Wellsteps joins the University of Colorado as an Intelligent Design Award winner from the Disease Management Purchasing Consortium of Boston, MA.
Wellsteps Joins the 100 Club | Disease Management Purchasing Consortium.
Hospitals, Testing Companies Face Questions About Value Of Community Screenings – Kaiser Health News
May 14, 2013 By Leave a Comment
Even the MSM is starting to tune into the bogus, expensive and very nearly fraudulent approach to mass screenings practiced by hospitals, health systems, and wellness vendors.
Hospitals, Testing Companies Face Questions About Value Of Community Screenings – Kaiser Health News.
Employers Love Wellness Programs — Businessweek
May 10, 2013 By Leave a Comment
Check out the assessment of employer interest in wellness programs by Bruce Elliott, the head of the Society for Human Resource Management.
And I quote:
“The one thing that does worry me is the utter lack of metrics, and, really, the utter lack of thought. We’re now more at a herd mentality.”
Hilarious. The head of the trade group that represents HR professionals — the same people who are pitching and buying wellness programs and, thus, perpetuating wellness mythology — thinks the whole thing is thoughtless and indicative of a herd mentality. Ummm, more specifically lemmings, I think.
Mr. Elliott’s candor does appear to at least put him within striking distance of wellness cynics like me, my colleagues, Al Lewis and Tom Emerick, and a few others. Or, as Al refers to us…the triple digit IQ crowd vs. the wellness ignorati. Nice quote in this article by Al, by the way.
Employers Love Wellness Programs. But Do They Work? – Businessweek.
Health care inflation slows: Health Affairs
May 9, 2013 By Leave a Comment
In its most recent issue, Health Affairs presents a series of papers looking at the slowdown in health care inflation over the past few years. You can access the Table of Contents using the link below. Most of the articles are behind a pay wall, but Editor John Iglehart’s editorial is not, and you can read it here.
Table of Contents — May 2013, 32 5.
There are also some well-written summaries of the papers; see here and here. In not a single one of the papers does anyone make any mention of, or give any credit to, corporate wellness programs. Nothing, nada, zip, zero. About 40 percent of the spending slow down is due to the recession; another chunk is due to cost shifting, as people find themselves dealing with higher copays and deductibles, which undoubtedly cause people to forego some care (sometimes appropriately so and sometimes not); changes in reimbursement frameworks; increasing hospital and physician efficiency; the slower advent of new technologies (and more skepticism about their proper use); and, an explosion in the availability and use of generic drugs. All of these impacts are occurring in the clinic, which is where there was the greatest room for improvement and cost constraint.
Huge challenges remain, however. No one knows whether any of this good news is sustainable. In a separate series of papers, published by the CDC in the new issue of Preventing Chronic Disease, researchers show that the prevalence of people with multiple chronic conditions (MCC) is increasing rapidly. Nearly 40% of adult visits to physicians in 2009 were by people with MCC; almost 40% of hospital discharges were for adults with 2 or 3 MCC and one-third had 4 or more MCC. People with MCC die sooner and use more care on their way to that endpoint than do people who don’t have MCC. MCC is a plague in the Medicare population, which will probably prove to be the biggest policy and fiscal challenge of all. Finally, the prevalence of lifestyle-related conditions is increasing steadily, even in younger adults.
Taken together, the data bring the debate back to the fundamental question of whether workplace wellness program should be trying to do things are more properly done in the clinic (such as health coaching for secondary prevention, which was shown in a study published just this week to be both costly and useless) or whether it should strive for primordial prevention. A shift in wellness toward primordial prevention is perfectly suited to an analogous shift by employers away from health contingent wellness programs to participatory ones. Employers are not doctors and neither are wellness vendors.
While you are on the Health Affairs website, take another look at my and Al Lewis’s recent papers there:
http://healthaffairs.org/blog/2013/04/29/the-million-dollar-workplace-wellness-heart-attack-screen/
The Scientific 7-Minute Workout – NYTimes.com
May 9, 2013 By Leave a Comment
As quick, simple, low-tech workouts go, this is as good as it gets. If done as intended, 30 seconds of each exercise with no resting in-between, this is pretty demanding. I am in excellent condition, and even I found that it did, indeed, make me work.
The Scientific 7-Minute Workout – NYTimes.com.
It is very much like the daily group workout done by the folks at OverItMedia, which I thought was just terrific.
The exercise routine outlined in the NYT article is doable in almost any company’s environment. All you need is a little space and some sturdy chairs (I recommend some kind of a stepping box for the step-ups instead of chair; most people will not be able to do step-ups on a conventional chair when they first start out because it’s too high).
BMC Cardiovascular Disorders: Cost-effectiveness of a coronary heart disease secondary prevention program in patients with myocardial infarction: results from a randomised controlled trial ProActive Heart
May 8, 2013 By 2 Comments
This randomized trial can only disappoint prevention proponents whose dream is a health coach for every person who could conceivably use one. Personalized health coaching for patients with coronary heart disease led to higher costs, more hospital admissions, and no meaningful change in health-related quality of life (HRQOL), using a real QOL instrument, the SF36. (Hey, there’s an idea…measure QOL with a real instrument, instead of a health risk appraisal [HRA].)
If this approach does not help people who should be ideally suited for it, how is it possible that your typical corporate wellness program, targeting younger, employed people with far less wellness-sensitive disease, could lower costs and improve QOL? Answer: easy…cook the books.
Notice also the differences between this study and Michael P. O’Donnell’s piece of dreck from the American Journal of Health Promotion. You know, the really complex stuff, like randomization, a control group, and valid measurement tools.
In a related vein, look at the randomized, controlled clinical trial proposal below from a team of European researchers, as well as the editorial and study abstract for work done by Canadian researchers. Both the proposal and the reported results pertain to the impact of exercise on patients with cardiac disease. The proposed study will aim to learn whether exercise can prevent readmissions (my bold prediction is that YES, it will), which is a major clinical and financial endpoint. The Mayo paper (a retrospective analysis of people with an average age of 60) reports that cardiovascular fitness is a major determinant of survival after cardiac rehabilitation, and, importantly, increasing physical capacity dramatically lowers mortality (and, although they did not report it, it would not surprise if it also lowered utilization). Because the study is behind a pay wall, it is especially important to read the editorial, which is not. The editorial describes the study well and includes two particularly powerful graphics: one of risk factor accretion and another of how cardiorespiratory fitness plays an irreplaceable role in cardiac health.
Proposed clinical trial discussion paper: http://www.biomedcentral.com/1471-2261/13/32
Cardia rehab abstract: http://www.mayoclinicproceedings.org/article/S0025-6196(13)00191-2/abstract
Cardiac rehab editorial: http://www.mayoclinicproceedings.org/article/S0025-6196(13)00225-5/fulltext {This editorial is the best summary of the data on the impact of cardiorespiratory fitness [CRF] on mortality that I have read in some time. When you read it, try to envision the population at your local mall. We’re in deep, deep trouble.}
So, let’s conclude today’s lesson with a summary of what we’ve learned:
Actual improvement in physical capacity improves health and lowers mortality
Having someone talk on the phone to a “health coach” not only doesn’t improve health, it worsens it and it raises costs, but, yet, this is what corporate wellness automatons tell us is essential
Using objective, measurable data (cardiorespiratory fitness, mortality, QOL, hospital readmissions, etc.) matters
