My guest in this health care podcast, Al Lewis, was telling me before we hit record that employer customers are vastly worse at evaluating wellness and point-solution vendors today than they ever have been in the past. Let’s break this down.
One aspect leading up to the “worse than ever” is the proliferation of point-solutions lately and all the PE (private equity) dollars flowing into the health care space. You pick up any rock and you’ll find 25 health care startups underneath it.
A second aspect is this: and this is not going to be a newsflash for many, but employers really trust their brokers and their EBCs (employee benefit consultants) to put together a good benefit package on their behalf. If an EBC says, “buy it,” employers click their heels and buy it a lot of times.
And with that great power comes great... opportunity. We see an uptick in brokers and employee benefit consultants, enjoying themselves a little arbitrage-ish money grab by taking money from these startups/vendors under a variety of umbrellas while at the same time they call the employers their customers.
This is especially profitable and also slimy when done under the cover of darkness because, as with so many aspects of health care, these backroom deals often happen without the employer customer knowing that there’s a vig involved in the recommendation process.
Al Lewis says he works in the “Integrity Segment” of the market. He is well known for outing vendors for basically lies they tell in their marketing. The thing is though, if a vendor comes to Al and asks questions about how to do it right, Al is always happy to help. He has said that he wants people to learn and if you’re asking questions, it means you’re interested in learning.
Al has been on the show before, actually multiple times, but one full episode was episode 245, and we dig into wellness that’s done “to” employees, not “for” them in that episode. So, check that out after you listen to this one, if you want more Al. Al also founded the Validation Institute and he’s also CEO over at Quizzify.
On the show in this health care podcast, Al explains the six major logical fallacies, computational flaws, tricks, if you will, that wellness vendors or point-solution vendors may deploy to inflate their “proven cost savings.” The six “watch outs” I’d guess I say for employers are:
Regression to the mean
Participants vs nonparticipants or matched controls or propensity scoring
The trend inflation trick
Plausibility testing
Actuaries and validation
Overstating engagement
These six things are all of the different logical fallacies some vendors employ in order to overstate their results or outcomes.
The Validation Institute has a PDF write up of each of these flaws which you can find in the show notes.
Bottom line? Buyer Beware. And, also, get a broker or an EBC who you know for a fact they’re working for you if you’re an employer because they’ve committed in writing to not taking payola from the vendors that they’re recommending to you.
One footnote is that if you haven’t listened to episode 329 with Joe Connolly you might want to go back and do so. Joe gets into the trend of some services who could, potentially, start taking on risk. Said another way, if services like these create their own bundles of point solutions and take on the risk of offering said bundle to employers, that could be nice.
You can learn more at the Validation Institute.
You can connect with Al by emailing al@quizzify.com, visiting the website at quizzify.com, on LinkedIn, or on Twitter at @quizzify and @whynobodybeliev.
Al Lewis wears multiple hats, both professionally and also to cover his bald spot.
Hat #1: Employee Health Literacy. He is the founder and “quizmeister-in-chief” of Quizzify, whose mission is to help companies teach their employees to utilize health care services appropriately, using a format best described as “Jeopardy meets Choosing Wisely meets Comedy Central.” Quizzify is the only vendor authorized to display the Harvard Medical School “Veritas” shield and has received excellent reviews from users.
Quizzify is also well known for its surprise billing “Prevent Consent” solution, which was recently featured in the New York Times. It can be taped to an insurance card, used as a stand-alone card, or downloaded into your Apple Wallet. Starting in 2022, use of this language prevents forced arbitration under the Surprise Billing Act and instead allows payment of 2x Medicare for non-elective care.
His quiz-specific background includes authorship of the best-selling Newsweek Presents the Ultimate Trivia Game, which Games magazine lauded as having the best questions of any trivia game; hosting two quiz shows on Boston network affiliates; and appearing on Jeopardy.
Hat #2: Outcomes Measurement. As an author, his critically acclaimed category best-selling book on outcomes measurement, Why Nobody Believes the Numbers, chronicling and exposing the innumeracy of the health management field, was named digital health book of the year in Forbes. Cracking Health Costs, written in conjunction with Walmart alum Tom Emerick, was also a trade best seller.
He was the cofounder of the World Health Care Congress’s Validation Institute.
His expertise in outcomes measurement got him named one of the unsung heroes changing health care forever.
04:49 Are brokers going to have to become more transparent about where their money is coming from?
07:33 Are carriers transparent?
08:09 What’s the goal of the Validation Institute?
08:55 “You either get a true statement put up or learn what you have to do in order to get a true statement put up.”
11:18 How is Regression to the Mean (RTM) used in a flawed way?
16:32 “If you do wellness for employees instead of to employees, the people who want the wellness will be able to access it.”
21:13 What is plausibility testing?
23:17 What about actuaries and validation?
23:40 “That’s one of the reasons the Validation Institute exists, is because actuaries are easily corrupted.”
25:18 What is a prime example of population health economics?
26:20 What does it mean to overstate engagement?
27:15 “How often did you use this and was it useful?”
28:55 “Are you validated by the Validation Institute, and if not, why not?”