ShapeUp and Highmark Blue Cross: A Lesson in How Not to Announce Wellness Outcomes

This post co-authored with my colleague  Al Lewis.

Sometimes an example comes along of a wellness program outcomes announcement that is just too instructive to ignore. ShapeUp’s program for Highmark Blue Cross is that example. If, as engineers say, more can be learned from one bridge that falls down than from 100 that stay up, ShapeUp, which claims leadership in using social networking to make employees healthier, is the wellness industry’s Tacoma Narrows. (Highmark, of course, is already notorious for its Penn State wellness program in conjunction with Truven Health Analytics.)

While most of ShapeUp’s one-page report is the usual wellness hyperbole, one seemingly innocent number buried therein invalidates the rest of it, and provides an excellent lesson in what Surviving Workplace Wellness observes: in wellness, you don’t have to challenge the data to invalidate it, you merely have to read the data — it will invalidate itself. This number is “163 employees lowered their BMI status from obese to overweight, or overweight to healthy weight.”

Here are three observations that a sophisticated reader of wellness outcomes would make:

1. In wellness, you always divide numbers that the wellness vendor doesn’t divide. There is usually a reason the wellness vendor has not done the division. 163 represents 0.86% (not a misprint) of Highmark’s 19,000 employees, giving ShapeUp’s outcomes announcement the industry’s highest ratio of braggadocio to actual success. Even if you only consider the two-thirds of Highmark employees who were likely overweight or obese, the success rate zooms to 1.3%.

2. As modest as 0.86% is, this figure excludes dropouts and non-participants. By definition, those groups were more likely to have gained weight than lost it.

3. And also as modest as 0.86% is, this is short-term weight loss. Though one would never guess it from the unimpressive magnitude of ShapeUp’s performance, short-term weight loss is easy to achieve. Keeping weight off is the hard part and of course no statistics are offered on that score.

Put these points together, and it’s quite possible that Highmark’s workforce actually had more people change weight categories in the wrong direction than in the right direction over the course of the ShapeUp intervention.

In all fairness to ShapeUp, we can’t conclude that they are purposely misleading people, though their decision not to divide 163 by either 19,000 or 12,500 suggests that they are. It’s also possible they simply don’t know how to measure wellness outcomes even though they are a wellness company. Either way, we would recommend using a different vendor.

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2 thoughts on “ShapeUp and Highmark Blue Cross: A Lesson in How Not to Announce Wellness Outcomes

  1. […] It turned out that ShapeUp’s own outcomes weren’t exactly bulletproof, as the company claims to have achieved a whopping 0.86% improvement (not a misprint) in weight categories at Highmark. As modest as that claimed improvement was, the 0.86% figure represented only the gross improvement — it excludes weight changes of non-participants and dropouts, and people who later regained the weight.  All these groups would have to be subtracted from 0.86% in order to arrive at a valid net improvement.  Read the whole story here. […]

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