As an HR leader, you want employees to be healthy, safe, and able to do their best work. You also need to help your organization manage healthcare costs, retain talent, and strengthen engagement. That means looking beyond individual benefits or programs to understand what your workforce needs and whether your investments are making a difference.

But the work spans benefits, total rewards, wellbeing, safety, vendors, communications, data, and stakeholders across the organization. Even with substantial resources in place, it can be difficult to see what is working, where employees face gaps, and what to prioritize next. The challenge isn’t a lack of investment—it’s coordinating those efforts into a cohesive strategy while managing workforce health without a clinical education in population health.

The HealthNEXT journey helps you bring those efforts together. With a clearer view of your current state and guidance on where to focus, you can build a coordinated strategy that supports a healthier, safer, more engaged workforce and advances your organization’s goals.

The Journey to Strategic Impact in Workforce Health, Safety and Wellbeing

Throughout your journey, you’ll work alongside HealthNEXT NEXTperts: experienced physician executives, including former Chief Medical Officers and corporate medical directors who have led workforce health and wellbeing strategies at organizations such as GE, Johnson & Johnson, and Procter & Gamble, among others. They bring both clinical expertise and executive leadership experience to help you manage workforce health at the population level—not simply address the needs of one individual at a time. HealthNEXT NEXTperts bring external perspective, clinical and operational expertise, and access to a broader network of corporate-health leaders—so you can draw on the right experience when you need it while making informed decisions with confidence.

The HealthNEXT client journey follows five connected stages designed to help you create a more coordinated, measurable, and sustainable approach to workforce health, safety, and wellbeing:

1. Assess against best practice
2. Identify and sequence the gaps
3. Create a strategic plan
4. Implement initiatives
5. Monitor, optimize, and reassess

The goal is not to leave you with another report or a generic list of recommendations. The goal is to help you build the clarity, capabilities, and confidence to lead an integrated strategy that supports your workforce and advances your organization’s goals.

1. Assess against best practice

Before you can lead meaningful change, you need a credible view of your organization’s current state. Through the HealthNEXT assessment, you can understand your organization’s current standing and where it needs to go in building a culture of health, safety, and wellbeing. The assessment evaluates your organization across 10 pillars, giving you a structured view of strengths, maturity, and process gaps that may be limiting progress.

The assessment examines how effectively your broader health, safety, and wellbeing system is working together to support employees and advance organizational goals. We’re not checking the box on whether you have a wellness program but instead asking strategic questions on how effectively your overall health and wellbeing system is working, such as:

• Is leadership visibly aligned around health and wellbeing, and do managers support employees in making it a priority?
• Are your benefits and vendor partners coordinating care and making warm handoffs so employees do not fall through gaps?
• Are you marketing and communicating not only how to access resources, but why they matter and how they can improve employees’ lives?
• Do you have actionable insight into workforce health risks, needs, and conditions?
• Have you made measurable, concrete improvements based on those insights?
• Are your benefits, communications, leadership practices, and workforce-health initiatives working together as one connected strategy?

NEXTperts can help validate areas of maturity, clarify which gaps are most consequential, and identify where process improvements can strengthen the effectiveness of your current investments.

2. Identify and sequence gaps

Once the assessment reveals the full picture, the next challenge is deciding where to focus first. Your role is not to solve every issue at once, but to prioritize the actions most likely to make an impact. This sequencing matters: many initiatives fail because organizations take on too much, skip critical steps, or introduce solutions before the right foundation is in place.

NEXTperts bring practical experience with the realities that can complicate workforce-health strategy, for example:

• Fragmented vendor ecosystems
• Limited internal resources
• Diverse employee populations
• Shifting business priorities
• Uneven leadership support
• The need to make progress visible

With NEXTpert guidance you gain a clear rationale for what to do first, what can wait, and why that sequence makes sense for your workforce and organization.

3. Create a strategic plan

Your organization does not need another static strategy document that loses relevance after a leadership meeting. It needs a living roadmap that guides decisions, clarifies accountability, aligns internal teams and external partners, and evolves as priorities and circumstances change.

The HealthNEXT journey helps you develop a customized, multi-year strategy that connects your organization’s business objectives with the opportunities revealed through the assessment.

Your roadmap defines:

• A shared mission, vision, and values for workforce health and wellbeing
• Short- and mid-term goals aligned with organizational priorities
• Strategic initiatives for the next three to five years
• Ownership across HR, Total Rewards, benefits, safety, occupational health, communications, leadership, and vendor partners
• Timelines, milestones, required resources, and target measures
• A practical implementation path that helps teams move from planning to sustained action

As you and your NEXTpert work together to shape the roadmap, they will provide clinical population health expertise to help connect high-level ambition to practical decisions. For example:

• What are the most prevalent risks, i.e. the most common issues, not the most expensive ones, affecting the workforce? Which workforce risks should receive attention first?
• Are mental health resources are needed, but will stigma prevent employees from reaching out? Are managers equipped to support employees or connect them with resources if they notice something?
• What barriers are preventing people from completing an annual health risk appraisal and biometric screening? Is there a lack of availability, awareness, perceived value, etc.
• Which current investments should be strengthened rather than replaced?
• Where are vendor handoffs creating friction for employees?
• What leadership practices or communication strategies are needed to build trust and adoption? Which measures will help demonstrate progress credibly?

You set the direction and lead the stakeholders. NEXTperts help bring experience, evidence-based perspective, and disciplined process that can turn broad goals into a strategy your organization can understand, support, and execute.

4. Implement initiatives

Without clear ownership, purposefully sequenced tasks, practical resources, and consistent accountability, an important initiative can stall—or become another short-term campaign that does not create lasting change.

The HealthNEXT platform helps you translate strategic priorities into visible action. You can use a centralized environment to organize initiatives, assign ownership, sequence tasks, track milestones, access resources, and keep progress moving.

This can include:

• Initiative plans and purposefully ordered task sequences
• Defined owners, timelines, milestones, and target metrics
• Practical templates, workbooks, and implementation guidance
• Curated resources and proven practices
• Progress tracking that makes accountability and momentum visible

Alongside platform resources, you can work with NEXTperts who understand the implementation challenges that can derail even well-designed plans. When an initiative is struggling to gain traction, they can help you consider whether the issue lies with the initiative itself—or with the rollout sequence, unclear roles, insufficient leadership support, employee communications, benefit navigation, vendor performance, or a disconnected experience for employees.

That perspective can help you avoid treating every problem as a reason to add another solution. Instead, you can identify the process improvement that helps existing investments work harder for your people and your organization.

5. Monitor, optimize, and reassess

As an HR leader, you should not have to enter executive discussions with only anecdotes, isolated vendor reports, or participation statistics. You should be able to explain what your organization is trying to achieve, how the strategy is progressing, what is changing for employees and the business, and what actions you recommend next.

The final stage of the journey helps you create that visibility.

By tracking progress against goals and key performance indicators that matter to your organization, you can demonstrate the connection between workforce-health strategy and meaningful outcomes. Depending on your priorities, you may track healthcare cost trends, employee engagement, program participation, retention, productivity, safety, and employee experience to understand progress across the Triple Aim: lowering the cost of care, improving population health, and strengthening the employee experience.

With NEXTpert guidance, you can connect business priorities into a stronger leadership narrative and explain not only what changed, but why it changed, what the organization learned, and what should happen next.

Regular reassessment also allows you to see progress over time: which gaps have closed, where organizational maturity has improved, and where the next opportunity lies. This equips you to lead with evidence, context, and actionable recommendations—not just data.

How to Elevate Your Role

When you have a clear baseline, prioritized roadmap, practical implementation support, meaningful measurement, and access to experienced guidance, your role can shift in important ways.

Lead the Next Chapter

You do not need to solve every workforce health challenge today. You need a clear view of where your organization stands, a practical path toward where it needs to go, and experienced guidance to help you make the right decisions along the way.

The HealthNEXT journey gives you a structured way to build that path: assess your current state, prioritize the opportunities that matter most, create a multi-year roadmap, implement initiatives with accountability, and continuously improve.

You lead the work. You shape the future of your workforce. HealthNEXT gives you the platform, proven process, practical resources, and expert guidance to turn that leadership into lasting impact. The result is stronger employee engagement and retention, better-managed healthcare costs, and improved business performance.

Ready to gain a clearer view of your organization’s opportunity and identify the next steps that can move it forward? Start your HealthNEXT journey.

This article explains how employers can use layered measurement tools—scorecards, dashboards, and cockpits—to track and improve workforce health, performance, and business outcomes. Written by the team at HealthNEXT, it is designed for C‑suite executives, CHROs, and HR leaders who are accountable for workforce strategy, culture, and financial performance. It focuses on how to align site‑level scorecards, program-level dashboards, and an enterprise cockpit to quantify illness burden and productivity loss, while connecting clinical, cost, and employee experience outcomes to better inform decisions and to generate sustained results. 

Building a layered measurement system for workforce health and wellbeing 

Health and wellbeing touch every corner of the organization—from frontline worksites and plants to business divisions and the ultimately the C‑suite—but the data each level needs to drive results is different. Participation counts are a useful starting point, yet on their own they don’t tell local managers, business unit leaders, or senior executives whether those activities are improving health, reducing risk, or supporting performance, so these investments still often get managed reactively instead of strategically. 

To move beyond participation and truly measure business impact, employers need a layered measurement system that tailors insights to each level of the organization. Site‑level scorecards help managers track participation alongside health risks and healthcare outcomes they can influence directly. These scorecards can be aggregated into business dashboards to provide insights for division leaders.  And division dashboards can be aggregated into an enterprise cockpit for a concise, C‑suite‑ready picture of workforce health, performance, and culture. 

This “top‑down and bottom‑up” structure ensures that data is both relevant and connected. Scorecards drive specific locations. Dashboards assist business units to act; and the enterprise cockpit gives senior leaders a coherent view of how health and wellbeing are contributing to overall business performance. 

Regardless of whether we are building scorecards, dashboards or cockpits the measurement approach is the same. They need to be: 

• Simple and easy to understand, balancing leading indicators (like screening rates and engagement) with lagging ones (such as absence, workers’ compensation claims, or chronic condition prevalence). 

• Comparable over time and across sites, so leaders can “rack and stack” locations, identify best performers, and support sites that are falling behind. 

• Directly tied to specific actions, such as strengthening mental health programs, improving medical home attribution, or closing preventive care gaps, so managers and leaders know what to promote to the segment of the workforce under their responsibility. 

Well-constructed health and wellbeing scorecards, dashboards and cockpits typically: 

• Organize metrics around the Triple Aim, showing whether your workforce and covered lives are becoming healthier (effectiveness), whether investments are moderating cost trends and performance loss (efficiency), and whether employees and families feel cared for and satisfied with their benefits and programs (experience). 

• Aggregate key measures such as participation, health risks, chronic condition prevalence, medical home attachment, safety outcomes, and engagement, alongside business KPIs like medical and pharmacy cost trend, absence, disability, and workers’ compensation. 

• Highlight patterns and gaps, making it clear where the program is approaching benchmark performance and where focused support or additional investment is needed. 

Scorecards: Giving local leaders the right levers 

Scorecards sit at the lowest level of the measurement hierarchy and are designed for individual locations, small business units, or worksites. They translate corporate strategy into a concise set of metrics local leaders can influence directly, such as participation in wellbeing programs, adherence to safety protocols, completion of health assessments or biometrics, and local illness or injury trends. 

Scorecards can show managers the specific profile of their own site or unit, which may look very different from others across the organization. A location with overnight shift workers, a more isolated workforce, a higher-risk operating environment, or different barriers to care may need a very different response than a corporate office or another business division. 

In practice, many employers find it hard to obtain consistent, worksite‑level data unless they conduct regular site scans and assessments or partner with a data warehouse/analytics vendor that can pull together information from health plans, vendors, HR systems, and safety programs and generate a composite view at the site level. 

This bottom-up view is critical because cultures of health and wellbeing are “lived locally”, not just declared in corporate policy. Employers that combine site-specific assessments with integrated analytics are better positioned to build scorecards that reflect local reality and guide action where it can be most impactful. 

Dashboards: Seeing program performance through the Triple Aim 

There are two common kinds of dashboards. One type rolls up scorecards to provide a business or division-level view, aggregating site metrics so leaders can see how their part of the organization is performing. The second type evaluates a specific program or portfolio of programs implemented across the enterprise, showing how those health and wellbeing initiatives are performing against the Triple Aim. 

A best-practice example of this second type is a behavioral health dashboard that pulls together data from multiple sources: EAP contacts and outcomes, utilization of psychological and psychiatric services, health risk appraisal results, biometric indicators, and use of healthcare services from inpatient and outpatient care to emergency room visits. By integrating these data streams, the dashboard can show whether behavioral health efforts are improving health and functioning (effectiveness), reducing avoidable utilization and productivity loss (efficiency), and enhancing employee perceptions of support and satisfaction with available resources (experience). 

Cockpits: A one‑page view for the C‑suite 

At the top of the hierarchy is the corporate cockpit: an integrated collection of a few, carefully chosen metrics that let executives manage workforce health as a strategic asset. A mature cockpit goes beyond traditional claims reporting by bringing together efficiency, effectiveness, and experience indicators—aligned with the Triple Aim—in an  executive‑ready enterprise presentation. 

Effective C‑suite‑ready cockpit metrics and visuals share several traits: 

• Quantitative, with clear numeric values compared against goals and benchmarks. 

• Actionable, clearly linked to specific levers in benefits, workplace design, and management practices. 

• Focused on leading indicators wherever possible, such as the prevalence of key risks and conditions, preventive care adherence, and primary care attachment, rather than relying solely on last year’s spend. 

• Causally connected, showing how risk factors lead to illness burden, claims, productivity loss, and turnover so leaders can see the full business impact. 

Example Cockpit 

In the example cockpit image below, the red, yellow and green colors indicate how the metrics are doing relative to goal: red is below goal, yellow is around goal, and green is above goal. 

The arrows indicate which direction the trend is heading.  

For example, employee turnover is above goal but currently trending downward, signaling to the C-suite the potential for next steps to avoid a downward trend.  

Why HR and the C‑suite can’t afford to fly blind 

For HR teams and senior leaders, the stakes are high. Healthcare spending captures only part of the impact; performance and productivity losses can be two to three times the cost of care, yet they are often invisible without the right measurement system. 

When data is fragmented, it is nearly impossible to see where value is being lost or where health and wellbeing investments are quietly delivering outsized returns. A layered system of scorecards, dashboards, and cockpits turns workforce health from a blurry cost center into a strategic asset that leaders can actually manage. 

By implementing aligned scorecards, dashboards, and cockpits, employers can: 

• Treat workforce health data as a strategic asset. 

• Direct leadership attention and resources to the highest‑value opportunities along the population health continuum. 

• Demonstrate, with evidence, how a strong culture of health and wellbeing contributes to lower medical cost trends, fewer injuries and absences, better retention, and stronger business performance. 

Ultimately, what gets measured gets improved and when you measure health and wellbeing with the same rigor as any other core part of the business, you give your organization a durable competitive advantage.  

Ready to see what a system of layered and connected scorecards, dashboards and cockpits could look like for your workforce? Contact HealthNEXT to explore how we can help you build a measurable, sustainable culture of health, safety and wellbeing.

This article explains how employers can use the Triple Aim framework to measure and improve workforce health, performance, and business outcomes. Written by the team at HealthNEXT it is designed for C‑suite executives, CHROs, and CFOs who are accountable for workforce strategy, culture, and financial performance. It focuses on how to apply the Triple Aim—effectiveness, efficiency, and experience—to employer health and wellbeing analytics, including workforce illness burden, productivity loss, and integrated dashboards that link clinical, cost, and employee experience outcomes. 

What is the Triple Aim? 

In healthcare, the Triple Aim concept popularized by Dr. Donald Berwick calls for better care, lower cost, and improved patient experience. HealthNEXT adapts this thinking for employers as three interconnected aims: effectiveness, efficiency, and experience. 

Effectiveness: Are your workforce and covered lives actually becoming healthier and more well over time, with lower illness burden and better performance status? 

Efficiency: Are your investments in health and wellbeing reducing performance loss, moderating cost trends, and improving productivity per dollar spent? 

Experience: Do employees and families feel cared for, satisfied with their benefits, and loyal to your organization because of how you support their wellbeing? 

Instead of looking at a single metric like medical cost trend, the Triple Aim pushes employers to balance all three dimensions so that progress in one area is not achieved at the expense of another. 

Inside the Triple Aim: metrics that matter 

Most employers now receive a flood of reports from health plans, PBMs, wellbeing vendors, EAPs, and safety partners, but those reports often sit in silos and do not clearly answer the question, “Are our people healthier, more productive, and more engaged—and is it worth what we’re spending?” 

HealthNEXT’s Triple Aim model translates each aim into practical employer metrics that can be embedded in dashboards, scorecards, and executive cockpits. These metrics can be tracked at the enterprise, business unit, site, or vendor level to support continuous improvement. 

Effectiveness: are people getting healthier? 

Effectiveness is defined as evidence that your workforce and covered lives are becoming healthier and more well, with lower aggregate illness burden and better functional status.  

Typical metrics include: 

• Preventive service rates increasing (e.g., mammography, colon cancer screening, immunizations) versus evidence‑based targets or HEDIS norms. 

• Closure of evidence‑based care gaps for chronic conditions such as diabetes, cardiovascular disease, musculoskeletal disorders, and behavioral health. 

• Reductions in aggregate risk scores from health assessments and biometric screenings, showing fewer people in high‑risk categories. 

• Decreases in the prevalence of key health risks (such as obesity, smoking, and physical inactivity) and in the prevalence of chronic conditions over time. 

• Increased medication adherence and treatment compliance, especially for high‑impact conditions, often with 80–85% adherence as a stretch target. 

For the C‑suite, a compelling effectiveness story might sound like: “Over three years, high‑risk prevalence dropped by 10 percentage points, chronic musculoskeletal and diabetes trends stabilized, and 80% of covered lives now have a primary care medical home.” 

Efficiency: are you saving money and performance? 

Efficiency captures evidence that your efforts are saving money, worktime, or advancing productivity and performance, not just moving costs from one bucket to another.  

Representative metrics include: 

• Per–employee-per-year (PEPY) or per-member-per-year (PMPY) total medical and pharmacy cost trends that are lower than external benchmarks (e.g., PwC, Mercer). 

• Reduced hospital admissions and days per thousand, shorter average lengths of stay, and fewer avoidable emergency room visits. 

• Greater use of lower‑cost sites of care such as urgent care and telemedicine, when appropriate. 

• Decreases in lost workdays due to illness (absence) and lost workforce performance while at work (presenteeism). 

• Lower workers’ compensation and disability claim costs over time. 

From a CFO viewpoint, efficiency metrics allow leaders to quantify savings per million dollars of healthcare spend, show how many FTEs have effectively been “returned” through lower health‑related time loss, and demonstrate cost avoidance compared with industry trends. 

Experience: do employees feel cared for? 

Experience reflects evidence that your efforts are appreciated and are generating loyalty, trust, and discretionary effort among employees and covered family members.  

Key metrics typically include: 

• Improvements in self‑reported health status through validated survey questions or wellbeing indices. 

• Rising satisfaction with benefits, health plans, and wellbeing programs, including Net Promoter Scores (NPS) for platforms and vendors. 

• High and improving participation in wellbeing initiatives, health challenges, and incentive programs across sites and demographic groups. 

• Declining voluntary turnover compared with industry norms. 

For HR and talent leaders, these metrics help connect a culture of health and wellbeing to engagement, retention, and employer brand, especially in competitive labor markets. 

The Triple Aim in a culture of health and wellbeing 

HealthNEXT’s broader methodology emphasizes building a culture of health and wellbeing across ten pillars, ranging from leadership and strategic planning to environment, engagement, vendor integration, and data warehousing. The Triple Aim serves as the measurement backbone for that culture, ensuring that every pillar ultimately contributes to effectiveness, efficiency, and experience. 

When leadership sees all three aims trending in the right direction—better health outcomes, moderated cost growth, and improved employee sentiment—health and wellbeing move from “nice‑to‑have programs” to a core business strategy. This, in turn, supports higher productivity, fewer avoidable disruptions, and a more resilient organization during periods of change. 

Case Study Example: from participation to performance 

For most organizations, the first step is not launching new programs—it is fixing the way results are measured. That starts with getting the right data in one place and agreeing on a balanced Triple Aim scorecard that everyone in the C‑suite can understand at a glance. 

A professional services firm had historically only reported wellbeing participation—how many employees completed a challenge or logged into a platform. After aggregating its health, HR, and productivity data, the organization re‑framed its reporting around the Triple Aim. 

Instead of a standalone participation slide, leadership now sees on one page that: preventive screening and chronic care compliance are improving (effectiveness), the enterprise medical trend has fallen below industry benchmarks and health‑related days lost per employee have declined (efficiency), and self‑reported health and benefits satisfaction scores are rising while voluntary turnover is edging down (experience). 

This shift allowed the C‑suite to see health and wellbeing as a strategic asset, not just a set of activities, and to invest with greater confidence in the initiatives that clearly move the needle on all three aims. 

When employers adopt the Triple Aim as their measurement North Star, they gain a clearer view of how health and wellbeing investments drive financial performance, workforce resilience, and competitive advantage. That clarity is what ultimately allows leaders to sustain and scale a true culture of health and wellbeing across the enterprise. 

TrumpRx‑era pricing and a rapidly evolving GLP‑1 marketplace are reshaping employer benefit decisions and plan design. Written by Dr. Ray Fabius, president of HealthNEXT and supported by the decades of experience of the HealthNEXT NEXTperts group practice, this article focuses on practical ways HR, benefits, and finance leaders can build integrated GLP‑1 strategies that manage cost, support equitable access, and improve workforce health and productivity.

The Stakes for Employers

GLP-1s are driving a large share of pharmacy trend, and many finance and HR leaders are feeling the impact in real time. At the same time, federal efforts like TrumpRx are changing how employees think about “fair” pricing and access. Employees are seeing headlines about lower direct-to-consumer prices and wondering why their employer plan looks different. Without a coherent strategy, employers risk paying more than they need to, disappointing employees, and missing the opportunity to actually improve health and productivity.

Obesity is a major driver of cardiometabolic disease, musculoskeletal problems, sleep apnea, certain cancers, and mental health conditions, all of which show up in absenteeism, disability, and presenteeism. Nearly two-thirds of the American workforce is overweight or obese, and by 2030, as many as one in two American workers may have obesity. That makes obesity both a health risk and a business issue.

GLP-1 medications such as semaglutide and tirzepatide have demonstrated meaningful, sustained weight loss, lower progression to type 2 diabetes, and fewer cardiovascular events in at risk patients. But those gains come with a high price tag, and employers covering GLP-1s are seeing pharmacy spend increase by 10–20% or more. In many organizations, weight management drugs account for a substantial portion of recent drug spend growth.

The central question is no longer “Should we cover GLP-1s?” but “How do we cover them in a way that delivers measurable value for our workforce and our budget?”

Why Coverage Without Support Backfires

The clinical evidence and mounting employer experience show that GLP-1s are most effective when combined with structured lifestyle and behavioral support. When people stop these medications, most will regain a significant share of the weight they lost, especially if healthy eating and physical activity have not become durable habits. That rebound is not just a clinical setback; it represents a poor return on a very large investment.

Adherence is another challenge. Side effects such as nausea, vomiting, diarrhea, constipation, hypoglycemia, injection site reactions, and pancreatitis contribute to discontinuation. Up to half of patients stop GLP-1 therapy in the first year, which undermines outcomes and wastes pharmacy spend.

Programs that combine medication with nutrition counseling, physical activity support, coaching, and behavioral health resources achieve much better persistence and value. For example, step therapy policies typically require members to try lower‑cost, evidence‑based options, such as lifestyle interventions and generic weight‑loss medications before “stepping up” to higher‑cost GLP‑1s, ideally under physician supervision and, when possible, in consultation with obesity‑medicine specialists who can individualize care.

International models reinforce this integrated approach. In countries like France, Germany, and Denmark, GLP-1s are typically prescribed with required nutritional counseling and specialist oversight, not as a standalone “quick fix.” The goal is to ensure that expensive therapies sit inside a care model designed for long term success.

TrumpRx and the New Pricing Reality

A new wave of formulations is further reshaping expectations. Both major manufacturers of the leading injectable GLP-1 medications now have FDA‑approved oral pill versions for weight management, and early pricing signals suggest these tablets are often 50% less expensive or more than the original injectable products depending on dose, channel, and plan design. As additional oral GLP‑1s and next‑generation agents enter the market, overall GLP‑1 treatment costs are expected to moderate over time as competition, new delivery forms, and alternative therapies expand employer and patient options.

Recent federal initiatives have added a new layer of complexity. Through TrumpRx and related agreements, manufacturers have lowered the direct-to-consumer price of several leading GLP-1s for eligible patients, while Medicare has agreed to expand coverage for certain indications. For some drugs, list prices that once exceeded 1,000 dollars a month are now being advertised starting around the mid-hundreds when purchased via TrumpRx.

From an employer’s perspective, this creates both opportunity and risk:

• Employees who see “headline prices” may assume those prices should automatically apply to the employer plan, even though plan costs are shaped by PBM contracts, rebates, and formulary design.
• Some employers are considering limited financial support (for example via a health reimbursement arrangement) for employees who purchase GLP-1s through TrumpRx or similar platforms when those medications are not covered under the plan.

• At the same time, employees who obtain GLP-1s through direct-to-consumer channels are less likely to receive the wraparound support, coaching, and care coordination that drive long-term success on and after these medications, which means employers could see more obesity related health care claims if the individuals on GLP-1s aren’t having sustained success.

This environment makes it even more important to have a thoughtful, transparent strategy that aligns coverage, affordability, and outcomes, and that deliberately connects GLP-1 access to the lifestyle, behavioral health, and care management resources employees need to succeed over the long term.

What Lilly Employer Connect Means for Plan Design

Adding to this complexity, Eli Lilly has launched its Lilly Employer Connect platform, which lets employers contract directly with a network of more than fifteen independent program administrators and a dedicated pharmacy network to expand access to its obesity medicines at lower, more predictable out‑of‑pocket costs for employees. These administrators range from low‑cost benefits administration partners to more holistic obesity‑care solutions that bundle clinical evaluation, virtual care, and behavior‑change support, giving employers new alternatives beyond traditional PBM arrangements.

For employers, Lilly Employer Connect effectively creates a parallel channel alongside TrumpRx and existing PBM contracts, one that is said to improve price transparency and cost predictability, but that still requires careful integration with plan design, step‑therapy policies, and equity goals to avoid fragmented care or uneven access.

A Blueprint for Value-driven GLP-1 Coverage

For employers, simply “checking the box” on GLP-1 coverage is not enough to manage cost, equity, or outcomes. A value driven approach builds GLP-1s into a broader, evidence-based obesity and cardiometabolic strategy.

HealthNEXT’s global group practice of clinical and executive “NEXTperts” recommends that employers consider the following design principles:

• Require participation in comprehensive lifestyle programs: This sets the expectation that medication is one component of a broader behavior change journey, not a standalone solution.
• Embed specialist expertise and centers of excellence: This improves clinical decision making, supports step therapy, and can reduce inappropriate prescribing.
• Integrate behavioral health, coaching, and care management: These services improve adherence and help employees sustain healthy habits even if medication is discontinued.
• Use clear, clinically grounded eligibility criteria: Prioritize GLP-1 coverage for employees with type 2 diabetes and those who meet FDA approved criteria for obesity treatment—for example, BMI greater than 30, or BMI greater than 27 with comorbidities such as hypertension, dyslipidemia, or established cardiovascular disease. As prices moderate and budgets permit, employers can consider gradually expanding eligibility.
• Apply step therapy where appropriate: Thoughtful step therapy helps control spend while still offering effective options, including lower‑cost generic weight‑loss medications when clinically appropriate and under physician supervision, ideally with access to obesity‑medicine specialists for complex cases.
• Coordinate with PBMs and assess TrumpRx implications: Reevaluate PBM contracts, rebate structures, and formularies to clarify how TrumpRx level pricing and pharmaceutical direct options impact with your actual net costs and ensure employees understand how cash pay options interact with deductibles and out-of-pocket maximums.
• Build a strong social support and culture component: Social support can significantly improve engagement, resilience, and long-term success in weight management programs. Employers work environment, policies, resources and benefits can all influence their employees to take better care of themselves.

With a thoughtful design, GLP-1s can be part of a broader, high value health strategy that improves lives, supports productivity, and uses every healthcare dollar more wisely.

This article, written by Dr. Ray Fabius, is designed for employers, benefit leaders, and their vendor partners who want to use data to improve cancer prevention, detection, treatment, and survivorship across their covered populations. It is adapted from the Greater Philadelphia Business Coalition on Health’s Oncology Resource Guide and summarizes the section authored by Dr. Fabius, “Creating a Data-Informed Strategy to Support Across the Cancer Care Continuum.” 

Why cancer care requires a data-informed employer strategy 

Employers today have more information than ever to support a healthy, motivated, and productive workforce, including across the cancer care continuum. Applying population health principles helps organizations reduce health risks, ensure rapid access to care, and support employees and family members facing serious illness. When people are thriving, they are less likely to develop cancer, and if they do, they are better able to tolerate treatment and recover. 

With the right knowledge and tools, employers can better understand and track key cancer risk factors. Obesity, certain infections such as hepatitis and human papillomavirus (HPV), and chronic conditions like autoimmune disorders and emphysema all play a role. Using data to identify people with these risks and connect them to appropriate screening procedures and care can help reduce complications and improve outcomes over time. 

Building on Prevention Science 

A strong cancer care strategy is grounded in the four levels of prevention: primordial, primary, secondary, and tertiary. Primordial prevention focuses on improving the work environment and culture, including reducing occupational exposures such as chemicals and radiation. These efforts are within the domain of environmental health and safety experts as well as occupational health physicians and inform decision-making.  

Primary prevention aims to eliminate illness by promoting healthy lifestyles, physical activity, smoking cessation, and vaccination rates for viruses such as HPV and hepatitis B. Secondary prevention emphasizes early detection through cancer screening, such as mammography, which can save lives and sometimes avoid more aggressive treatment (lumpectomy). Tertiary prevention ensures access to the best care, including centers of excellence, and provides ongoing support for the growing population of cancer survivors. 

Applying the Triple Aim to Cancer Care 

The framework of the Triple Aim—improving care, reducing costs, and enhancing experience—offers a clear structure for a cancer continuum dashboard. Employers can track metrics that demonstrate better outcomes, lower per-case costs, and higher satisfaction with cancer care and benefits. 

Across the cancer care continuum, distinct phases such as diagnosis, treatment, survivorship, and palliation each deserve tailored metrics. Measuring efforts in awareness, advocacy, navigation, education, coaching, and case management creates a more complete view of how employers, health plans, vendors, point solutions, and EAPs are performing together. 

Step 1: Understand Your Cancer Burden 

Begin by building a dashboard that illuminates cancer prevalence across your covered lives. Key element examples include: 

• Prevalence of cancer-related health risks such as obesity and smoking. 

• Acute illnesses associated with cancer, including infections that require strong primary care follow-up. 

• Chronic conditions linked to cancer and the extent to which affected individuals access appropriate specialty care. 

• Cancer prevalence by diagnostic groupings and across high-cost claimants. 

• Cancer prevalence and types among disability and life insurance claims. 

This foundation helps employers prioritize where to focus prevention, early detection, and care management efforts. 

Step 2: Define Triple Aim Metrics 

Next, frame your Cancer Care Continuum Dashboard around effectiveness, efficiency, and experience. 

Effectiveness 

Example metrics include: 

• Reductions in associated health risks 

• Improved cancer screening rates 

• Higher percentages of early-stage diagnoses 

• Increasing cure rates.  

• Greater use of EAP services in families coping with cancer and appropriate use of home care and hospice 

Efficiency  

Example metrics include: 

• Reduction in cancer prevalence 

• Reduced cost per case 

• Decreased cancer-related Hospital days 

• Decreased workdays lost 

• Decreased disability days due to cancer 

• Increased accommodation for cancer patients 

• Faster return-to-work timelines 

• Fewer lives lost to cancer 

Experience  

Example metrics, often survey-based, include: 

• Greater awareness of the connection of health risks to Cancer  

• Greater awareness of the importance of cancer screening  

• Greater satisfaction with the cancer care received  

Step 3: Activate and Communicate 

Capturing data is only the start; leading employers use multiple communication channels to supplement care delivery and educate/activate their workforce. They prioritize cancers that affect large segments of covered lives, for example, focusing programming on breast cancer when data shows it is highly prevalent. 

Best practice includes: 

• Ongoing review of benefit design and vendor relationships to ensure they collectively support high-quality cancer care 

• Convening a vendor summit to align stakeholders on shared metrics can foster collaboration and accelerate improvement 

• Guiding timely referrals to complex case management is particularly valuable for employees who lack medical expertise in their families 

Step 4: Support Work, Life, and Recovery 

A comprehensive cancer care continuum must also address work and life beyond the clinical setting. Employers can track accommodations that allow employees to keep working during treatment or return to work more quickly, recognizing that continued employment may be associated with better outcomes. Monitoring the use of EAP and related support for both patients and family members offers insight into the broader impact of cancer on the household. 

These efforts help employees and their families maintain stability and productivity while navigating a cancer diagnosis. Over time, such support improves not only health but also engagement and retention. 

Looking Ahead: Evolving the Dashboard 

Cancer diagnostics and treatment are advancing rapidly, with new screening tools, surgical techniques, chemotherapies, radiation approaches, and immunotherapies emerging. As these innovations mature, employer cancer dashboards can expand to incorporate new metrics that reflect earlier detection, more targeted treatment, and better long-term outcomes. 

Cancer care is increasingly transforming from a purely catastrophic event into a chronic condition managed with maintenance therapy and vigilant follow-up. By continually refining data strategies, employers can increase the likelihood that workers and their families experience cures, sustained health, and a full return to life at work, at home, and at play.