Outcomes and savings · Case study
Public sector employee benefits trust · North Dakota · Live since May 2024
Sustaining 88% engagement across five quarters
with a North Dakota health trust
Engagement stayed above 88% for five consecutive quarters as participation grew from 84 to 449.
Public sector health trust · Through the May 2025 outcomes report02 · Impact summary
Delivering health outcomes
and financial savings.
What Digbi built with public sector health trust based in north dakota, from the population it started with to the outcomes and savings it has produced since.
Public sector health trust · Through the May 2025 outcomes report03 · Contents
What is inside
this case study.
Every page carries its own figures and source, from the covered population through outcomes, member voice and savings delivered for public sector health trust.
Pages
- Client snapshotPage 04
- The populationPage 05
- The challengePage 06
- Risk concentrationPage 07
- Why DigbiPage 08
- The programPage 09
- Participation curvePage 10
- Key figuresPage 11
- Health outcomesPage 12
- Client voicePage 13
- Book of businessPage 14
- Request the full studyPage 15
- Sources and definitionsPage 16
Public sector health trust · Through the May 2025 outcomes report04 · Client snapshot
Ten thousand lives,
and a medication cliff ahead.
A public sector benefits trust covering roughly 10,000 employees, facing a pharmacy benefit change that ends branded GLP-1 coverage.
At a glance
- Industry
- Public sector benefits trust
- Region
- North Dakota
- Population
- ~10,000 covered employees
- Program launch
- May 2024
- Review cadence
- Biannual business review
- Participants
- 449 as of Q2 2025
Public sector health trust · Through the May 2025 outcomes report05 · The population
Email is the front door
for this population.
Roughly 10,000 covered employees across public sector and school employers. Email outreach drives 80% of new enrollments.
Population mix
Gender split
83:17
Women to men among participants, May 2025 report
Dependents enrolled
14%
Underrepresented relative to the covered population
Email driven enrollment
80%
Share of enrollments attributed to email outreach, 2025
Email open rate
72%
Up from 50% in 2024, with clicks up from 5% to 8.5%
Public sector health trust · Through the May 2025 outcomes report06 · The challenge
A pharmacy change
with a date on it.
Where the pressure comes from
01
Comorbidity distribution puts mental health at 56%, insulin and cholesterol issues at 41%, digestive health at 38% and sleep issues at 38%.
02
The pharmacy benefit manager stops covering branded GLP-1 medications from October 2026, which forces an active transition for members already on therapy.
03
Genetic risk data shows 30% of members at high risk of weight gain and 20% at high risk of regain, which supports a preventive rather than reactive design.
04
The population is distributed across public sector and school employers, so outreach has to work by email rather than on site.
Public sector health trust · Through the May 2025 outcomes report07 · Risk concentration
Where the risk
concentrates.
Comorbidity distribution across the population, from the May 2025 report. Mental health leads, followed by insulin and cholesterol issues.
Top comorbidities
Mental health
56% of the population
Insulin and cholesterol
41% of the population
Digestive health
38% of the population
Sleep issues
38% of the population
30%
High risk of weight gain
20%
High risk of regain
Oct 2026
Branded GLP-1 coverage ends
Source · Outcomes and impact report, May 2025
Public sector health trust · Through the May 2025 outcomes report08 · Why Digbi
Works with medication,
and without it.
With branded GLP-1 coverage ending in October 2026, the program has to hold results for members on and off medication.
The differentiators the client cites
01
A member survey on digestive symptoms among GLP-1 users showed how the program manages those symptoms, which drew a strong reaction from the trust's advisers.
02
Medication support is handled end to end, including prior authorisation and pharmacy routing for members who need it.
03
An AI engagement layer gives members meal feedback between coaching sessions, with close to 80% positive feedback on that feature.
Medication transition
Prior authorisation and pharmacy routing are managed end to end.
Results either way
83% of members on medication lost weight, and 53% of those without it.
AI meal feedback
Close to 80% positive member feedback on the feature.
Public sector health trust · Through the May 2025 outcomes report09 · The program
What members
actually receive.
Enrollment runs on email outreach, then members log meals and work with a coach against nutrient density scoring.
Member journey
- 01Email led enrollment, which drives 80% of new members
- 02App based logging with nutrient density scored meal feedback
- 03One to one coaching
- 04Monthly clinical consults and prior authorisation management for members on medication
- 05Communications capped at twice a month to avoid over contacting members
Every member begins with a gut and genetic test, shipped to the door
Public sector health trust · Through the May 2025 outcomes report10 · Participation curve
Participation grew from 84
to more than 440.
Documented participant counts at the two reported points. Engagement stayed above 88% across five consecutive quarters in the same window.
Active participants
84
Q1 2024
449
Q2 2025
Source · Outcomes and impact report, May 2025
Public sector health trust · Through the May 2025 outcomes report11 · Key figures
Every number here is
labelled and sourced.
88%+
engagement rate held for five consecutive quarters
2024 through 2025 · Outcomes and impact report, May 2025
84 → 449
participants, a fivefold increase
Q1 2024 through Q2 2025 · Outcomes and impact report, May 2025
74%+
of active members lost weight
2024 through 2025 · Outcomes and impact report, May 2025
35%
of active members passed the 5% weight loss threshold
2024 through 2025 · Outcomes and impact report, May 2025
10.5 → 12.2
nutrient density score, into the 12 to 14 range
2024 through 2025 · Outcomes and impact report, May 2025
72% / 8.5%
email open and click rates, up from 50% and 5%
2025 versus 2024 · Outcomes and impact report, May 2025
No savings or ROI figure is published for this client. The source report contains two different totals that have not been reconciled.
Public sector health trust · Through the May 2025 outcomes report12 · Health outcomes
Five quarters of engagement
above eighty eight percent.
Weight, engagement and medication cohort outcomes are all computed in the May 2025 report and reviewed with the trust each quarter.
Outcome status
Measured
Weight loss
More than 74% of active members lost weight, and 35% passed the 5% clinically significant threshold across 2024 and 2025.
Measured
Engagement
Engagement held above 88% for five consecutive quarters while participation grew from 84 to 449 members.
Measured
GLP-1 and non GLP-1 members
83% of members using GLP-1 medication lost weight. Among members not using medication, 53% still achieved meaningful loss.
Public sector health trust · Through the May 2025 outcomes report13 · Client voice
In the words of
the members.
Member voices
Anonymous participants, Public sector health trust, North Dakota
Anonymous quotes from the May 2025 outcomes report. No attributed testimonial is cleared yet.
Recorded testimonial
“I honestly feel like a new person. My back pain has almost completely disappeared, and I have far more energy through the day.”
My blood pressure came down quite a bit, and I just feel better, mentally and physically.
Here is the fun part. I have not had acid reflux in weeks. I did not think that was even possible.
Public sector health trust · Through the May 2025 outcomes report14 · Book of business
What Digbi has delivered
for comparable employers.
Context from other Digbi employer clients, not this client. Shown so a reader can see where a mature program tends to land.
Claims cost per enrolled member
2021
$9,320
On Digbi
$9,320
Not on Digbi
2022
$7,035
On Digbi
$10,465
Not on Digbi
2023
$6,310
On Digbi
$12,497
Not on Digbi
2024
$5,403
On Digbi
$14,576
Not on Digbi
42%
Reduction in claims cost per enrolled member over four years
11.6 lbs
Average weight loss at six months, blue collar employer cohort
74%
Of engaged members reduced blood pressure, blue collar employer cohort
Source · Digbi Health multi employer claims analysis 2021 to 2024, and the national food distributor case study, 2023. Other clients, not this one.
Public sector health trust · Through the May 2025 outcomes report15 · Request the full study
Want the full data pack
and the savings model?
Share your details and the Digbi team will send the complete study, including the underlying analysis and the enrollment model.
Or reach us directly
partner@digbihealth.com
digbihealth.com/meet
Public sector health trust · Through the May 2025 outcomes report16 · Sources and definitions
Where each figure
comes from.
01
Outcomes and savings figures: outcomes and impact report, May 2025, Digbi Health internal. This is the most recent report located.
02
Comorbidity and genetic risk figures: same report.
03
Engagement and email performance: same report, 2024 and 2025 comparison.
04
Open methodology question raised by the client's adviser: claims data does not include lab results, only which tests were performed.
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