Guest blogger Linda K. Riddell is here again, taking on the topic of health analytics. Full disclosure: there are shameless plugs all over the place. Linda references a book by Al Lewis, who used to write a monthly column for EBN. Al’s book references both Linda and the EBV blog. It’s a promotional extravaganza — tastefully done, of course. There, I’ve disclosed. Read on, and as always, share your thoughts in the comments. —KMB
It’s rare that a book about mathematics is funny. And this is not just any math: It’s population health analysis. Al Lewis has created such a book in “Why Nobody Believes the Numbers: Distinguishing Fact from Fiction in Population Health Management.”
This is the stuff that employers, benefit managers, CFOs and many others want to know: how to figure out if an intervention “worked” and reduced costs. Lewis takes a wry look at the numbers wellness/disease management consultants and vendors use to calculate cost savings. He debunks their “undetected claims costs” and “non-chronic trend” using fifth grade math and common sense.
A former economics professor at Harvard and current health policy professor at Brandeis University, Lewis has the credentials to stand up against the industry. He has spent 17 years in disease management, and in fact, is credited with inventing disease management.
Finding the real savings does not take a law degree (though Lewis has one), he argues. It does take a bit of courage to withstand the prevailing theories.
In the chapter on wellness programs, Lewis writes that plenty of companies claim to have saved money, but none have connected the program to the savings so they cannot plausibly say that the wellness intervention caused the savings. “No study . . . asks, ‘Yes, but did the utilization of medical services decline in the categories in which one would expect utilization to decline, having first increased in the categories where utilization would be expected to increase in advance of that decrease?’”
Wellness should initially cause costs to increase. People should be getting more preventive care, such as getting their cholesterol tested. This is typically ignored, in favor of finding cost reductions. Wellness vendors will try to outdo their competition on short-term savings, when there shouldn’t be any.
Lewis does not get into questioning whether the whole wellness assumption is flawed. But in fact, it is. Research has never proven that people who get routine physicals have better health or lower costs. For a health plan, putting a lot of people onto cholesterol-lowering medications is actually more expensive than paying for the heart attacks. Wellness programs that promote either of these will, by definition, not reduce costs – no matter what math a person tries to use.
The book is a solid, worthwhile read for anyone who wants to get past the puffery and into the real numbers. And you’ll have plenty of chuckles along the way.
The book will be available June 19 on Amazon and in stores June 28. You can read the first 10 pages and/or order the e-book on Lewis’s website.
If you have already registered to Employee Benefit Views, please use the form below to login. When completed you will immediately be directed to post a comment.
You must be registered to post a comment. Click here to register.