The Most Provocative Man in Wellness
Why Al Lewis Believes Wellness Should Be Done FOR Employees, Not TO Employees
When you present at a conference exposing the inadequacies of “Disease Management” and then the industry begins to crumble, you might be a person whose opinion should be heard. Such is the perceived power of Al Lewis, who formerly taught economics at Harvard and ran Peer Review Analysis, a NASDAQ health care company, a man widely credited with inventing disease management, although he’s quick to say he didn’t. A more accurate description these days might be “Bouncer,” standing guard at the gate to discourage bad behavior.
Al has made a reputation for himself, especially on LinkedIn, promoting corporate wellness vendors whose methods have been validated, and calling out those who do not measure up to the standard. If you are on his naughty list, be warned. “I call out those who are lying through their teeth,” Al says.
Indeed, even the most cursory review of Al’s LinkedIn activity reveals his fearless cross-examination of people and companies who regurgitate bad data or make wellness promises they can’t keep. And he often does it by name, tagging the companies he is calling out.
“Aren’t you afraid of getting sued?” I asked him.
“Make my day,” he says. “Sue me, but I won’t be settling. And I’ll be blogging about it the whole time.”
In fact, Al invites a lawsuit. He’d like to prove his point on the record. He puts his attorneys’ address on his website, creating the picture of a strapping guard standing at the gate, whose presence is enough to give pause to those who throw frivolous claims around. As a former attorney, he does all his own cross examination. He will not accept lies.
So how did the man who fathered Disease Management end up a LinkedIn vigilante, and the CEO of his own corporate wellness offering, Quizzify?
It started with Al’s time in disease management, where after promoting it vigorously and successfully for years, Al noticed that the entire industry, including himself, had been measuring the savings invalidly – and in reality there were none. (Founding Father Declares My Kid is Ugly).
Disillusioned, Al became a proponent of wellness in the workplace. After all, everyone says wellness saves money, right? But he couldn’t escape the fact that it was still the same snooker, with much greater potential for rigged numbers because the programs were so much more expensive. He noted that wellness savings couldn’t possibly cover the costs. For example, employers might spend $100/PEPY on a program, while total spending on diabetes admissions and heart attacks is just $50-$75/PEPY. He doesn’t just prove savings are impossible. He also offers a $3 million reward to anyone who can show otherwise.
Plus, he was concerned that wellness presents huge potential for harm, like the episode of The Office where Michael Scott pressured his staff to starve themselves in preparation for everyone to stand on the oversized scale in the warehouse for weigh-in, part of the interoffice wellness competition.
Having explored both sides of this coin and finding there was waste and inaccuracy on each, he found himself looking for solutions. Around this time, Al had the opportunity to view disease and wellness from the perspective of the patient. While a patient, he was pushed toward over-testing, over-treatment and unnecessary surgery. Al was knowledgeable enough to rebuff these recommendations, but he came to wonder, if he could be subjected to misguidance by the healthcare industry (and the bills that come with that), what could happen to the average person who wouldn’t know they should, or even that they could, say no? He had found a niche that was overlooked by both sides.
At this point it helps to know that, Al, a renaissance man, has another resume item. He was the author of Newsweek Presents the Ultimate Trivia Game, the host of two TV quiz shows, and was a contestant on Jeopardy. So, it seemed a natural and attractive pairing to bring healthcare education into the world of trivia, effectively changing the rules of the healthcare industry’s game. Quizzify was born, with the mission of providing the education employees need to be health-literate, wiser and more confident healthcare consumers.
“Healthcare literacy is the most solvable problem,” Al believes, “While the bigger challenges of provider prices, drug costs, and people being ripped off right and left require more complex solutions, a little education can go a long way in getting employees to ease up on their demands for antibiotics, surgeries, tests and treatments that are unnecessary and possibly harmful. They realize it’s in their own best interest to create some very simple behavioral changes and know what they are talking about when they go to the doctor.”
With Al holding dual roles of Quizmeister-in-Chief and wellness vendor antagonizer-in-chief, I was curious to know how Al reconciles “good” wellness and “bad” wellness in the workplace? To Al, the answer is simply whether wellness is being done TO employees or FOR them.
“(On-site gyms, fitness classes), better food in the cafeteria, second opinion programs, EAPs, help with student debt repayment, childcare support that kind of thing- what’s not to love? Employees like them, and these offerings help companies recruit and retain employees. That's great. But when you basically tell employees to lineup and get screened, and if they don't lose weight, or lower their cholesterol, or quit smoking they will lose money... they fail! That's been proven up, down and sideways to not only lose money, but to actually harm employees because they do things to manage to the test rather than to actually improve their health.”
And yet, workplace wellness is such a generic term these days, it could mean anything from in-office massage and yoga to office child-care to biometric screenings and health clinics. There’s a lot of noise out there, so how can HR benefits manager can sift through the information when adding to their wellness programming? That’s easy, according to Al. Here are his 5 tips:
If studies are being cited, look at who the study is connected to. Virtually every favorable one is connected to the wellness industry in some form or another. By contrast, Al peer reviewed the Rand study of Pepsico for Health Affairs, and feels it meets the muster.
Utilize The Validation Institute to find vendors that are reputable. Quizzify is one such company, validated as measuring and guaranteeing savings validly. Only one company, Quantum Health, is validated for actual savings achieved on a total healthcare spend. While several wellness vendors are validated (including US Preventive Medicine, which has reduced population-level risk, a rarity in this field), none has been validated for actual savings.
Cancel your “pry, poke, prod and punish” wellness program, or give employees the choice to participate, which has a more positive impact. Educating employees on the potential harms and benefits of screening and then letting them make the decision to get screened if they think they need it, is another elegant solution to the problem.
If you do have screenings, have them according to clinical guidelines vs. screening everyone every year for everything and generating tons of false positives.
Add lifestyle programming like fitness, nutrition, meditation, fertility benefits, etc... Al says, “We are big fans of this type of programming. This indicates that employers care about their employees’ true health and wellness, and it’s wellness for, not to, employees.” But he cautions to understand that these are long term investments in the overall health of employees, and won’t necessarily bring a measurable ROI on the bottom line, though they may improve metrics like increased goodwill toward employers, employee retention and recruitment.
Al has already changed the corporate wellness industry in many ways, so what does he think workplace wellness look like in the future? His answer, it will be mostly about employee health education. It will be fun and engaging, and poking and prodding won’t be a part of it.
It will be a future in which we will sleep better knowing Al is guarding the gate.
Interview by Heather Waibel, Article by Gizelle Erickson