Case Study
How a 3,000-Member Self-Funded Employer Drove $1.2M in Savings and a 91.5% Diabetes Program Enrollment Rate
A large self-funded employer partnered with Northwind Health to deploy a high-touch, clinically-driven diabetes program — and the results speak for themselves.
Industry Leading Results
Over the course of the 2025 program year, the client saw clinical outcomes that most employers only read about — combined with financial results that justify every dollar of program investment.
Costs Came Down. Significantly.
Total medical cost reduction for members with diabetes, over 10 months.
Drop in medical cost per member per month.
Fewer ED visits among members with diabetes.
Reduction in ambulance utilization.
Fewer inpatient hospitalizations for moderate-to-severe diabetes cases.
Annualized GLP-1 savings driven by clinical review — $504K captured in Q1 alone.
GLP-1 denial rate for waste or abuse, backed by clinical oversight.
Annualized CGM savings from clinically-reviewed denials.
Members Got Healthier. Measurably.
of members achieved an A1c below 8% — the clinical threshold for controlled diabetes.
reached A1c below 7%
of enrolled members are now approaching full diabetes remission, with A1c levels below 6.5%
of members achieved an A1c below 8% — the clinical threshold for controlled diabetes.
average A1c reduction among the highest-risk members — those entering the program above 10.
of members maintained medication adherence throughout the program.
achieved controlled blood pressure
pounds lost across the enrolled population
The Challenge
This client is the largest senior healthcare provider in the state of Indiana with a 10,000-member workforce.
In 2024, ASC employees had above average health risk and high employee turnover — a combination that makes chronic disease management both critical and complicated.
Diabetes wasn’t just a health issue — it had become a cost crisis. Half of all prescription spend was tied to diabetes, with a 39% spike in diabetes prescription costs year over year. Twenty percent annual increases in diabetes-related care had become the norm. And half of all members with diabetes were accessing prescription medications with no coordinated oversight in place.
The status quo wasn’t sustainable. It was time for a different approach entirely.
Key Issues
- Rising GLP-1 costs with no visibility into whether utilization was clinically appropriate.
- High rates of uncontrolled A1c values putting members at serious long-term risk.
- Significant gaps in preventive and chronic care.
- A fragmented medication management system that left members — and the plan — exposed.
The Approach
Northwind Health operates at the intersection of four disciplines most health plans treat as separate: Third Party Administration, Pharmacy Benefit Management, Pharmacy, and Chronic Disease Management. Bringing all four to bear on a single population isn’t just efficient — it’s transformative.
The program was built around two goals: produce measurable health outcomes that improve the bottom line, and eliminate the waste, fraud, and abuse that inflate costs without improving care.
Program design pillars:
1
Full diabetes carve-out
Every diabetes-related claim, medication, and touchpoint flows through a single, coordinated program. No fragmentation. No gaps.
2
Incentivized engagement
Members have a real reason to participate, and 91.5% of eligible members opted in.
3
Narrow network pharmacy with tight controls
A limited distribution model, quantity limits on high-cost medications and supplies, and a single kit copay structure give the plan meaningful leverage over spending without compromising care.
4
High-touch member and provider communication
Northwind’s clinical team doesn’t wait for problems to escalate. They build relationships with members and their providers from day one and maintain them throughout.
How it works in practice:
Each enrolled member starts with a 1:1 discovery call with the Chronic Disease Management (CDM) team. From there, the clinical team connects directly with the member’s provider and local pharmacy, develops a clinically appropriate care plan, and coordinates a diabetes kit through Northwind’s pharmacy. Members receive ongoing pharmacist consultations and health coaching, supported by regular provider visits, labs, and preventive screenings. Care plans are continuously adjusted based on real clinical data — not assumptions.
This is what coordinated care actually looks like.
Member Stories
These aren’t hypotheticals. These are members in the program — and what happened when they had real support.
From Hospitalization to Hope
A member entered the program in February with an A1c of 15% — one of the highest-risk cases in the cohort. By May, that number had dropped to 11%. By August, she was at 7.5% and closing in on controlled range.
What made the difference wasn’t just medication. It was continuity. Northwind’s team supported her through an unplanned hospital stay, coordinated her continuous glucose monitor, and kept her engaged through free health coaching and pharmacist consultations. Her CGM now shows 76% time in range. She’s walking daily and working toward a goal of one mile — and getting closer.
A1c 15%
February
A1c 11%
May
A1c 7.5%
August
Additional Wins
- Participating in regular Pharmacist and Health Coach consultations
- CGM reporting 76% time in range
- Walking daily and steadily increasing her distance
- Supported through an unplanned hospital stay
Precision Therapy Pays Off
When previous therapies weren’t working, the clinical team didn’t stay the course — they changed it. A switch to GLP-1 therapy in February helped this member drop their A1c from 11.8% to 5.8% by July. That’s not just controlled diabetes. That’s remission-level glucose control.
Close collaboration with a health coach on sustainable lifestyle changes made the outcome stick. This is what happens when therapy decisions are driven by clinical data, not inertia.
A1c 11.8
February
A1c 5.8%
July
Additional Wins
- Participating in regular Pharmacist and Health Coach consultations
- CGM reporting 76% time in range
- Walking daily and steadily increasing her distance
- Supported through an unplanned hospital stay