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6 Myths and Facts About Employee Health Literacy

Updated: Jan 14, 2020

While employee health literacy is a fast-growing segment of employee health benefit services, what’s amazing is not the number of organizations embracing it. It's the number of organizations ignoring it, despite the fact that reducing use of inappropriate interventions by educating employees on appropriate healthcare utilization is by far the most painless way to control healthcare spending.

Put another way:

  1. Employees get “empowered” to spend their deductible…but no guidance on how to spend it wisely.

  2. Employees get “transparency tools” to find the best prices for scans and procedures…but no tool to help them assess whether they really need those scans and procedures in the first place.

The bottom line: healthcare is the only line item in any organization where every employee is given an unlimited budget…with no training in how to spend it. Consider that for a minute: Companies spend more time teaching employees how to purchase office supplies than they do healthcare.

Here are 6 reasons for this disconnect, all of which constitute the health benefits design equivalent of urban legends.


Myth #1: Preventing diabetes and heart attacks is a much bigger deal than teaching employees about healthcare.

FACT: Here’s how diabetes and heart attack admissions compare to misuse/overuse of healthcare:

  1. Admission rate for diabetes and heart attacks combined: 2 per 1000 employees and dependents*, or roughly 2% of your total cost. (If you are showing much more than 2%, it’s because you are counting all expenses for all employees with those two conditions, rather than theoretically preventable expenses.)

  2. By contrast, inappropriate use accounts for roughly 25% of your total cost. Money lost to overdiagnosis may even be greater than that. New statistics from Washington show that a whopping one million state residents received unnecessary or inappropriate tests, procedures or treatments in a single year.

In other words, ten times as much money is lost to inappropriate medical care than to wellness-sensitive medical events like theoretically preventable diabetes admissions, which no one has actually proven can be prevented. This doesn’t include the lost productivity and absences of employees wandering from test to test, focused on their (mis)diagnosis, rather than their job.


Myth #2: Employees can’t be taught to purchase healthcare.

FACT: They are much more amenable to being taught about healthcare than being urged to eat more broccoli. Look at (or watch, in a few cases) the testimonials from many users saying how they immediately changed behavior after learning something through Quizzify.

The reason for that? In wellness, everyone knows what to do (quit smoking, lose weight etc.) but actually changing behavior is very difficult. In contrast, with health literacy/employee medical education, the behavior change is simple once you have the knowledge. For instance, once you know that CT scans have 100 to 1000 times the radiation of x-rays, you will be much less likely to demand one.

And once you know it is perfectly possible to get about two-thirds of all cavities fixed without needles, drills, or filling, why would anybody not do this?


Myth #3: The savings from wellness is much greater than the savings from teaching employees healthcare.

FACT: Quizzify is the only company in employee health benefit services with a 100% savings guarantee:

The guarantee is validated by the Validation Institute, meaning that it is calculated using valid metrics. By contrast, wellness has been shown by RAND, the National Bureau of Economic Research, and the New York Times’ economists to lose money. It may appear wellness is saving money — that misperception is largely due to participants-vs-non-participants bias, to which The NBER attributes 100% of perceived wellness program impact.

Wellness also costs ten times what employee health literacy costs, so it would have to be ten times as effective to earn the same ROI.


Myth #4: Employees already know this stuff or can learn it on well-being quizzes from a wellness vendor.

FACT: They don’t. If they did, then, to use two examples that show up frequently on our quizzes:

  • The US would not lead the world, by far, in use of CT scans (perhaps the #1 thing that people learn about through Quizzify) if indeed employees were aware of the many hazards of radiation, overdiagnosis, and allergy to the dye;

Quizzify educates employees to be aware of the hazards of these two commonly abused and misunderstood interventions. We are aware of no wellness vendor that teaches this curriculum to employees, certainly not with the imprimatur of a leading medical school, as Quizzify’s content is reviewed by doctors at Harvard Medical School.


Myth #5: We dropped all wellness initiatives because employees hated them, they wouldn’t provide personal information, and they were cheating.

FACT: It is true that employees generally hate wellness. Its “Net Promoter Score” (NPS) is -52, according to WillisTowersWatson (p. 19)

This NPS is by far the lowest of any industry ever surveyed. Other industries get positive scores:

In contrast, employees love Quizzify. One of the biggest complaints we get is: “Not enough questions.”

There is no intrusiveness issue because Quizzify doesn’t ask personal questions at all.

While it is well-established that up to two-thirds of employees do cheat in wellness (sometimes harming themselves in the process, like binge-eating before an initial weigh-in or taking diet pills before the final weigh-in), Quizzify encourages “cheating.” We want employees to look up the answers before responding to the questions, to improve retention.


Myth #6: Doctors are now being taught to stop overdiagnosing and overtreating employees – it’s their responsibility, not the employees’.

FACT: Been there, done that…didn’t work. Choosing Wisely, a very well-intentioned professional education program design to do exactly that, has failed. There are many reasons for the failure, but one analogy sums it up best: before Rachel Carson wrote Silent Spring and basically ended the purchase of DDT, she tried to convince Monsanto to stop the sale it. They obviously didn’t.

That’s what happens when you ask a producer of anything to stop producing it because buyers are better off without it. Healthcare is no different. As one healthcare executive put it: “Show me any industry willing to cut its own revenues in half.”

Quizzify actually got started because of our CEO’s own healthcare journey into the land of overdiagnosis and overtreatment…and he can vouch for its being alive and well as the healthcare industry business model.


Having cleared up all the reasons not to educate your employees, consider the reasons to educate your employees:

  1. They need to know that, as we say at Quizzify: “Just because it’s healthcare doesn’t mean it’s good for you.”

  2. Wiser employees make healthier decisions…and healthier decisions save money.

  3. Your employees have so many benefits that, without a tool to educate them on the benefits of those benefits, your investment is going to waste.

Quizzify is not just a content tool, but also a communications tool about other benefits.

Contact us now…and start employees on the path to wiser use of all their benefits, and healthcare as a whole.


*2014 is the last year for which full statistics are available. The roughly 150,000,000 commercially insured Americans suffered 158,895 heart attacks and 126,710 diabetes events – a combined rate of slightly less than 2 per 1000. This data is available here.


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