Why Nobody Believes the Numbers Distinguishing Fact from Fiction in Population Health Management

Author: Al Lewis
Publisher: John Wiley & Sons
ISBN: 9781118313183
Published In: June 2012
Format: Hardback , 213 pages
Jurisdiction: International ? Disclaimer:
Countri(es) stated herein are used as reference only

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Possibly the funniest serious healthcare industry book ever. Includes 12 case studies of vendors, carriers, and consultants who were apparently playing hooky the day their teacher covered fifth-grade math, as told by an author whose argument style can be so persuasive that he was once able to convince a resort to sell him a timeshare. The lesson of Why Nobody Believes the Numbers: no need to hire fancy consultants or to believe what your vendor tells you -- instead you can estimate your own savings using “ingredients you already have in your kitchen.” Don't be intimidated just because you lack a PhD in biostatistics, or even a Masters, Bachelor's, high-school equivalency diploma or up-to-date inspection sticker. Qualifications aren't everything. After all, Elvis didn't have a PhD in musicology and Paul McCartney can't read music.

There are serious lessons too. Why Nobody Believes the Numbers helps you interpret the numbers you get shown, and explains how to tell if they are real...and why they usually aren't. You'll learn how to:

Figure out whether you are "moving the needle" or just crediting a program with changes that would have happened anyway
Determine whether the ROIs your vendors report are plausible or even arithmetically possible
Synthesize all these insights into RFPs and contracts that let vendors know that you weren't born yesterday

Introduction xiii

Chapter 1 Actuaries Behaving Badly 1

Chapter 2 Plausibility Testing: How to Measure Outcomes Using Ingredients You Already Have in Your Kitchen 35

Chapter 3 Case Studies That Flunk Every Plausibility Test Known to Mankind 53

Chapter 4 Case Studies That Flunk Every Plausibility Test Known to Mankind and Then Some 73

Chapter 5 Case Studies of Where, When, and How Wellness Programs Have Actually Worked 125

Chapter 6 Yes, Virginia, There Is a Savings Clause 141

Chapter 7 Disease Management Programs That Actually Work (Pinch Me) 151

Chapter 8 Contracting/RFP Checklist of Do’s and Don’ts (Mostly Don’ts) 175

Appendix: The Keys to the Numerical Kingdom 193

Author’s Note on Sources 195

Notes 197

Glossary 201

About the Author 207

Bibliography and Further Reading 209

Acknowledgments 211

AL LEWIS, President of the Disease Management Purchasing Consortium, is widely credited with inventing disease management and was named "the national leader in analyzing care management outcomes" in the 9th Annual Report on the Disease Management and Wellness Industries. He provides procurement and outcomes consulting to health plans and human resources/benefits departments, and administers the industry certification program in Critical Outcomes Report Analysis. He holds undergraduate and graduate degrees from Harvard.

“It’s rare that a book about mathematics is funny. And this is not just any math: It’s population health analysis. 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.”—Employee Benefit News

“Do yourself a favor and buy this book. And, keep it handy the next time you entertain a DM/wellness proposal or examine data submitted to you by your vendor. You will never read those proposals or reports the same way again”—Khanna on Health