Why Nobody Believes The Numbers: Distinguishing Fact From Fiction In Population Health Management

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

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.

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