The GLP-1 Equation: Balancing Innovation, Access & Cost - 2026 NextGen Healthcare Summit Recording Series

In this episode of Risk & Resolve, it breaks down the exploding cost of GLP-1 medications and why many organizations are spending millions on diabetes care—with little improvement in health outcomes. Featuring leaders from American Senior Communities and Northwind, this conversation explores a bold, mandatory program that combines medication, coaching, and accountability to drive real health improvements. From behavior change to data-driven strategy, this episode challenges the “medication-first” mindset and reveals what it actually takes to reverse chronic conditions at scale.

Main Talking Points

• The wake-up question: Are we spending millions on medications while employees remain sick?
• Why diabetes medication costs can be 10x higher than any other condition category  
• The decision to carve out diabetes care and implement a mandatory, managed program
• How Northwind’s model removes barriers: cost, access, complexity, and fragmentation
• The power of combining medication + health coaching + accountability
• Why “mandatory” can actually be the most compassionate approach to employee health
• The reality of behavior change: why people resist—and how to move them anyway
• Key KPIs that matter: engagement, risk reduction, GLP-1 utilization, and cost per patient
• Results that matter: improved A1Cs, reduced high-risk populations, and lower overall spend
• The hidden dangers of GLP-1 overuse and “set-it-and-forget-it” prescribing
• Why medication alone is insufficient—and often just masks the problem
• The long-term risk: how today’s solutions could create future health and cost issues
• Communication strategy at scale: reaching a fragmented workforce effectively
• Real-world impact: helping patients move toward remission—not just management
• Why sustainable health requires behavior change—not just prescriptions

Transcript

Welcome To Risk And Resolve

SPEAKER_00 0:00

You're listening to Risk and Resolve, where leadership, business, and risk management collide. Bring you real conversations, sharp insights, and strategies for success. And now for your hosts, Ben Connor and Todd Hopper.

The Million Dollar Diabetes Question

SPEAKER_04 0:19

So uh it was in 2024, uh there was a question asked in a meeting that uh stopped all of us in our tracks. Um, and it was the question: is it possible that we are spending millions of dollars on medications for our diabetic population and they are still sick? That one was was kind of a tough pill to swallow, um, no pun intended. Um that uh we were spending millions of dollars on diabetic medications, and we had some confidence that our workforce is walking through their condition and still being sick. Um we were spending millions of dollars on diabetic medications. This isn't necessarily like a rule of thumb, but something that we've noticed. Uh, diabetic medications within your health plan is likely upwards of 10x your next highest uh condition class. So if you're spending 20 grand on whatever number two is, you're gonna be spending 200 grand in the in the diabetic medication class. Again, rule of thumb, not not gospel. Um it was clear, it was the clear area that we needed to address. I think from a consulting perspective, uh we uh try this really complex uh methodology, which is find the biggest problem and solve that. Um uh so today we're gonna talk about the journey of building a solution that met the needs of the organization, which the organization uh is uh American Senior Communities, where Mary leads as the as the benefits administrator.

Building A Mandatory Carve-Out Program

SPEAKER_04 2:09

So with this problem, I'm actually gonna describe what we did. Um we saw that this was an issue, so we um really searched the market to find a solution provider that could help us with carrying out a system or a program to come alongside and help our individuals get better. Um, and two, if people are getting better, is it possible that they can then not be on medication in the future? Um so through that, uh we came across uh Northwind as a solution provider. Um and what we decided to do was exclude the diabetic uh medication class out of our PBM and had it solely sourced through Northwind. Um and so one thing that made it was the idea of mandatory. So if we exclude it out of our PBM and you have to source it through Northwind, by definition, it is mandatory that you get your diabetic medications uh through Northwind. Um we then established that if they uh participated with a health coach along with obtaining medications, what that wasn't required to be a part of a health coach, but if they did, we would reduce the copace for participation with the the health coach. Um and from there, that allowed us to really understand our information alongside of Northwind. Um so we were able to manage data and set aside key performance indicators. So because this is Northwind, the high level of expertise for them, we now know, you know, our KPIs, I can share them with you. It is what's our total percentage of engagement? We can know that number, how many people uh are participating with a health coach. Number two is what's our percentage of uh employees that would be considered high risk for this condition? Um, since they're managing the population in an accountability measure, which is good, accountability is a good for relationships. So the accountability measure is if we know how many people are what percentage is high risk, and if we're helping them get better, that number should come down, right? Um, so what percentage of members are high risk, what percentage of our population is on a GLP one? And uh what is our total cost per patient? Um, and so that just measures is is that being addressed. Um so we could from those KPIs, we could see if folks uh were really reversing their condition and even reducing or removing the need to medication. Um and that is what we think is the linchpin of managing GLP1s is helping people get better, reducing their risk. And if you're in remission from your condition, we can change your treatment pathway. Uh not in like a scary way, but in a natural progression of you um uh you know making improvements with your health.

KPI Results And Medical Spend Drop

SPEAKER_04 5:16

So some of those results um from those KPIs, our engagement percentage. Uh, we averaged in 2025 91.5% engagement with a health coach, which is crazy. Usually when you talk about like a like a carve-out solution, that's like a 30% is like, yeah, you're doing really good. Um we were able to achieve 91.5%. Um percent of patients that were high risk went from 80% down to 72.8%. Um percent of members on GLP ones, which is still our opportunity area, and I know we're making good strides here, is 56.2% of our members are on GLP1s. Um, and then our cost per patient is actually 4% lower than it was the prior year. Um, the last thing that I think was really interesting uh in our conversation um was because you're you were stress testing this idea, right? And one of the things is would we consider it a win if our medication costs stayed similar or the same or flat, but with improved health, our medical spend went down. Um, because if someone is managing a condition, they're maybe not ending up in the emergency room and those sorts of things. Um, and we're pleased to say through the data that our medical spend for that for a calendar year went down by a million dollars. Um, so we know that the approach is working. Now, do we have uh things in front of us to accomplish still? Of course, but um so far, so good. So that's a long-winded intro. But I think it's really helpful to get context to what are we really talking about here? So I have a couple questions for the panel to really shed some insight. Um, and the first one is for Mary, um, as she trusted us to uh walk through this process. Um, but the first question is um I think knowing your population and the typical expected behavior is really important when introducing

Communication Challenges Across 100 Sites

SPEAKER_04 7:30

a program like this. So, what were some unique parts of this change that you knew were necessary for your population? What were some things like, hey, this we have to do this for it to work inside of our population?

SPEAKER_03 7:47

Is this on? Hello? Yep, yep, okay. Um, so our population is very spread out. American Senior Communities has over a hundred facilities across the state of Indiana. Um, we have about 11,200-ish employees, um, and communication is horrible. So it's hard to communicate with facilities when they're so spread out. Some facilities do a great job, some facilities do not. Um, and so the biggest hurdle when we decided to do this was how are we going to communicate to employees so that on February 1st, 2025, when they walk in the pharmacy and the pharmacy says, I'm sorry, I can't fill your prescription, they know why, right? So we started in November with Northwind, November of 24, with a mighty, mighty communication strategy, um, letters to employees, outreach by Mandy's team, um, directly to employees. Now that sounds really easy, but people don't like their employers to contact them. Does that does anybody else, right? They don't want you to call them, they don't want you to send a letter. They take their phone numbers and their emails and they don't change their address. So it was a good thing we started two months before 2025 because we had a lot, and Mandy's shaking her head, and a lot of folks that we didn't get in touch with. And then, of course, we had folks that get the letter and they're like, What is this? Right? Because employees don't like you to tell them what to do either. Right? Um, so it was a hurdle, it was a little scary. Um, we knew it was going to be not seamless, like we knew it wasn't going to be perfect. Um, so we didn't call it on 1125. We didn't say on 1125, if you haven't signed up, you're not gonna get any meds. Well, you can't do that for a diabetic, you know, that's dangerous, right? So that was my biggest concern. How do we make sure that people are still getting their meds and rolling over into the northwind world? And so we made a cutoff of two one. So we gave us ourselves three months to get in front of people. Um, but then you have to think some people filled a medication for 90 days in January, right? So it's really 4-1 now. So people had a lot of time to get used to it. Um, and I will say it actually went better than I thought it would. We had some angry folks, um, for sure, mostly for people on a GLP one for weight loss only, which we exclude. Um, they weren't very happy with us, let's just say that. Um, and the other thing that completely blindsided Northwind, myself, Ben, Laura, um, was coupons. Does anybody know what I'm talking about there? They have these little manufacture coupons that are 25 bucks. They get their GLP one. Um, that was a hurdle. Um, because people were like, well, what you're charging me is more than my coupon. And I'm like, coupon? What are you talking about? So that was interesting. Um, but live and learn, right? I mean, it was um for all I can say is I think the rollout was successful. I think it was stressful, um, but with compassion and understanding and a lot of patience. By the time we got to July, things started to settle down. Um, I think Mandy would agree.

SPEAKER_04 11:43

Yeah. Yeah, that grace fill. If you talk about a big pharmacy change change, a one-time grace fill is a is a winning strategy if you have a population that is very difficult

Why Mandatory Worked For Employees

SPEAKER_04 11:56

to communicate with. Um in my opening, I said a word that I think might scare the hell out of most leaders and especially HRs, and it's the term it's the word mandatory. Um why was why why is mandatory, Mary, uh so important for ASC? And actually, and even to we viewed that word, again, most people that scares them. It's like, how can I do mandatory with my employees' health? That's something, you know, whatever, however you want to describe that. We actually viewed it as positive. So how do you view, how did you view the the the approach of doing a mandatory change? How is that a how does ASC look at that as a positive situation for really the employee?

SPEAKER_03 12:46

So for ASC, it was either mandatory or not at all. Why do it? Um because we know our population, like I said, employees don't like in their employer to tell them what to do, right? So basically, what was mandatory was that their meds came from Northwind. It wasn't mandatory that they had to join the blueprint for coaching. However, I think Ben, you said we were at 90%. Um so we did, you know, the copay was lower if you were in the blueprint, um, but not by much. But people actually signed up for it. Um, and the mandatory piece we vetted a lot to make sure that we were compliant and all those things. Um, and we did get some pushback. Um, we did get some nasty phone calls. I know Mandy Steen probably had a little bit of um abuse during that time where people were like, you know, I don't want to do this, and we're like, you don't have a choice. Um that's a hard thing to say to an employee. However, I want to just say the mandatory piece did calm down again, like people calm down. And what was really amazing, um, just remember you can't please everybody, right? Some people are never gonna be happy no matter what you do. Um, I don't know. Um I think Adam, when you were talking about this, some people are just not happy. Um, so that mandatory piece did calm down. And what was amazing is some of our most disgruntled folks, I think, Mandy, actually went, wow, thank you. Look what you did for my health. I think for me, for employee, I'm an employee advocate person. Um, and I want them to be healthy so that they can do their job better to take care of our residents in our facilities. We're long-term care. Um, and it I think it came full circle. I really do. Um, I'll let Mandy speak with some of that. But I want to give kudos to Mandy on that. We can talk about it in a little bit, but um, what patience they had because people weren't not happy at first.

SPEAKER_04 14:57

Yeah, yeah, and it goes back to uh it's we all know that really no one likes change. We can all think we really like change, but when it comes down to it, no one really likes change. Um, so as we stay true, and the way we looked at that piece of mandatory is going back to what I said at our premise. Is it possible that we're spending millions of dollars on medication and people are still sick? And what would it look like to help our people become healthier? So if our goal is to help people become healthier, is it not the kindest thing that we could do for them to encourage them, make it mandatory to participate in something that's for their own good and interest? And that's where for me that was just such a mind change of this, well, we have to do it this way. I would be we would be unkind to do it any other way. Um so uh great job, Mary, and in leading

Northwind Blueprint And Barrier Removal

SPEAKER_04 15:56

that effort. Um, so before we get uh I'm gonna step aside and get back into a little bit of a technicality, um, Catherine, if you could, could you uh briefly explain like the genesis of the diabetes clinical blueprint that Northwind deploys?

SPEAKER_01 16:17

Absolutely. Um so Northwind's clinical programs were born out of the concept of removing barriers. So when you have a population of people that are suffering with chronic disease, namely the ones who are very uncontrolled getting sicker, to Ben's point, over the course of time, despite your plan covering things and them having the ability to get what they need, um, people tend to get sicker over time. And so oftentimes it's because things get in the way. So cost barriers, access barriers, complexity barriers, it's difficult. And what I talk about a lot as I get in front of groups is that these people, we as humans all only have our own limited bandwidth. So kind of um what we were talking about earlier as well in our keynote, that you can only give so much in so many places. And so when someone's dealing with chronic disease, they're also dealing with all the other things that we all deal with every day as well. And so we ask them, and we can talk about diabetes in particular, that um, you know, we ask you to take your medications every day, sometimes multiple times a day. We ask you to eat well and move more and check your blood sugar and all the things and go to all these pharmacies and get the stuff and make sure you you have it all when you need it, and do your job and take care of your family and manage stress and all the other things. And so if you can imagine, all those things get in the way. And so our programs are really designed to help remove a lot of that off of their plate, make it really easy, take away the barriers so that they could focus on the things that they could control and do and actually execute on taking care of themselves. Um, and so partnering with that, making that easy, seamless, simple, um, and then partnering that with expert clinical support. So our programs in this one too, we partner with pharmacists and health coaches to guide both the medication management optimization, making sure that that continues to align with the patient's needs. Not only are they getting what they need, are they using it properly? Is it working? Are they having adverse outcomes, et cetera? Do we need to work with their doctor on making changes? Um, and then on the health coach side, it's about how do you enable or empower somebody to actually become an active participant in their own health? Because that's really what's going to create longevity and sustainability for them as a human or for you as an employer, is if people actually want to be healthier. Um, and it is one of our, one of our two-pronged approach, is actually to produce health across a population. So that is where our programs were born. It's why we exist today, um, and we continue to fight the good fight.

SPEAKER_04 19:06

How has the program changed as the ramp up of GLP ones have has occurred in the last couple of

GLP-1 Demand And Plan Waste

SPEAKER_04 19:14

years?

SPEAKER_01 19:14

Great question. Um, so I would say when we first started with the clinical programs, we did partner with employers oftentimes on more of an opt-in sort of model where you do it, you give them an incentive, and somebody can show up. What we've learned is that the more control you can put around something like diabetes management, GLP1 management, et cetera, across your population, the better off you're gonna be as an employer and the better off your members are gonna be. Um, what we also find in the world of GLP1s is as everybody in this room has heard of them, they are the number one most talked-about medication, maybe in the history of ever. Um, and they're very highly sought after, namely because of their benefits, um, weight loss, et cetera. And so people will seek these products, whether it's covered on plan or not, and they will try to find a way that they can access these medications in any way they can. Again, we kind of discovered this with the cash pay market of late, where there's a whole market out there of people trying to get their piece of it. So what we know is that, and certainly what we've learned through our partnership with ASC is that when you really get in there and you start to parse out what's going on on the plan, you also find a lot of waste, abuse, fraud, namely. So you find that people are accessing medication, not covered by your plan design, but somehow they wiggled their way through. You find that people might be accessing it because they have a diagnosis, um, but maybe it's not clinically appropriate anymore. But no one's looked at that again. So it's it's approved, but they just keep going whether it continues to be necessary or not. So when it adds up over time, it's a lot of excess spend on the plan. Um, and so we've just learned that as you get your arms around it, as you have data, as you know the members, as a partner may know your members, um, you can actually, as the employer and the decision maker, make really strategic decisions about how you manage that when you know actually what you're managing.

SPEAKER_04 21:22

Yeah. Um, and along those lines, and and this was certainly a process, as I would call more of like an iron sharpened iron approach. Um uh we really talked about what belief, like how what how useful is the tool of GLP1 and how should it be used versus how is it generally being used? We've had a lot of conversations, we've had a lot of debate. Um, I'm rather opinionated about that. Um, but what has Northwind's stance been? Around GLP1s and helping employers maximize its maximize

Balancing GLP-1 Benefits And Risk

SPEAKER_04 22:06

its benefits while managing that expense.

SPEAKER_01 22:11

I love this question. So it piggybacks on what I just talked about, where um I think we spend a lot of time talking about the benefits of GLP1. Everything we all see is they do this, they do that. There's more indications coming. I heard in a uh symposium I was at last week, at some point there will be enough indications that every person in the United States will have a reason they can take a GLP one, which is terrifying.

SPEAKER_04 22:37

And your health plan can't afford that, by the way.

SPEAKER_01 22:40

Um and while that may be true, because we know GLP1s have many places they act in the body and they probably do solve a lot of problems. Um but there is there is a pendulum. And so what we're focused on is how do you invest in this expensive tool, valuable tool, but expensive tool, to get the value out of it to lower risk across your population. So what is the population that's driving risk? And what is the right population to actually invest in to get the good out of that, to actually swing the pendulum back to the middle where you're spending the right amount of dollars to manage the appropriate risk. The other thing that I don't think we talk about often enough is that oftentimes it's a set it and forget it, kind of what I just said. People start the medications, and we know, as Mary said as well, that once they're on them, um I liken it to a security blanket. They don't want to let go, um, despite their clinical picture. And so um, what I don't think we talk about often enough in the market is that with every drug, there are benefits and there are risks, every single one. Um, and so when you take something for too long, your pendulum will start to swing the other direction. And while your neutral is your perfect place of managing risk and benefit, um, you will start to swing it the other way. And we're not there yet. So we, these GLP ones and the outcomes of them, we're seeing the good. So we're seeing the pendulum swing back to the middle. But what we're gonna see in the next five to 10 years is the result of excessive use. And it's gonna start swinging the other way, where we're gonna start having increased medical spend and we're gonna start paying for the outcomes and the things, the vitamin deficiencies, the muscle wasting, the osteoporosis, all of the other things that that we're starting to see happen, um, but the result of that, and it's gonna incur more risk on our plants. So it's really important to understand where that population sits and how to manage it well so you balance that in the middle.

SPEAKER_04 24:51

Yeah. And that's a courageous question because obviously you talked about a security blanket for GLP1s. And if you say, hey, like you've really managed your condition to where you're in remission of sorts, like let's look to see if we can like lower the intensity, right? And uh that can be a very unpopular conversation, uh, but I think that's a conversation of victory. You've like beat a condition. We should sell, we should send them confetti cannons. That I've suggested that that like when people get like their A1C in the normal range, confetti cannons celebrate. Um, because if we don't, everyone in America is gonna be on a GOP1 and your health plan can't afford that. So it's either an unpopular conversation of you have you're winning against your condition, or it's an unpopular conversation around premium increase. I like this one. Um, so that takes a lot of courage to walk down that pathway and ask those questions.

Targeted Outreach And Incentives That Land

SPEAKER_04 25:52

Um I have a question for Mandy. So Mandy uh has been uh the driver in this whole thing and has really made uh this program successful. And I would call it bridging Northwind and ASC and giving um the ASC population, because as Mary mentioned, it's really hard to communicate to all of the employees, seemingly. However, Mandy has done that, and she's able to communicate the message that this program exists because we care about you. We care about you so much we're willing to do this, which is change, and no one likes change, but we care about you so much we think this is the pathway we have to go down. So Mandy's been able to uh deliver that message. I'm sure it wasn't heard that way at first. Uh, but what communication strategies were critical to minimize that? Like when someone hears change and you have to do something different, automatically they're mad. So, how do you how do you change that that conversation with the employees so they can hear what's trying to be accomplished?

SPEAKER_02 27:04

Great question, Ben. Well, to Mary's point, we I think when it came to communication, our first strategy was we need to start early, we need to communicate often, um, and we need different modes of communication. Um, everybody, some people don't open their mails, some people won't read a text. Um, there's so much spam out there right now with things. So those were kind of the three buckets that we had to put things into at first. Um, and then we had to use data to help drive our communication as well. So we needed to know who's accessing diabetes medications and supplies and target our outreach to them. So whether that was letters, phone calls, text messages, trust me, they got it all. Um I think the studies say you have to communicate at least seven times. I think that is a very low number to the reality of the world most of the time these days. Um, and so we also really use the data to help us understand who is most at risk because I am accountable to Mary, and Mary is concerned about who's on her plan that will go to the pharmacy and not be able to get their insulin. And so we're able to look at the data and say, hey, who are the high-risk members? Let's make sure that the outreach to them is more. So they got put in a special cohort and they got more touches from Northwind. Um, and then it was never a, you know, set it and forget it or one and done kind of thing. We continue to go after these people until they know how they can access their diabetes medication. And then around the messaging Ben, I think it was important when we were able to communicate with them, which was just always a hallelujah. Like I actually get to have a conversation with you. This is a win. Um, we've gotten a hold of you. Then it was how do we communicate what this is? Um, and for us, it was helping them to understand to everyone's point, unless you are the person who's creating the change, you typically don't like it. Um, there's lots of levels of that, right? There are the people that are like, oh, okay, well, I didn't really get it, but now I do. And then the people that um, those are the angry people, they get the one, three, four. That's my extension. So um they come to me and we get to have a more detailed conversation. But when we had that conversation with them, it was helping them to understand that diabetes is a very complex chronic disease process. And your employer recognizes that for you to be supported in it, for you to have success in managing this also progressive disease process, we they wanted to say, hey, they need more than just that medication that's a tool. They need a program to wrap around them and support them and say, hey, let us take away some of those barriers. Let us take away, I have to go here to get my supplies and here to get my medication and I get them at all different times of the month. I mean, I take one medication and picking it up on time is a challenge. So I don't know how people with diabetes that are having to go a lot of different places, let's put it together for you in a kit and ship it right to your front door. And then every month, it just shows up there for you. Nothing keeps people more accountable to taking their medication than when it just keeps showing up for them. Um, so helping them to really understand this is your employer recognizing that you have something that's challenging and they want to help you find a solution for it. Um, so when we had those conversations, it was also helping them to understand there's an incentive here as well. If you engage in our program, then you will have a reduced copay. Um, for us, as Mary said, those most upset people, we know, we already know when we talk to them, 90% of the time, they're gonna be our biggest cheerleaders. We know we'll make that impact, but until we can fast forward through that time frame, we need a hook. We need an incentive to pull them into the program until they can really understand the value of it and really see how it's truly an investment in them and their wellness.

SPEAKER_04 30:58

Um, we mentioned earlier about this idea of people taking medication and still being sick.

Medication Plus Lifestyle Change

SPEAKER_04 31:06

And the, I mean, that you could hear a pin drop in the boardroom when we kind of rolled that question out. Why do you believe medication alone is insufficient in trying to manage this condition?

SPEAKER_02 31:19

Well, as I mentioned, diabetes is very complex, right? It's not linear, it's not in a silo. Um, it takes a lot to manage it. And certainly, medication is an important piece of that. It is a very important tool in the toolbox. But the medication is really a risk management strategy. It's impacting the right now. If you want to have sustainable long-term outcomes in your population, that's where the behavior modification, the lifestyle modification has to come into it. So the medication, while it's an important piece of it, especially in the GLP1 space, it was never intended to be a standalone solution. That's how it's marketed, that's how people are taking it. That was never how it was intended to be as it was created. So you can, um, Catherine talks about this a lot, and I always love when she says it. We can take anyone with that medication tool and make them look better on paper. We can make that A1C look lower, but is that truly producing health in your population? Is that producing wellness in your population? It's a different story when you take that tool of medication and you combine that with now this person is also changing how they eat, changing how they move. Um they're making meals at home, they're not smoking anymore, they're working on their stress management, they're sleeping better. That's producing health and life change that creates that sustainable um outcome for you.

SPEAKER_03 32:49

Can I say one thing, then? Um, one of the things that I found fascinating as we had this journey last year, um, our data group, Mandy, um, would show that not now through this coaching, people are going to the eye doctor, they're going to the foot doctor. Um, they might even be finding a new provider because their provider really wasn't helping them. Um, because diabetes is a progressive disease. People lose their feet, they go blind, like things happen with them. And I think that piece of it was really eye-opening that people were getting not just care for their diabetes, but for the the downstream effects of their diabetes was really interesting to watch.

SPEAKER_04 33:34

Uh question for you. Uh, what are you most proud about with this program?

SPEAKER_03 33:38

Um, we lived through it. That's a good thing. Um, um, I think this program for me was very, we learned a lot. And there's nothing wrong with learning, right? We learn forever. Um, that was number one. Um, I think for me, and Mandy, I'm probably gonna embarrass you. Without Mandy and her team, this program would not have happened. Um, she's the kindest, most patient person I've ever met. I don't know how she talked to what is the people on our plan that are, it's like 360. 360. Um, and her team probably talked to all three hundred of them, right? And when they were angry. So um patience, I'm just proud of the fact that it's working. When you see somebody with these graphs that started the program with an A1C of 15, 17, that's dangerous. That's life-threatening. And now they're at a 6.5. Um, that's really like

Pride Moments And Real Patient Wins

SPEAKER_03 34:46

you just go, wow, look what we did for this person, even if it's only one person that you saved their life. The other thing is there are many people out there in our population that weren't taking medications because they couldn't afford it. So that's scary. Now they have this kit that comes to their house that's affordable. Um, and that was a proud moment, too, to just see people go, thank you. I can afford my medication now. Um, you don't really know what's going on with people, you know, you don't really know what's going on in their life. Um, and we still really don't, but we do know that their health is better, so that they probably feel better or they're on the wrong medication. We had a lot of people like that too. Um, and then I'm most proud to, and I just have to say this my team is sitting right over here. Um, and they took the brunt of some of those angry calls at the beginning and did very well with that. Most of the time we just sent them over to Mandy, but um we still had to uh take the brunt of their anger when they first called. But uh we have had I've had no, it's been months since somebody's called me personally and said I'm angry. I haven't had that for a while, so that's a proud moment.

SPEAKER_04 36:02

Yeah, people just don't like change, but once you get through it, the program can stand on its own merits. Um you think about that person that started at a 15 and is now down to like a six. Um, you know, you think about it, and I mean, we can we're highlighting ASC, right? So it's like, oh my goodness, someone was feeling that unwell and handling patients. It's like, well, look at your own business. You might have someone that is feeling not well operating a heavy machine or whatever it may be, whatever industry you're in, that same thing can be occurring. Um, but one thing about that graph, and I'm gonna probably should have put an example of this up here. So I'm probably gonna do a lousy job explaining it. But we have a bar chart that has unidentified for uh for PHI uh matters, but it shows uh you know member ID numbers, so we don't know who it is, but the first bar is first A1C. The second bar is their most recent A1C for 300 people, and it is incredible to see um, it's interesting because you see life. So you have someone that's at a 15 that went to a six, you have someone that's at an 11 that's at seven, but you also have somebody that's at a nine that went to an 11. That's real life, folks, right? Like we're trying to solve problems, but it's not always like going great all the time. Um, but as we look at that chart and we scroll through for the for the executive team for the for the entire C-suite, and uh one of the owners, he goes, That's my favorite chart. Um, because you can see the health of his population improving. And isn't that what we're here to do? Um so just just something to think about. Um uh Catherine, I got a question for you as we as we wrap

Surprising Outcomes And Near Remission

SPEAKER_04 37:53

up. What piece of information has surprised you in a positive way of like, oh, I I'm actually surprised that this was an outcome through this program.

SPEAKER_01 38:05

Well, I think there's many. Um one of the surprises, I think it goes along with what Ben said is, um, and we see this across our book of business, but particularly in the world of ASC, how many people are out there struggling? Um, despite everyone doing their best to provide the the richest benefit structure for them, that there are people that are unwell, so unwell that, like Mary said, it is risky, it is life-threatening, um, that any day a critical event could occur that could end their life or make it significantly different. So to see the people that have come in, 16, 15, 14, there's many of them, and knowing they were out there and that now they're in such a better place is inspiring. I think the other outcome for me that stands out among all the great outcomes we've had is that we're sitting right now after one year in a program with ASC and have nearly 90% of people at a stable A1C across the across almost 400 people. So that number can stack up against anything. 90% of Mary's population now are considered stable. A1C is under eight. And maybe even more interesting, um, which speaks to our model and our health coaches, is that almost 60% of people are nearing diabetes remission. So A1C's under six and a half, which for anybody, all of you probably been in this business a long time. Um, historically, managing diabetes, you were lucky to get somebody's A1C in the low six. It's under six was unheard of, almost bad sometimes. And now we have 60% of Mary's population in what we would consider nearing or approaching diabetes remission by definition in the pre-diabetes A1C state. So very proud of that and excited for the work we'll continue to do with Mary and her team.

SPEAKER_03 40:13

And think how good they feel now, right? All right, when they come to work every day.

SPEAKER_04 40:16

And to Adam's point, also when they're at home with their families and doing the other things that life is important in life. Um, let's give a round of applause to our panelists.

Closing Thanks And Sign-Off

SPEAKER_00 40:30

Thanks for tuning in to Risk and Resolve. See you next time.