This episode features an interview with Jen Jones and Cody Fair from Noom Health. Jen is the Director of Clinical Solutions and supports teams with alignment on client needs and clinical programs. Cody serves as the Chief Commercial Officer leading the company’s commercial division and drives growth initiatives across all segments. In this episode, Kirk, Jen, and Cody explore the importance of integrating GLP-1 medications with behavior change programs, challenges related to yo-yo dieting and coverage, and how Noom Health employs tools like body scans and AI to enhance user engagement and outcomes.
This episode features an interview with Jen Jones and Cody Fair from Noom Health. Jen is the Director of Clinical Solutions and supports teams with alignment on client needs and clinical programs. Cody serves as the Chief Commercial Officer leading the company’s commercial division and drives growth initiatives across all segments.
In this episode, Kirk, Jen, and Cody explore the importance of integrating GLP-1 medications with behavior change programs, challenges related to yo-yo dieting and coverage, and how Noom Health employs tools like body scans and AI to enhance user engagement and outcomes.
-------
“ There's just an incredible level of frustration at the employer level right now because they genuinely want to do something obviously, that is helping their employees and their members. They want to be able to provide these medications that they know can be incredibly effective. But at the same time, they have to be good stewards of the business and the cost. And that's again, really where the two come together is being able to provide a patient experience and benefit, but weighing that against the cost. And so trying to find a solution that allows them to go down that middle road where they can control the cost, but still allow an ideal patient experience and have the access to medications that can be effective.” – Jen Jones
“ What AI will allow us to do is to mine these massive data sets and really start to understand human behavior deeper to where we'll know the exact time that I should reach out to this individual with the exact note that I should send them to make sure we kind of keep them on the program, so to speak. For that person that's going to fall off the wagon and we're never going to see him again. It will give us the ability to figure out the times that we should reach out and how we should reach out and that type of messaging. Something that just pure human intervention would not be able to deliver.” – Cody Fair
-------
Episode Timestamps:
*(01:01): Jen and Cody’s journeys to Noom Health
*(06:02): The importance of behavior change
*(16:38: The role of GLP-1 medications
*(25:33): Managing GLP-1 costs and access
*(34:59): The future of GLP-1s and Noom Health
*(38:05): Leveraging AI for better health outcomes
-------
Links:
Learn more about Collective Health
[00:00:00] Kirk McConnell: Healthcare costs are rising. Benefits are confusing, and the system doesn't always work for the people who need it most, but it doesn't have to be that way. Smart employers and their brokers are flipping the script, cutting costs, making things simpler, and creating a health benefits experience their people love.
[00:00:23] Kirk McConnell: Welcome to The Benefits Playbook. I'm Kirk McConnell, and in each episode we uncover the bold strategies that are rewriting the rules of self-funded health benefits. Today, I'm really excited. We're joined from two folks from Noom Health. We have Jen Jones, the Director of Clinical Solutions, and Cody Fair, the Chief Commercial Officer.
[00:00:42] Kirk McConnell: Thank you both for joining us today.
[00:00:44] Jen Jones: Thanks for having us.
[00:00:44] Cody Fair: Thank you for having us.
[00:00:46] Kirk McConnell: So obviously a lot to talk about. We want to talk about Noom Health. We wanna talk about where you are today. We wanna talk about GLP-1s and the role they play in your space, and hopefully spend a little bit of time getting y'all's brain on where things are going next.
[00:00:59] Kirk McConnell: But maybe to start at the beginning, I'd love to just have you all talk a little bit more about your background. So Jen, you have a really interesting clinical background. How did you end up in this field?
[00:01:09] Jen Jones: It has been quite the ride. So I actually went to school and have a degree as a registered dietician, and I worked probably about three to four years
[00:01:18] Jen Jones: treating patients in both inpatient outpatient hospital settings, and it just drove me crazy. I just couldn't do it. I didn't feel like I was having an impact. It was obviously a very slow churn to get anything done, and so I left and actually went into more of HR and training for a while and then. Got some really eye-opening and some really good HR stories from that, but quickly got the urge to get back to health and wellness in general.
[00:01:45] Jen Jones: And about that time, Indy was really becoming a hot center for onsite clinics and population health. And so as that really developed into its own, there were a lot of employers that were really looking to be able to utilize their healthcare data. To be able to translate that into how to develop wellness strategy.
[00:02:05] Jen Jones: So I had an amazing opportunity to work for a local health and welfare benefits practice here in Indianapolis for several years and really got into the population health, health strategy. And that just continued to grow and allowed me to be in a couple different positions with a healthcare data analytics company, and then eventually over to Noom about a year ago where I continued to work in health strategy and clinical direction.
[00:02:29] Kirk McConnell: And nothing's ever easy. But are you hitting your head against the wall less now than you did when you were in clinic?
[00:02:35] Jen Jones: Yes, much so. Definitely learned a lot, obviously, about the healthcare system, trying to teach someone about. What we used to call the heart healthy diet immediately after having a quadruple bypass is not the time to educate people on those types of life changing events.
[00:02:52] Jen Jones: So this is a lot easier.
[00:02:54] Kirk McConnell: Yeah. And within, within Noom Health, how do you spend your days?
[00:02:58] Jen Jones: It's a lot of conversations with employers and payers, and honestly providers sometimes too, that are looking to truly address and understand the obesity epidemic and looking for solutions that can truly have an impact.
[00:03:12] Jen Jones: I think we have obviously tried to solve the obesity crisis for decades. 'cause it's really how long it's been going on and continues to get worse and we can't seem to quite get it right. So I spent a lot of time working with them and our commercial team, sales team specifically explaining what new can do, how we can really bend that curve and have an impact for their populations.
[00:03:33] Kirk McConnell: And Cody, that's probably a good segue to you. Walk us through how did you end up at Noom Health?
[00:03:38] Cody Fair: Yeah, so, my journey ultimately started in college. I was always gonna go towards healthcare. I went to pharmacy school, only stayed for a year, which my team likes to joke that I think I'm a sixth of a pharmacist.
[00:03:52] Cody Fair: But the plan was always to go in kind of the healthcare space. So soon after that. I've been in healthcare the vast majority of my career. I was also at the same data analytics company that Jen mentioned. We worked together there and when Noom came calling I, you know, what we did at this data analytics company was basically analyzed through claims Medical and rx. The success of a lot of the digital health programs that were out there.
[00:04:19] Cody Fair: And one of the things that always struck me as we were mining through all this data for employers is. There were great digital health programs, but they really suffered from adoption. There wasn't many employees that actually enrolled in the program, so Noom Health came calling and said, you know, 25% of all employees will enroll in our program because of the Noom brand.
[00:04:39] Cody Fair: That's broadly known throughout the country, and my immediate reaction is, no they don't. You're lying there. There's no way you get that level of adoption. I soon found out they were telling the truth. You know, I would also have had a personal journey around metabolic health. I've been overweight the majority of my adult life
[00:04:56] Cody Fair: And had used Noom successfully myself. And so it was kind of felt serendipitous looking at data for years and years that a lot of these companies didn't actually deliver outcomes. And then, you know, combining that with my personal journey, it made it, I would say, a no brainer to come to Noom about three years ago.
[00:05:14] Kirk McConnell: And so let's dive into Noom Health specifically. Cody, if you find yourself on an airplane sitting next to someone and they ask you what you do, how do you explain Noom Health?
[00:05:24] Cody Fair: Yeah. Overall, our mission is to help everyone everywhere live better, longer, which I would say a big emphasis on the better, and not just living longer, but living better longer.
[00:05:34] Cody Fair: Overall, we do that through behavior change. I think a lot. When they think of Noom Health or the Noom in general, they think of as a weight loss company. And we certainly help individuals lose weight, but we do that through behavior change. So we use evidence-based techniques to really reframe the why behind the decisions you're making.
[00:05:53] Cody Fair: So when Noom works, you have long-term sustainable success because you've ultimately retrained your brain to follow more healthy habits.
[00:06:00] Kirk McConnell: You know, Jen, lemme pass that to you. Why is it so important for you and the Noom health team to be clear that you're more than just weight loss?
[00:06:09] Jen Jones: I think we, as we think about obesity, a lot of times we think it is a lack of willpower or a lack of eating enough or enough physical activity on the individual part.
[00:06:21] Jen Jones: So to think about it's more than just that because it is a chronic condition and you need to treat it like one. So there's yes. Physical activity and eating correctly or better nutrition are certainly components of that. But there's a lot more that goes into that as far as our environment, our relationships, and psychology and behavior is a key component of that, and that's really one of the biggest drivers of success.
[00:06:46] Jen Jones: So being able to understand that and encourage people to work on that component, and again, the other factors are certainly important, but you've got to be able to focus and understand and learn the behaviors behind that too.
[00:07:00] Kirk McConnell: And Jen, I know recently you've been talking about that nineties term we all love of yo-yo dieting and how that's endemic of, I think how Noom is trying to take a different approach.
[00:07:10] Kirk McConnell: Kinda walk us through kind of that yo-yo dieting, how we need to move past that and kind of recognize the challenge underneath that idea.
[00:07:16] Jen Jones: Yeah, and I'm gonna take a quote from Cody too 'cause he always talks about how he's lost the same 20 pounds over and over again. I mean, I've done the same thing.
[00:07:23] Jen Jones: I've lost the same weight over and over again too. And, but that's the issue is, and we think about it a lot of times when we're utilizing GLP-1 specifically, we have people that have a tremendous weight loss. But when you haven't learned the proper behaviors to be able to keep that weight off post medication.
[00:07:41] Jen Jones: Or if while you're on that medication, you're not focused on maintaining your lean body mass, you come off the medication, your weight goes right back up, or even maybe more than where you were before. But I can 99% guarantee you that the weight you're regaining is not going to be muscle mass. It's going to be fat.
[00:07:59] Jen Jones: So now we have skewed our body fat percentage even higher than what it was before, which is going to lead to worse outcomes. You're actually gonna be in worse health than you were before you started the medication or before you lost the weight because we didn't properly address what we needed to do to get the best outcomes and maintain that weight loss over time.
[00:08:19] Kirk McConnell: And I think that's something that's so intuitive for all of us, this yoyo or the cycling up and down and up and down. You know what I think is interesting is you said that cycling is not even just a return to baseline, but could actually get you to a worse spot than where you started.
[00:08:32] Jen Jones: And even sometimes it may be like, oh, well I only gained 10 of the 20 back.
[00:08:37] Jen Jones: But again, when you look into the insights behind that, like, but what's your body fat percentage? And what's your muscle mass from a pound to pound perspective? So even if you remain lighter per se, that body fat percentage and that makeup could still be skewed in an unfavorably way.
[00:08:55] Kirk McConnell: Tell me more about that.
[00:08:56] Kirk McConnell: So you're making it sound like the scale does not tell the whole story. Well, what does the scale not tell you?
[00:09:01] Jen Jones: Yeah. Well, we're always so tied to the number, and oftentimes we have some very strong affinities to weighing ourselves, but that's actually one of the core components. That we preach at Noom as far as you should be able to weigh yourself daily, just to use that as a simple data point, but it doesn't tell the whole story.
[00:09:18] Jen Jones: We have a, a great new feature called body scan, which if you have ever done body impedance testing or DEXA scan, anything like that, where you actually can see your overall skeletal, mass body, fat mass, you know, and then how that's distributed across your body. That's what tells the story. You want to be able to lose fat.
[00:09:39] Jen Jones: Majority of the time when you lose weight, you'll lose probably a little bit of muscle, but we wanna focus on the fat mass loss, not the muscle. We all know muscle weighs more. So when it's coming off the scale, we don't know what's really behind the weight loss. So having the additional tools available to you to be able to really track.
[00:09:58] Jen Jones: So if you, you know, you lose, let's say five pounds of fat, that's, you know, gonna translate to a different number on the scale as opposed to 10 pounds of muscle. So we wanna focus on the fat loss versus the skeletal muscle mass.
[00:10:10] Kirk McConnell: Cody, so that's such an interesting insight in itself. Walk me through Noom Health.
[00:10:14] Kirk McConnell: How do you help people understand those dynamics and not only understand, kind of put into action to lead that better, healthier life?
[00:10:22] Cody Fair: Yeah. So, you know, one of the things I was gonna say about the body scan, I, I personally find it incredibly useful because I, I do weigh in every day, but you don't always see results every day.
[00:10:33] Cody Fair: Right. And at times you can be frustrated. Maybe it's been a few weeks or whatever it might be, and I've not lost weight. But I'll typically do our body scan monthly within the app. It's incredibly simple. You just set your phone in front of you, basically turned in a circle, but I can start to see the other results that I'm getting, right?
[00:10:49] Cody Fair: Like maybe it hasn't shown up as weight loss on the scale, but I. I'm ultimately, you know, my waist is getting smaller, my arms are getting smaller. You know, I'm gaining some of that muscle while I'm losing fat at the same time. So it's incredibly important to have a full look at that. And until recently you could only do that through incredibly expensive like DEXA scans or something like that.
[00:11:09] Cody Fair: You know, you might have a gym that provides access and usually a fee each time. So it's really nice within the new map that you can do that. To directly answer your question, we ultimately at Noom have the, what we call the Four Cs of Noom. So everything, and what we're really famous for is our content.
[00:11:25] Cody Fair: So when you engage with Noom, you engage in a daily curriculum that takes about five to 10 minutes a day. Where we're retraining your brain. Like I mentioned earlier, we've really optimized that time in there because we know it's how much time we can take from you in a day, but get you coming back every single day.
[00:11:41] Cody Fair: These changes aren't gonna happen overnight, so we need you to keep engaging and keep coming back. And if we take a half hour, 45 minutes of your day, the likelihood of you doing that are pretty low. From there, we bring in the second C, which is coaching. So you have personal wellness coaches that are communicating with you day in and day out.
[00:11:58] Cody Fair: They're letting you know that hiccups are part of the journey. They serve as motivation and just someone to run ideas off of. The third C, then being community. So there's a robust community of like-minded individuals that are going through the same type of journey that you may be going through. So you know, maybe you're over 40, maybe you're going through menopause, maybe you need to lose a set amount of weight.
[00:12:19] Cody Fair: You can join specific groups of individuals that are going through that same journey and kind of talk with each other as you're doing it. And then the fourth C are clinicians. So in our clinical level program, we do provide clinicians that prescribe anti-obesity medications that help you throughout the entire journey.
[00:12:36] Kirk McConnell: Jen, tell me about that first C, the content. What is the content? Is it how to eat? Is it how to live? Is it across the board?
[00:12:43] Jen Jones: It's really across the board. Again, as we talked about, behavior change is going to affect all the various components as we think about trying to lose weight, obesity, and overweight.
[00:12:55] Jen Jones: So there are modules on basic understanding, basic nutrition, understanding your hormones, understanding physical activity and its overall importance, stress, sleep, relationships, really getting to the cornerstone of your ultimate why. Why you want to do this. And it's what I love about the content is. It's really these small little, it takes like two to three minutes to read each little article a day.
[00:13:21] Jen Jones: You can listen to that via audio, or you can read it on your phone. It's very easy to ingest and understand and take away the key points. There's quizzes, there's parts where a user may need to add input, but it's just, it's very practical and really understandable for everyone to take away and really, again, understand the relationship you're having with food and with your overall weight loss journey where, you know, understanding what some of those.
[00:13:47] Jen Jones: You know, big barriers are for you. When I started going through Noom, I'm like, oh, I'm a registered dietician. I know everything, right? There's not much I can take away from this. But it was just easily understanding. For me, it was like, oh gosh, yeah, I do that sometimes. Like it's a long day at work. It's five o'clock.
[00:14:03] Jen Jones: I just picked up the kids like I've earned calling DoorDash, or I've earned ordering DoorDash tonight. Like, yeah, that's fine, it's one night. But it's like when that becomes two or three or four nights, it's like, yeah, I've gotta break that habit. So it's just being able to understand and identify your habits sometimes.
[00:14:20] Jen Jones: And so what some of those triggers are that, again, we may think we're eating really well and doing all the things we should be doing, but this is a way to really uncover all of those. Quote unquote bad behaviors and really understand that and and be able to successfully rearrange that in your mind and be successful going forward.
[00:14:40] Kirk McConnell: Cody, you mentioned that one of your aha moments coming to Noom Health was that it had such a high engagement rate, you know, a couple years in. What do you think is driving that engagement rate?
[00:14:51] Cody Fair: I think ultimately what has driven it is the 15 plus years and the millions and millions of users that Noom has had from the consumer side.
[00:14:59] Cody Fair: So we're very unique that before Noom Health came along four or five years ago, we had a consumer company that had been around, like I said, for 15 plus and tens of millions of people have downloaded the new map. We have run thousands of AB tests with thousands of individuals per arm in those tests. To figure out the best way to keep individuals coming back for good.
[00:15:24] Cody Fair: I think with the advent of GLP-1s, there's companies popping up every single day that say their behavior change and they do these different things and, and I'm sure they do a great job, but it's that experience and testing. I mean, down to the smallest detail we've tested at Noom, what's the best way to get you coming back?
[00:15:41] Cody Fair: Because we know, again, you're not gonna change these behaviors in a day. It's a really, really long term that we want to change it for good. And our ability to look at tens of thousands and close to millions of users in these tests is what enabled us to create a platform that keeps individuals coming back every day.
[00:16:00] Cody Fair: And right now of our monthly active users, 50% are daily active users. So that means one outta every two individuals using Noom is using it every single day. And that level of engagement is typically only seen in social media or messaging apps, which is pretty impressive from our standpoint and and is what allows us to drive outcomes.
[00:16:21] Kirk McConnell: Let's turn the conversation to GLP-1s. Cody, you bring up an interesting contrast that Noom you believe is successful because it's been around for so long, and then you contrast that with the term of the moment, which is GLP-1s. You know, Jen, help me understand our GLP-1s themselves with Magic Bullet, and all you need is a GLP-1 and you're good to go.
[00:16:45] Jen Jones: They are incredibly effective when you compare them with behavior change too. I mean, they can work for people on their own, but as we talked about that yo-yo dieting, that cycling. As soon as you come off of that medication, you will gain all the weight back if you don't change any of the behaviors that you had before going on the medication.
[00:17:07] Jen Jones: What the medication is incredibly effective for is reducing a lot of that food noise. So you're not constantly thinking about the hunger you have or what you're going to eat the next time or anything about weight loss in general. It really softens that internal talk and it also fills you up incredibly fast.
[00:17:27] Jen Jones: So what you have may have prepared for normal, let's say, plate or dinner meal, you may only be able to eat, let's say, a quarter of that. So it automatically changes your eating behaviors for you. So when you come off of that medication, if you haven't created a way to be able to deal with the food noise and the hunger when it comes back after the medication, you're going to continue to eat more, go back to the way you were eating and all the other behaviors you had beforehand.
[00:17:54] Jen Jones: So they, like any other medication, are incredibly effective when you compare the with behavior change. So where we see the success and, and really coming together is an individual who would qualify for a GLP-1 is still going through all of that Noom content and the support from the clinicians and their health coach.
[00:18:11] Jen Jones: Then if it's appropriate and they begin tapering and ideally deprescribing off of the medication, they've already built that foundation of the behavior change. So they know their why, they've identified their triggers, and they've really put the work in to understand their core behaviors. So the medication comes away and they know what to expect and they can successfully maintain that waste long term because they've really instituted the behavior change.
[00:18:37] Kirk McConnell: So let's stay kind of on that topic for a second. If one of the challenges is getting used to life after GLP-1, I'll ask the obvious question. Why not just stay on g GLP-1s forever?
[00:18:48] Cody Fair: We'll probably take it from a few different perspectives. I would say that one, most people, and we've done a lot of research on this, do not want to stick a needle in their side.
[00:18:58] Cody Fair: Every week for the rest of their life, right? People do want to live healthy without medication assistance. So I would say that is, is one thing. The other thing that is probably of more importance today is the. Astronomical cost of the medications. Right now. Employers and plans cannot afford to keep anyone that would qualify on a GLP-1 for life.
[00:19:23] Cody Fair: They're just too expensive. The list price is typically anywhere from 1200 to $13 a month. There's an, an incredible amount of data out there of a lot of employers or plans that ha had opened up the floodgates, so to speak, allowing individuals to get GLP-1s and it's, you know, borderline gonna bankrupt the plans because they just don't have the ability to pay for it long term.
[00:19:47] Jen Jones: The other thing I would add there, there is a lot of talk around. People who could potentially not need it for an extended duration or for a lifetime are those individuals who haven't necessarily had an overweight or obesity issue for their entire life. So those that you know, were overweight and adolescents and young adulthood and continued to, you know, have issues as far as with obesity and adulthood, those are most likely the candidates that would be higher risk and potentially be much more successful and need to be on the medication long term.
[00:20:22] Jen Jones: Those that may be in like a more short term issue, like an individual, like a woman in her forties who's gaining a lot of weight during perimenopause or post pregnancy and not able to lose weight, those types of things where they're having more of an acute episode. As far as with experiencing weight gain, they are the ones that
[00:20:45] Jen Jones: theoretically should and could be able to taper off and be able to come off the medication and just use that for a short term avenue for the weight loss and be able to come off as well.
[00:20:56] Kirk McConnell: Jen, let's keep going on that topic. I'm gonna put you back on the airplane. You're sitting next to someone that like, man, our GLP-1 spend is through the roof.
[00:21:07] Kirk McConnell: I don't even know where to begin. How does Noom Health start coaching employers through, okay, here are the questions you should be asking yourself. Here are the pillars to the strategy you should be putting in place.
[00:21:18] Jen Jones: I think the, the first question is what is your current strategy within the plan? Are there certain parameters as far as who has access?
[00:21:27] Jen Jones: Are there PAs in process? Is there a behavior change program required with this? Just get a baseline understanding for who all has access and then it's. It's really going to be important. I mean, GLP-1s are not going to go away. There's just, they're going to continue to come to market. There's gonna be different iterations of them and orals, et cetera.
[00:21:45] Jen Jones: So it's going to be important to think about what's your three to five year strategy around this? Employees expect their employers to cover them. We've seen in our instance groups that because they cover GLP-1s are magnets. For a benefits perspective, like people will go and work there because they want access to GLP-1s, so you need to be able to have parameters and guardrails around access to them.
[00:22:14] Jen Jones: We would advocate for something stronger than just what may be in place as far as within your PBM relationship. And that's why we've developed our Noom Med program to really put some constraints around the access and the overall utilization, but also ensuring that the right people around the medication and again, learning the behavior change at the same time.
[00:22:35] Kirk McConnell: Cody, tell us about that Noom Med program and maybe in the context of if an employer is saying what. Should the end-to-end solution be be it behavior change in GLP-1, maybe talk about Noom Med, but how it fits into the broader Noom experience for your members.
[00:22:52] Cody Fair: Yeah, so the, the Noom experience starts with the triage, what we figure out the goals, the needs, the symptoms, severity of your individual employees and overall members.
[00:23:02] Cody Fair: From there, we place them into the right program. So there's lower acuity individuals that go into our standard Noom weight program. A little bit higher, go into a diabetes prevention or even a diabetes program, but those that qualify clinically will go into our Noom Med program. From there, we offer all of the wraparound support that you would want to put in place for an employer.
[00:23:23] Cody Fair: One of the concerns if you're getting these medications through your primary care physician is that physician through no fault of their own. Only knows what happens inside their four walls. So maybe you come in couple times a year, every few months, whatever it might be. But they don't know what your diet's been like.
[00:23:42] Cody Fair: They don't know what you're, you know, if you're exercising and what all you're doing. They just know that they've given you a GLP-1 script and presumably, you know, weigh you in at that specific appointment. So the nice part of Noom Matt, is it's a kind of a full suite where the Noom clinicians understand what's happening from a behavior change perspective.
[00:24:00] Cody Fair: They understand through our app, you know, are you exercising? Are you logging your weight and doing all of these things to where they can better serve you. So, I guess essentially said they understand what's happening outside of those, which allows them to treat you at a much higher level. The other thing is, as primary care physicians, my understanding is through med school, have very little training when it comes to obesity medicine and where we've hired our clinicians.
[00:24:26] Cody Fair: Many of them are a BUM certified, so certified in obesity medicine. Our entire program is led by our medical director that has a certification. So we have individuals that are experts in weight loss and how to help you out. Which is very important. With that, then I would say the bigger piece of the program is managing the overall cost.
[00:24:45] Cody Fair: So not everybody that enters our program gets access to a GLP-1s. We use lower cost AOMs for those that are a lower acuity, because what we found is when you pair a lower cost AOM. That typically doesn't have the same efficacy as the GLP-1, but when you combine that with Noom, you can get GLP-1 like results.
[00:25:04] Cody Fair: So in many cases, we're able to achieve the results that they desire at a a less costly medication. If that doesn't work, we will always titrate them up to a GLP-1, but it really serves to make sure you have the wraparound support, but do it in a manner that frankly, the plan or employer can afford.
[00:25:22] Kirk McConnell: Cody, I know you are one sixth of a pharmacist, but for the rest of us, what is an AOM?
[00:25:28] Cody Fair: Anti obesity medication.
[00:25:29] Kirk McConnell: Gotcha. Then walk me through on the cost side, how are you helping the employer manage, maybe even just the procurement and the specific price point and just the benefit design around those GLP-1s.
[00:25:41] Cody Fair: Yeah. So what we have done, and part of this, and I won't go too deep into it, but I'm a, a GLP-1 user myself. And you know, like I mentioned at the beginning of this, I've dealt with obesity, the, the majority of my adult life. And I like many others, when I found out about GLP-1s, I. Thought my miracle had arrived.
[00:26:00] Cody Fair: Unfortunately, it went away as quickly as it had arrived due to the shortages. Due to the prior authorization protocols. A, a whole litany of reasons that just the healthcare system was not really set up to support me and I. Hundreds of thousands other Americans, and what ultimately happened, it will be, it's two years this month since I started taking GLP-1s.
[00:26:21] Cody Fair: And in that 24 months, I have only been on therapy six to seven of those months, and never more than two months in a row. Again, there were shortages. There's prior authorization protocols. We changed, you know, health plans, all of these different things that created the yo-yo dieting that we kind of spoke of because I was never really on therapy for a long period of time.
[00:26:41] Cody Fair: So ultimately, I tell you that, not to feel sorry for me, but to kind of explain the program that we put together that we call Noom Med with Smart Rx. So we sat down as a team and said, there's gotta be a better way. Right? At Noom, we have always been concerned about the consumer, the inpatient. Not as much about maybe the competing incentives that exist in healthcare today.
[00:27:03] Cody Fair: So what this program does is it allows employers or plans to carve GLP-1s out from the PBM. So they no longer cover that medication through their standard formulary. They cover it as a supplemental benefit through Noom, that offers a few things. We're typically getting the medication a couple hundred dollars cheaper per script per month than you would through the PBM, and that's after rebates.
[00:27:28] Cody Fair: And then we set it up as a supplemental benefit, like I mentioned, that allows you to decide the cost share. So you could say, all right, let's say it's gonna be $650 per script. I can only cover half of that, or maybe 30% of it. But as an employer, you ultimately make that decision on where you can buy in at, so your employees know how much essentially they're on the line for.
[00:27:49] Cody Fair: Then from there, we went to solve the shortage issue, which I do understand that GLP-1s are no longer on shortage, but there's also the concern these days that pharmacies are losing money every time. They fulfill a GLP-1 script, so they don't really wanna keep 'em in stock. So we have a network of pharmacies across the country that guarantee access to GLP-1s and actually deliver it to our patient's door within five days.
[00:28:13] Cody Fair: And these are all branded GLP-1s. And then ultimately we put together the wraparound services that we've been talking about. So it's our clinicians, it's our behavior change. We're making sure you're engaging, you're doing the things you're supposed to in order to keep getting those medications and deliver the results that both the individual patient want and the employer.
[00:28:32] Kirk McConnell: Yeah. I think one of the things you're saying is this is now more than just the prototypical point solution. It needs to be deeply woven into the PBM structure, the supplementary benefit structure, the benefit design. I know within my organization, we're really excited about the partnership that our two teams have created.
[00:28:53] Kirk McConnell: Why is it so important for this program to be built pretty deeply into the TPA or into the health plan, especially when all these pieces are starting to come together at a deeper level?
[00:29:03] Cody Fair: Yeah. I, I think, you know, on, on the surface, you all have the data that we don't have, right? So you know the patients better than we do.
[00:29:12] Cody Fair: You understand who could benefit from Noom? And that could just be the standard Noom weight program. It could be our clinical level program. But you know, and understand and have that data, and that's one thing that I. That Jen and I, you know, lived at our previous world in the data analytics, all of that data is not always coming to one place, and it's very, very difficult for an employer to compile all that and deliver any type of insights or any plans from it.
[00:29:37] Cody Fair: So you all kind of complete, I would say, our service and that you have the data that, that we do not have. And it's this kind of deeply woven together with your all's care team to make sure that we're talking to the right individuals, we're getting to them at the right time, so ultimately we can deliver the best outcomes.
[00:29:56] Kirk McConnell: It almost seems like there's a couple of ingredients here that are required for this to really work. You speak about the data, how do you make sure you are getting in front of the right people at the right time, but then also how do you make sure that that member isn't experiencing a. Benefit or a program that doesn't feel at odds with their health plan, but it feels deeply woven into it.
[00:30:18] Kirk McConnell: Do you feel like employers are realizing kind of those various pieces have to come together?
[00:30:24] Cody Fair: Yeah, I think so. I mean, I think even from a a, a basic, which is certainly not the reason you put the program together, but even from a basic contracting standpoint, right? Employers don't want to go contract with Noom and then this provider here and this provider, it's just a broken, fragmented system.
[00:30:41] Cody Fair: And they also know when you do that, your likelihood of engaging those individuals at the right time goes down. If there's five and six different apps or you know. Websites that they have to go to to figure out what benefit they need and all of that. So this relationship with Collective Health, they kind of have that one point of entry.
[00:31:00] Cody Fair: You guys know when it's time for us to get to them, and then we certainly still depend on our name brand and that. And that's one of the the beautiful things for us. When your employer says, Hey, we're working with Noom. Most of your employees know who that is and they're like, oh, that's fantastic. This is something I could benefit from.
[00:31:18] Cody Fair: Where there's others, it could be a name that you or I know because we work in healthcare, but the standard employee doesn't know, you know, a lot of these point solutions and vendors out here just because they're not in it every day like, like we are.
[00:31:31] Kirk McConnell: Jen, I think one of the key learnings I'm having from this conversation is the power of GLP-1s also become the double-edged sword because if you get the results without necessarily developing the discipline, then when you take them away, those results are not sustainable. When you have those conversations with employers, is there a pushback or does that just intellectually make sense?
[00:31:55] Jen Jones: I think people understand that.
[00:31:57] Jen Jones: I think there's just an incredible level of frustration at the employer level right now because they genuinely want to do something. Obviously, that is helping their employees and their members. They want to be able to provide these medications that they know can be incredibly effective, but at the same time.
[00:32:15] Jen Jones: They have to be good stewards of the business and the cost, and that's again, really where the two come together is being able to provide a patient experience and benefit, but weighing that against the cost. And so trying to find a solution that allows them to go down that middle road where they can control the cost.
[00:32:36] Jen Jones: But still allow an ideal patient experience and have the access to medications that can be effective. But I think trying, like, you know, we've seen where groups have covered it and then they've taken it away and then they've had, you know, huge pushback from the employee population. And then it's, you know, trying to figure out what type of solution is out there.
[00:32:57] Jen Jones: That can allow us, again, to have the happy media amongst both of those as far as being able to control the cost and allow our members to have access to these medications and not have them have to jump through so many different hoops to where it becomes a poor experience for them, or, you know, knowing that.
[00:33:16] Jen Jones: Again, right now they're technically out for shortage, but we know people are still having a difficult time finding the medication. So how can we find a program that again, weaves all of that together that ideally controls costs, and improves the patient experience?
[00:33:31] Kirk McConnell: There's such an interesting corollary we've been talking about, yo-yo dieting.
[00:33:35] Kirk McConnell: I think employers right now are at the risk of what I'll call yo-yo coverage, where they're not sure. So they cover it and then they freak out and they turn it off and they realize they need to bring it back in. And that probably has probably as much of a negative impact as yo-yo dieting itself.
[00:33:49] Jen Jones: Yeah, I think that's a, a really good analogy there because when we first brought Noom Med to Market, it was a traditional program that integrated with an employer's existing PBM.
[00:34:01] Jen Jones: But what we quickly learned is that's great and there are a lot of groups that wanna do it that way, but there are also a lot of groups that want something more. Innovative than that and allow them to have different levers to pull from an access point from the type of medication that's offered. And that's really what Cody spoke to as far as, you know, with the Smart Rx program that's, you know, a full carve out solution allows you to develop the supplemental benefit and that's very attractive to employers.
[00:34:27] Jen Jones: Again, to help think about how can I find the best path forward that prevents the yo-yo and really allows the general even keel experience. As far as I'm still able to control my cost. I have much better expectation of what that uptake is going to be. Oh, and by the way, my members are really happy with the program because they have the medication they need, but also the clinical support that they need for the program.
[00:34:51] Kirk McConnell: Let's look forward a little bit. I wanna talk about the future. I also wanna talk about the role that AI can play in all of this. Fast forward a couple years. What role do you think GLP-1s will play in health plan integration and employer coverage? Cody, maybe we'll start with you. Where do you think this whole space is going?
[00:35:09] Cody Fair: So I think that in the, the near term, call it, you know, three to five years, um, there's many, many, I think we're tracking, I wanna say 70 different drugs, you know, weight loss medications in the market. So there's gonna be more competition coming. And ultimately, like anything else, competition is good. It should drive down pricing.
[00:35:30] Cody Fair: It should increase access to where now they're, you know, you see different stats, but let's say roughly 50% of of self-funded employers are not covering these medications today. So I think in the next three to five years, as you start to see more drugs entering the market and the cost coming down, more and more are gonna choose to cover that.
[00:35:50] Cody Fair: Ideally, it gets to a point in the distant future. Where GLP-1s are on everybody's formulary, and employees have access to them at a much more affordable, let's say, access point than they do today.
[00:36:04] Kirk McConnell: But that probably becomes then the temptation to say if they're more affordable, people can just stay on them longer.
[00:36:08] Kirk McConnell: Yeah, and that probably kind of undermines the whole idea that they are a tool but not a solution on their own.
[00:36:15] Cody Fair: That's something that, that we're passionate about here and our roots in. And you know, and Jen talked about this at length, but, and I was sadly case in point, just because I was taking a GLP-1 doesn't mean I was doing things healthier.
[00:36:27] Cody Fair: You know, oftentimes it meant I was eating once a day and I thought, oh, I could just eat whatever I want. 'cause I mean, once a day, right? And like, that's the wrong mindset and that's not necessarily making us. Overall healthier long term, there's always gonna be a need to behavior change.
[00:36:42] Jen Jones: I think that goes back to your, like our mission is to live healthier longer.
[00:36:47] Jen Jones: That is not living healthier. You may live longer because your weight may be better, but you're not going to have a healthier life, essentially. So I still think there will be people that, you know, we, we know now up to 20% of the population is essentially a non-responder to a GLP-1. There are newer cases that are coming out where their body may slowly decline as far as the response to a GLP-1.
[00:37:13] Jen Jones: So playing around with this module of therapy as far as like, do you take a break for X amount of months and come back? Or do you extend the dosing time? And there, I think there's still a lot more that will need to be researched and tested as far as. How can we become more effective with them? But from the price point, yes, I think that will make it more accessible for individuals, but maybe not necessarily continue to be on long term.
[00:37:39] Jen Jones: I think having it be more accessible, I think we haven't necessarily talked about SDOH or health equity or anything like that. But I think really being able to drive those medications to underserved populations who can't access them now because of the cost is the driver of the win that comes with affordability cost.
[00:38:01] Kirk McConnell: Well, let's talk about what comes next for Noom Health. I'm curious, how are y'all leveraging AI in your solutions or anything other thing on the horizon that gets you both excited? Maybe Jen, start with you.
[00:38:14] Jen Jones: I think we've done an incredible job utilizing AI to make. Everyday life easier for our users. We highlighted the body scan.
[00:38:23] Jen Jones: That's a huge new addition for us, but we've done a lot with ai, photo, food, logging, those types of components that save time. And I think from just a food logging perspective in general, we know it saves our users about 15 minutes a day. Which there's a lot you can do in 15 minutes, and that's, you know, we think about it from an adherence standpoint as well, that if we can save you time and make the most mundane task ever, which is food logging easier and shorter, people will do it more often.
[00:38:54] Jen Jones: If you're doing that more often, you're going to start to see results again from a weight loss perspective too. So being able to leverage AI like that to make everyday life. Easier that, again, will translate to outcomes. That's where I think we will continue to innovate. But I'll let Cody speak to more of kind of roadmap items as far as we see AI.
[00:39:14] Cody Fair: Yeah, I think like from a general standpoint, when we look at ai, it will allow us to engage with our patients or users at the exact right time. So if you think of all the data that we have from the last 15 years of. When people log in and when do they fall off, and certainly not everyone that engages with Noom is the perfect outcome, right?
[00:39:35] Cody Fair: There's people that log in for a week and never come back. But what AI will allow us to do is to mine these massive data sets and really start to understand human behavior deeper. To where we'll know the exact time that I should reach out to this individual with the exact note that I should send them to make sure we kind of keep them on the program, so to speak, for that person that's gonna to fall off the wagon and we're never gonna see 'em again.
[00:39:59] Cody Fair: It will give us the ability to figure out the times that we should reach out and how we should reach out, and that type of messaging, something that just pure human intervention would not be able to deliver.
[00:40:10] Kirk McConnell: Yeah, because it, it sounds like one of the keys is not to get members to use the app more or for longer, but to have a more effective engagement with the app, doing the right things at the right time.
[00:40:21] Kirk McConnell: Well, Jen and Cody, this has been fantastic. I know I have learned a lot. If folks want to continue the conversation, where can people reach out to you if they want to learn more?
[00:40:32] Cody Fair: Yeah, so we, we would love to, to continue the conversation, we certainly would encourage you if you are a Collective Health client, reach out to your, you know, your account managers and all of that there.
[00:40:44] Cody Fair: If you would like to reach out to us directly, you can go to Noom.com/health and that will take you to our website and there certainly forms you can fill out there and we'll be happy to reach out.
[00:40:55] Kirk McConnell: Excellent. Well, thank you both for your time during the conversation and we'll see you next time.
[00:41:00] Cody Fair: Thanks for having us.
[00:41:01] Producer: This podcast is brought to you by Collective Health, a health benefit solution that guides employees toward healthier lives and companies toward healthier bottom lines. Check us out at collectivehealth.com.