A Better Partner in Health
Northwind Health partners with self-funded employers to improve employee health outcomes while stabilizing total cost of care.
“Being independent and employee-owned means we can do the right thing every single time by our clients.”
Why Self-Funded Employers Prefer Northwind
Peace of Mind
Northwind offers the ease of being fully-insured with the control, flexibility and actionable insights of being self-funded. As a stand-alone health company, Northwind can be innovative and transparent to maximally benefit members and clients.
Healthier Members
Through high-touch personalized member care, Northwind drives industry-leading clinical results while offering high risk high cost members the tools for better health.
Cost Stabilization
While emphasizing health production, Northwind seizes every opportunity to eliminate waste and abuse in sponsor-health plans, delivering significant spend reductions year one.
How Northwind Delivers
NDC-level Audit Reporting For Fiduciaries
The plan sponsor of a self-funded plan owes fiduciary duties to participants and beneficiaries. Northwind operates on a transparent fee-based model with NDC-level audit reporting, pass-through rebates, and cost-plus pharmacy pricing — the documentation a plan sponsor needs to demonstrate prudent stewardship to leadership, auditors, and employees.
One Accountable Partner, Not Five Disconnected Vendors
Most self-funded employers run their health plan through five or more vendors — a TPA, a PBM, a chronic disease vendor, a wellness program, and a rotating set of point solutions. Each adds a layer of cost. Each creates a data silo. Each blames the others when results stall. Northwind delivers TPA, PBM, pharmacy, and chronic disease management under one roof, executing on a shared multi-year strategy with one team accountable to the employer.
Clinical Blueprints: Hope for High Risk Employees
A small share of high-cost claimants drives the majority of plan spend at almost every self-funded employer. Northwind's clinician-led model pairs each high-cost, high-risk member with a pharmacist and a board-certified health coach. The team coordinates directly with providers to stabilize members whose claims would otherwise become the catastrophic events that blow through the budget and trigger stop-loss.
Transparent, Fee-based Economics Auditable at Every Layer
PEPM and PMPM administration fees. Cost-plus pharmacy pricing since 2008. Pass-through rebates with NDC-level audit reporting. Employers see exactly what they are paying for and exactly what they are saving — the level of transparency a CFO needs at quarter-end and an HR leader needs in a benefits committee meeting.
Industry-leading Waste and Abuse Elimination
Northwind targets eliminating 8 to 12% of combined pharmacy and medical spend within 18 months of onboarding. Common waste and abuse line items include unnecessary procedures, billing redundancies, rebates captured by prior vendors, and misaligned incentives across siloed point solutions.
The More Northwind Controls, the Better the Results
Third-Party Administration
- Eligibility, enrollment, claims processing, and adjudication.
- Broad national networks, Northwind High-Performance Narrow Care Networks, direct provider contracts, and worksite clinic integration. Real-time analytics drive every decision.
- Self-administer with Northwind’s support.
Pharmacy Benefit Management
- Cost-plus pricing since 2008.
- Pass-through rebates with NDC-level audit reporting.
- A national network of more than 67,000 pharmacies.
- Average first-year client savings of 11.5%. 100% client retention.
- 86% generic dispensing rate.
The GLP-1 question every employer is facing
One in eight American adults uses a GLP-1 medication. An estimated 137 million U.S. adults are clinically eligible — 35 million for diabetes management, 129 million for weight loss, and 9 million for secondary prevention of major adverse cardiovascular events.
For self-funded employers, GLP-1s sit at the intersection of two responsibilities: the duty to provide appropriate care to employees and the duty to manage the plan within the financial reality of the business. Open access threatens the plan budget. Restrictive coverage may fail employees who genuinely need treatment. Northwind’s proprietary GLP-1 management model applies clinical eligibility criteria, pharmacist consultation, and integrated health coaching to ensure appropriate use of these medications while controlling their financial impact. GLP-1 strategy is integrated with Northwind’s chronic disease management program, not bolted on as another point solution.
What employers receive
Senior leadership access and dedicated support
Every Northwind account is supported by the executive leadership team. Each employer has a named administrative and clinical team with deep knowledge of the plan, the workforce, and the employee population. Key employer personnel have direct cell-phone access to account leadership for urgent matters.
Reporting built for leadership review.
Northwind’s proprietary digital dashboard provides employer leadership with real-time visibility into plan spend, drug utilization, program engagement, and clinical outcomes. Monthly, quarterly, and annual scorecards track benchmark KPIs against industry baselines — the documentation a CFO needs at quarter-end and a benefits committee needs at every review.
Member support, seven days a week.
A 20-person in-house member services team, led by a registered nurse and staffed with clinically trained personnel, supports members Monday through Friday and on weekends, including holidays. Most member issues are resolved in under 24 hours. Bilingual staff and translation services are available.
Seamless implementation.
Northwind’s onboarding process includes extensive pre-work to understand each employer’s history, plan design, and employee population, followed by scheduled post-go-live updates. Employees feel the transition as an upgrade in service, not a disruption.
Coordination with existing partners.
Northwind collaborates with onsite clinics, wellness vendors, health systems, pharmacy support services, TPAs, and PBMs already engaged by the employer. Employers retain the relationships they value while consolidating where consolidation creates savings.
Frequently Asked Questions
What data does Northwind need to evaluate our plan?
A complete analysis requires full pharmacy and medical claims files and a census file. Northwind will return a targeted plan analysis with specific savings opportunities and implementation considerations.
What size employer does Northwind Health serve?
Northwind Health’s ideal employers have between 1,000 and 20,000 covered lives.
Is Northwind a TPA, a PBM or a chronic disease management vendor?
Northwind is all four, operating as an integrated health solution. Employers can engage individual divisions independently — and many do — but the integrated solution typically produces the strongest financial and clinical outcomes.
Can an employer self-administer using Northwind's tools and services?
Yes. Employers that prefer to self-administer can do so with Northwind’s support, including access to claims administration capability, national care networks, Northwind High-Performance Narrow Care Networks, direct contracts, and worksite clinic access.
How much can Northwind reduce our healthcare spend?
Northwind targets 6% year-over-year increases in healthcare spending versus the 18% industry average, and targets eliminating 8 to 12% of combined pharmacy and medical spend through waste, fraud, and abuse reduction within 18 months of onboarding. PBM first-year savings average 11.5%.
How does Northwind price its services?
Northwind prices on PEPM or PMPM models. Pharmacy is priced on a cost-plus basis with pass-through rebates and NDC-level audit reporting. Analysis, audit, and strategy services are priced on deliverables. Other financial arrangements are available based on the needs of the employer.
What reporting do employer leadership and benefits teams receive?
Employers receive real-time access to a proprietary dashboard covering plan spend, drug utilization, program engagement, and clinical outcomes, plus monthly, quarterly, and annual scorecards formatted for leadership review.
How does Northwind manage GLP-1 drug costs?
Northwind’s proprietary GLP-1 management model applies clinical eligibility criteria, pharmacist consultation, and integrated health coaching to ensure appropriate use of GLP-1 medications while controlling their financial impact on the plan.
What does the employee experience look like?
Members get live, non-automated access to registered nurses and pharmacists seven days a week. High-cost, high-risk members are paired with a dedicated pharmacist and a board-certified health coach. Most member issues are resolved in under 24 hours. Bilingual staff and translation services are available.
Does Northwind work with our existing onsite clinic, wellness vendor, or health system partner?
Yes. Northwind collaborates with onsite clinics, wellness companies, health systems, pharmacy support services, TPAs, and PBMs to execute the employer’s benefit plan choices with minimal disruption.
Does Northwind work with our Advisor or benefits consultant?
Yes. Northwind partners with Advisors and benefits consultants throughout the sales, implementation, and ongoing service process. Northwind operates on a transparent fee-based model with no hidden spreads, and Advisors are compensated directly by the employer on a fee basis. Advisors receive the same data access and reporting as the employer.
What states does Northwind serve?
Northwind is licensed in all 50 states, with facilities in Indianapolis, Indiana, and Oregon. Current growth markets include Indiana, California, Texas, Arizona, Nevada, and Florida.
