A virtual diabetes management program offered by UnitedHealthcare has shown measurable changes in members’ behavior, and for some employers, a return on investment.
The Level2 program, originally launched under Optum in 2019, combines continuous glucose monitors, personalized coaching, and a virtual care model. It targets employees with type 2 diabetes and aims to improve clinical outcomes through self-management and simplified access to care.
“A lot of the cost for diabetes is with the highest-risk patients, so we had our physicians and team focus on how to engage more patients that are high-risk,” David Moen, MD, a physician executive at Level2, told Becker’s.
In a June study published by the American Diabetes Association, UnitedHealth researchers analyzed 3,773 Level2 Specialty Care participants with at least 180 days of CGM usage between January 2023 and June 2024. The patients used the CGM for an average of 83.6% of days, and 82% of them logged actions in the Level2 app. The most common types of actions were related to nutrition (36%) and movement (33%), followed by tracking (19%), mindfulness (9%), and treatments such as medications or talking to a physician (1%).
While movement made up one-third of all actions logged, it was also the most widely adopted behavior overall, with more than half of participants (54%) recorded at least one movement-related action during the study period. Treatment-related actions were recorded by only 4% of participants.
“What’s interesting is that they make [lifestyle changes] because of what they’re seeing on their glucose monitor,” Dr. Moen said. “Some people on a Mediterranean diet get big glucose spikes when they eat bread, pasta, or rice. And so they observe what’s going on in their body, then meet with our coaches.”
Dr. Moen noted that about 20% of patients who saw meaningful improvements in their A1C did not speak with a coach or clinician and only interacted with the app.
The number of Level2 participants is now in the tens of thousands, with UnitedHealthcare seeing a 207% increase in employer clients offering the program over the last 16 months. While Level2 is also available within the company’s fully insured products, Dr. Moen said the focus is on self-insured employers looking to reduce diabetes-related costs.
“Our longest customer, which is a large national employer, currently has over 30% of their eligible people with type 2 diabetes enrolled and engaged,” he said. “And that’s why for that customer, we’re seeing the ROI is there — the amount they spend on the program plus a guaranteed savings against projected trends have occurred. They’re actually seeing a reduction in trend, which is really hard to do.”
One of the study’s more notable findings may be what wasn’t used by participants. Despite growing national reliance on GLP-1 drugs to treat diabetes, treatment-related actions were the least common category of self-management logged.
Dr. Moen said the data reflects the program’s core design of empowering patients with tools and a connection to a care delivery team. Still, about 40% of Level2’s current participants are taking GLP-1s, which is up from 20% in 2022.
“GLP-1s are a powerful medication. Optimizing them is required,” Dr. Moen said. “What’s different is that our people taking GLP-1s are more adherent than the general population with type 2 diabetes. The CGM is a great tool to titrate a GLP-1 and it’s much more specific. So we can change dosing, decrease dosing, and deal with side effects much more effectively.”
Among participants who see Level2 providers, Dr. Moen said roughly half opt to shift medication management to the Level2 care team. With one large employer client, Level2 tracked a 20% reduction in inpatient hospitalizations among participants versus individuals not using the platform.
“That’s where the trend bend happens in the cost trend,” Dr. Moen said. “And it’s led by a reduction in hospitalization. What I love is it’s not by tricky utilization and contractual stuff and trying to limit. It’s truly about driving better clinical outcomes, which ultimately cost less.”
