loss program, gave this answer:

“any weight loss program can show weight loss over 3-6 months, but a year or two later they gain it back and often gain back more.”

So they started the day honestly and finished it a little less so, to put it nicely. But the bigger issue is:

Isn’t part of our job as experts to inform and educate clients to do what works, what is evidence based and report on what’s meaningful and real? ”

Why would you let one of your clients present this at a major national conference. And then while you are on the stage, tout it as success and look the other way. And, if this is a reflection on your program, one allowing excess testing, inappropriate visits and the reporting of meaningless results what does it say about your program?

Come on, we can and must do better.

 

 

Leave a comment

Filed under Uncategorized

The Validation Institute and Certification – Stand out from the Crowd

Validation-Institute-Standard-Full-Color-RGB

 

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.

Continue reading

Leave a comment

Filed under Uncategorized

Marketing Presentations: You Never Know What you May Learn.

I was on a call the other day with a company that provides a targeted consumer engagement platform based on psychographic data that is used to “bucket” people into one of a few groups and then send targeted messaging to them via different communication systems. When they got to their results slide my antenna went up.

Here were two of their claims directly off of the PowerPoint slide:

  • 72% of at risk employees joined a diabetes education program versus 10% nationally
  • A personalized patient messaging program created an additional $70,000 in revenue per month for a 300 physician group.

So I asked a few questions:

Me ” What data source did you use to claim that 10% of employees typically enroll in a diabetes education program?”

Him “We looked at the Rand Report (The DOL) Study which showed that 21% of employees typically engaged and then…(wait for it, wait for it)… only 50% of companies have programs, so that’s how we came up with the 10%”

To say I was incredulous would be a huge understatement.

So I asked to clarify

“So, you are counting the 50% of people who have no access to a program to begin with?”

Him “Yes”

Me “that’s just not right”

Him “Well it is true on a national basis”.  (On a side note this also may or may not be true on a national basis; just because 50% of companies don’t have a program does not mean that 50% of the employees don’t, depends on the companies in each group and their employee size.)

I was finally able to get him to admit, that the statistics he used might be a problem, when he then said “The original program was done with on-site staff enrolling employees and they were getting over 50% engagement.”

So the truer statement is they went from somewhere north of 50% to 72%, not bad, but much different than from 10% to 72%.

Now I dug into the second issue, the $70,000 per month. So I asked about this,

Him “yes, they told us that the program had increased their revenue by $70,000 per month.”

Me “lets do some calculations. It’s a 300 physician group, correct?”

Him “yes”.

Me “So lets assume that each physician generates $500,000 in annual revenue, that’s $41,666 per month. Multiply that by 300 and they are generating about $12,500,000 per month. $70,000 is just over one half of one percent of $12,500,000. That’s peanut’s, now take that and divide it by 300 physicians that equals $233 per month per doctor. Or maybe 4 office visits.”

Him “but wait, that’s profit, does the slide say revenue?”

Me “Yes it does”

Him “oh I need to correct that”

Me “yep, and still, so if its ‘profit’ they generated an additional $233 per doctor? Still seems rather small.

Him “Well that’s the number they gave us.”

Word to those who are looking for vendors and being presented with marketing materials: Ask a few Questions; you never know what you may learn.  Perhaps I should refer them to the Intel Care Innovations Validation Institute.  Full disclosure, I am on the Validation Institute’s  advisory board.

3 Comments

Filed under Uncategorized